{"meta":{"exportedAt":"2026-10-23T06:56:28.429Z","formatVersion":2,"selection":{"q":"peer-reviewed","system":"","harm":"","context":"","country":"","role":"","relation":"core","evidence":"","year":"","response":"","severity":"","verification":"","view":"incidents","sort":"added"},"totalIncidents":2,"coverage":{"cases":2,"countries":0,"languages":1,"unknownLocation":2,"locationPending":0,"unknownLanguage":0,"unknownDate":2,"lawsuits":0,"regulatory":0,"minors":1,"coreRelations":2,"contextualRelations":0,"mixedRelations":0,"unknownRelations":0,"relationPending":0,"relationUnknown":0},"countingNote":"Distinct public cases in this selection. People counts apply within individual cases only; cross-case person overlap has not been resolved. No population incidence estimate.","affectedCountNote":"Interpret person counts with affectedCountStatus and the reported effects. Unquantified zeros are placeholders, not a measured zero.","source":"AI incidents","publisher":"NOPE","url":"https://nope.net/incidents","license":"CC BY 4.0"},"incidents":[{"id":"2025-turkiye-adolescent-ai-chatbot-overdose","caseFacts":{"claims":[{"id":"c1","status":"documented","evidence":[{"locator":"'A 17-year-old male patient was admitted to the intensive care unit via the emergency department'; 'with suicidal intent, and a psychiatric consultation was requested.'; 'He had no prior psychiatric hospitalizations but a long history of depressive symptoms.'; 'His psychotic experiences reportedly began two years earlier, with persecutory and referential delusions.'","relation":"supports","source_id":"s3"}],"assertion":"The case report describes a 17-year-old male with a long history of depressive symptoms and psychotic experiences that began about two years earlier, who was admitted to an intensive care unit through the emergency department after a suicide attempt, and for whom a psychiatric consultation was requested.","causal_attribution":"Clinical facts recorded by the treating consultation team in a peer-reviewed case report."},{"id":"c2","status":"reported","evidence":[{"locator":"'After this attempt failed, he searched'; 'The AI system used was a general-purpose large language model (LLM)-based chatbot accessible via a widely used consumer platform'; 'Despite the chatbot's response containing information about potential risks and the need for urgent help'","relation":"supports","source_id":"s3"}],"assertion":"According to the patient's account in the case narrative, after an earlier self-harm attempt he asked a general-purpose LLM-based chatbot on a widely used consumer platform about suicide; its response contained information about potential risks and the need for urgent help, and he then made the attempt.","causal_attribution":"The patient's report to clinicians, written up by the authors; no conversation record is reproduced."},{"id":"c3","status":"reported","evidence":[{"locator":"'Out of fear, he asked the AI chatbot again what he should do.'; 'The chatbot answered that there was an \"eighty percent chance of death\" and recommended calling an ambulance.'; 'Frightened, he then contacted emergency services.'","relation":"supports","source_id":"s3"}],"assertion":"According to the case narrative, after the attempt began he asked the chatbot again what he should do; it answered that there was an 'eighty percent chance of death' and recommended calling an ambulance, and, frightened, he contacted emergency services.","causal_attribution":"The patient's report to clinicians; the reply is not reproduced from a record."},{"id":"c4","status":"reported","evidence":[{"locator":"'The chatbot did not encourage suicidal behavior; in fact, it recommended seeking help.'; 'proved to be a critical turning point that reinforced his suicidal decision and accelerated his transition to action.'","relation":"supports","source_id":"s3"}],"assertion":"In their Discussion the authors say the chatbot did not encourage suicidal behaviour and recommended seeking help, but that the patient's psychotic cognition distorted its probabilistic statement into validation, and that the interaction reinforced his suicidal decision and accelerated his transition to action.","causal_attribution":"The authors' interpretation; it conflicts with their own narrative, which places the mortality estimate after the attempt began (claim c3)."},{"id":"c5","status":"documented","evidence":[{"locator":"'The patient's suicidal ideation was rooted in a delusional belief'; 'suggests a diagnosis of major depressive disorder with psychotic features.'","relation":"supports","source_id":"s3"}],"assertion":"The clinical team diagnosed major depressive disorder with psychotic features and ADHD; his suicidal thinking was rooted in a delusional belief that people would in future be executed according to their intelligence.","causal_attribution":"Clinical assessment recorded in the case report."},{"id":"c6","status":"reported","evidence":[{"locator":"'this case highlights AI chatbot interaction as one contributing element within a complex interplay of psychopathological vulnerabilities.'","relation":"supports","source_id":"s1"},{"locator":"'this case highlights AI chatbot interaction as one contributing element within a complex interplay of psychopathological vulnerabilities.'","relation":"supports","source_id":"s3"}],"assertion":"The authors present chatbot interaction as one contributing element within a complex interplay of psychopathological vulnerabilities, not as a sole trigger.","causal_attribution":"The authors' framing in the abstract, shown on the article page and in the PDF."},{"id":"c7","status":"documented","evidence":[{"locator":"'Submission Date November 17, 2025'; 'Acceptance Date April 9, 2026'","relation":"supports","source_id":"s1"},{"locator":"'Publication Date April 25, 2026'","relation":"supports","source_id":"s2"},{"locator":"'Written informed consent was obtained from the patient and parent/legal guardian for publication'","relation":"supports","source_id":"s3"}],"assertion":"The manuscript was submitted on 17 November 2025, accepted on 9 April 2026 and published on 25 April 2026, with written informed consent for publication from the patient and a parent or legal guardian.","causal_attribution":"Publication record on the journal page and the consent statement in the PDF."}],"effects":[{"label":"suicide attempt and intensive-care admission","claim_id":"c1","direction":"negative"},{"label":"contacted emergency services after a chatbot reply recommended an ambulance","claim_id":"c3","direction":"positive"}],"sources":[{"id":"s1","url":"https://dergipark.org.tr/en/pub/dtfd/article/1825194","kind":"peer_reviewed_case_report","access":"read","language":"en","translation_note":"Read in English on 2026-10-21 (live page, HTTP 200; bodies/lr-turkiye-page.html/.txt). Journal article page with abstract, author affiliations, submission, acceptance and publication dates.","independence_group":"duzce-medical-journal-case-report"},{"id":"s2","url":"https://doi.org/10.18678/dtfd.1825194","kind":"peer_reviewed_case_report","access":"read","language":"en","translation_note":"Read in English on 2026-10-21 (HTTP 200 after redirect to the journal article page; saved text identical to s1). The DOI resolver for the same publication.","independence_group":"duzce-medical-journal-case-report"},{"id":"s3","url":"https://dergipark.org.tr/en/download/article-file/5427087","kind":"peer_reviewed_case_report","access":"read","language":"en","translation_note":"Read in English on 2026-10-21 (HTTP 200, application/pdf; text extracted with pdftotext, pages 103 to 107; bodies/lr-turkiye-pdf.pdf and lr-turkiye-pdf-raw.txt). Full text of the case report; Figure 1 inspected only through its caption.","independence_group":"duzce-medical-journal-case-report"}],"version":1,"ai_roles":["own_use"],"contexts":["health"],"unknowns":["The event date. The report does not state it; the manuscript was received on 17 November 2025, so the event was in or before 2025, and the year in the stored id is not established by the report.","Where the event took place and where the patient lives; the authors' affiliation does not locate either.","Which chatbot or platform he used; the report says only that it was a general-purpose LLM-based chatbot on a widely used consumer platform.","The order of events: the case narrative places the mortality estimate after the attempt began and says it frightened him into calling emergency services, while the Discussion says it reinforced his decision and accelerated the act.","The exact wording of the chatbot's replies; they come from the patient's account and no conversation record is reproduced.","His condition after the psychiatric consultation; no follow-up is reported."],"geography":{"basis":"The full text locates only the authors, by affiliation (a university department of child and adolescent psychiatry in Türkiye). The case narrative names no city, hospital or country for the admission, the attempt, the chatbot use or the patient's residence. An author affiliation does not locate an event or a patient, so both country lists stay empty. No court proceeding is described. Carried forward from the 2026-10-05 metadata review.","court_countries":[],"event_countries":[],"affected_person_countries":[]},"publication":{"basis":"Published as a core case (communicated_with). A peer-reviewed case report documents an adolescent's suicide attempt and intensive-care admission and describes the chatbot's replies to him before and after the attempt began; its authors connect the exchange to the attempt, while their own narrative also shows the chatbot advising urgent help and an ambulance. The causal role is unclear because the report's two accounts conflict.","reviewed_on":"2026-10-21"},"ai_involvement":{"basis":"The case report, resting on the patient's account to clinicians, says a general-purpose LLM-based chatbot answered his question about suicide with information about potential risks and the need for urgent help before the attempt, and later answered that there was an 'eighty percent chance of death' and recommended calling an ambulance, after which he contacted emergency services. The authors' Discussion connects the exchange to the harm: it says the interaction reinforced his suicidal decision and accelerated the act, while also saying the chatbot did not encourage suicidal behaviour. Their narrative places the estimate after the attempt began, and the report does not reconcile the two accounts. No conversation record is reproduced.","status":"reported"},"person_relations":["communicated_with"]},"name":"Clinical case report describes adolescent's suicide attempt after AI chatbot exchanges, with conflicting accounts of the chatbot's role","summary":"A peer-reviewed case report by three child and adolescent psychiatrists, published in the Duzce Medical Journal in April 2026, describes a 17-year-old with major depressive disorder with psychotic features and ADHD who was admitted to intensive care after a suicide attempt. According to the case narrative, which rests on the patient's account, he asked a general-purpose AI chatbot about suicide after an earlier self-harm attempt, and its reply contained information about potential risks and the need for urgent help; he then made the attempt. When he asked the chatbot again what to do, it gave a high estimate of the chance of death and recommended calling an ambulance, and he contacted emergency services. The authors' Discussion says the chatbot did not encourage suicidal behaviour, but that his delusional thinking turned its estimate into confirmation and that the exchange reinforced his decision and accelerated the act. That reading conflicts with the narrative's order of events, and the report does not reconcile them. The chatbot is not named and no conversation record is reproduced.","incidentKind":"single_event","incidentDatePrecision":"unknown","exposurePattern":"repeated_interactions","reportedDate":"2026-04-25","aiSystem":"General-purpose LLM-based chatbot on a widely used consumer platform (not named in the case report)","aiProduct":"Unidentified chatbot","severity":"critical","verificationStatus":"credible","harmCategories":[],"harmOutcomes":["suicide_attempt","hospitalization"],"harmOutcomeSummary":"A 17-year-old was admitted to intensive care after a suicide attempt that followed exchanges with a general-purpose chatbot. The case report conflicts on whether a chatbot reply contributed to the attempt or came after it began.","frameworkFacets":[],"pathwayDirection":"inward","causationStatus":"unclear","participantUsersAffectedMin":1,"otherPeopleHarmedMin":0,"affectedCountStatus":"exact","affectedCountEvidence":"The case report describes one patient.","victimAgeRange":"minor","platformType":"assistant","outcomeType":"media_coverage","outcomeStatus":"unknown","primarySourceUrl":"https://dergipark.org.tr/en/pub/dtfd/article/1825194","primarySourceLabel":"Duzce Medical Journal, 25 Apr 2026: case report on a suicide attempt in an adolescent after AI chatbot interaction","firstPublishedAt":"2026-08-18T02:56:07.455248+00:00","updatedAt":"2026-10-21T03:02:25.380873+00:00","scopeVersion":"facts-v3","tags":["case-report","peer-reviewed","minor","suicide-attempt","psychosis","adhd","hospitalization"]},{"id":"2025-bromism-chatgpt-poisoning","caseFacts":{"claims":[{"id":"c1","status":"documented","evidence":[{"locator":"'A 60-year-old man with no past psychiatric or medical history presented to the emergency department expressing concern that his neighbor was poisoning him.'; 'In the first 24 hours of admission, he expressed increasing paranoia and auditory and visual hallucinations, which, after attempting to escape, resulted in an involuntary psychiatric hold for grave disability.'; 'Gradually, over the course of a 3-week admission, his chloride and anion gap normalized and psychotic symptoms improved.'; 'His bromide level ultimately was 1700 mg/L'","relation":"supports","source_id":"s1"},{"locator":"'He tried to escape the hospital within 24 hours of being admitted and, after being sectioned, was treated for psychosis.'","relation":"supports","source_id":"s2"}],"assertion":"A 60-year-old man with no past psychiatric or medical history was treated for bromism: he presented fearing his neighbour was poisoning him, developed paranoia and auditory and visual hallucinations, was placed on an involuntary psychiatric hold after trying to escape, and recovered over a three-week admission, with a serum bromide level of 1700 mg/L.","causal_attribution":"The clinical course is the treating clinicians' own record; the diagnosis of bromism rests on their workup and the measured bromide level."},{"id":"c2","status":"reported","evidence":[{"locator":"'For 3 months, he had replaced sodium chloride with sodium bromide obtained from the internet after consultation with ChatGPT, in which he had read that chloride can be swapped with bromide, though likely for other purposes, such as cleaning.'","relation":"supports","source_id":"s1"},{"locator":"'The patient told doctors that after reading about the negative effects of sodium chloride, or table salt, he consulted ChatGPT about eliminating chloride from his diet and started taking sodium bromide over a three-month period.'","relation":"supports","source_id":"s2"}],"assertion":"The patient told his clinicians that, wanting to eliminate chloride from his diet, he had for three months replaced sodium chloride with sodium bromide bought online after consulting ChatGPT, where he had read that chloride can be swapped with bromide, though likely for other purposes such as cleaning.","causal_attribution":"The patient's own account as recorded by his clinicians; the conversation itself was not available to them."},{"id":"c3","status":"reported","evidence":[{"locator":"'Based on the timeline of this case, it appears that the patient either consulted ChatGPT 3.5 or 4.0 when considering how he might remove chloride from this diet. Unfortunately, we do not have access to his ChatGPT conversation log and we will never be able to know with certainty what exactly the output he received was'","relation":"supports","source_id":"s1"},{"locator":"'They added that because they could not access the patient’s ChatGPT conversation log it was not possible to determine the advice the man had received.'","relation":"supports","source_id":"s2"}],"assertion":"The authors did not have the patient's ChatGPT conversation log and state they cannot know what output he received; they judged from the timeline that he used ChatGPT 3.5 or 4.0.","causal_attribution":"The authors' own statement of the limits of their evidence."},{"id":"c4","status":"reported","evidence":[{"locator":"'However, when we asked ChatGPT 3.5 what chloride can be replaced with, we also produced a response that included bromide. Though the reply stated that context matters, it did not provide a specific health warning, nor did it inquire about why we wanted to know'","relation":"supports","source_id":"s1"},{"locator":"'when the authors consulted ChatGPT themselves about what chloride could be replaced with, the response also included bromide, did not provide a specific health warning and did not ask why the authors were seeking such information'","relation":"supports","source_id":"s2"}],"assertion":"When the authors asked ChatGPT 3.5 what chloride can be replaced with, the reply included bromide and said context matters, but gave no specific health warning and did not ask why they wanted to know.","causal_attribution":"The authors' separate test; it does not reproduce the patient's exchange."},{"id":"c5","status":"reported","evidence":[{"locator":"'The chatbot’s guidelines also state it is not “intended for use in the diagnosis or treatment of any health condition”.'","relation":"supports","source_id":"s2"}],"assertion":"OpenAI's guidelines state that ChatGPT is not intended for use in the diagnosis or treatment of any health condition; the Guardian reports no OpenAI comment on this case.","causal_attribution":"General product terms relayed by the Guardian, not a response to this case."}],"effects":[{"label":"bromide poisoning with paranoia and hallucinations, an involuntary psychiatric hold and a three-week hospital admission","claim_id":"c1","direction":"negative"}],"sources":[{"id":"s1","url":"https://www.acpjournals.org/doi/10.7326/aimcc.2024.1260","kind":"peer_reviewed_case_report","access":"read","language":"en","translation_note":"Live URL answered HTTP 403 on 2026-10-11. Read in English from the Internet Archive capture 20250807211025 of this URL (bodies/lr-acp-wb.html): complete article (Background, Case Report, Table 1, Discussion, references, author information), published online 5 August 2025 by Eichenberger, Thielke and Van Buskirk; the treating clinicians' own report of the case.","independence_group":"acp-case-report"},{"id":"s2","url":"https://www.theguardian.com/technology/2025/aug/12/us-man-bromism-salt-diet-chatgpt-openai-health-information","kind":"news_report","access":"read","language":"en","translation_note":"Read in English on 2026-10-11 (live page, HTTP 200). A relay of the case report with no independent contact with the patient or clinicians, so it shares the case report's group; it adds OpenAI's general product statements, which do not address this case.","independence_group":"acp-case-report"}],"version":1,"ai_roles":["own_use"],"contexts":["health","everyday_life"],"unknowns":["What ChatGPT actually told the patient: his prompts, the replies, any warnings and the number of exchanges are unknown because the clinicians had no conversation log.","When the substitution and the hospital admission took place; the report gives a three-month period of ingestion and a three-week admission but no dates.","Where the patient lives and was treated; the report names no hospital or place.","Whether other sources, such as the bought product's labelling, contributed to the decision."],"geography":{"basis":"The complete case report names no city, hospital, region or country: the patient 'presented to the emergency department' and the authors refer to 'Our institution's laboratory' and 'the Poison Control Department' without naming them. University of Washington, Seattle appears only as the authors' affiliation, which is not used as an event or residence location. The Guardian calls the publication 'A US medical journal', which locates the journal and not the patient. No proceeding is reported. Carried forward from the 2026-09-19 metadata review and re-verified in the archived article on 2026-10-11.","court_countries":[],"event_countries":[],"affected_person_countries":[]},"publication":{"basis":"Published as a core case (communicated_with). The treating clinicians' peer-reviewed case report documents the bromide poisoning, psychosis and three-week admission and records the patient's account that he made the substitution after reading in a ChatGPT consultation that chloride can be swapped with bromide. The chatbot's output to him is known only through that account, so AI involvement is reported and causation alleged. The Guardian relays the same report and is not an independent account.","reviewed_on":"2026-10-11"},"ai_involvement":{"basis":"The treating clinicians' case report records the patient's own account that he replaced table salt with sodium bromide for three months 'after consultation with ChatGPT, in which he had read that chloride can be swapped with bromide, though likely for other purposes, such as cleaning'. That exchange is what connects the chatbot to the substitution, and the substitution to the bromide poisoning the clinicians diagnosed. The authors did not have his conversation log and write that they 'will never be able to know with certainty' what output he received. Their own later query to ChatGPT 3.5 about replacing chloride also produced a reply that named bromide without a specific health warning; that test is not the patient's exchange.","status":"reported"},"person_relations":["communicated_with"]},"name":"Case report: man hospitalised three weeks with bromide poisoning told doctors he swapped table salt for sodium bromide after consulting ChatGPT","summary":"A peer-reviewed case report by University of Washington clinicians (Annals of Internal Medicine: Clinical Cases, published online 5 August 2025) describes a 60-year-old man with no psychiatric history who presented fearing his neighbour was poisoning him and was found to have bromism, with a serum bromide level of 1700 mg/L. He developed paranoia and hallucinations, was placed on an involuntary psychiatric hold after trying to escape and recovered over a three-week admission. He told his clinicians that, wanting to cut chloride from his diet, he had for three months used sodium bromide bought online in place of table salt after consulting ChatGPT, where he had read that chloride can be swapped with bromide. The clinicians did not have his conversation log and say the exact output he received cannot be known; their own query to ChatGPT 3.5 produced a reply naming bromide without a specific health warning. No place or date is given.","incidentKind":"single_event","incidentDatePrecision":"unknown","exposurePattern":"unknown","reportedDate":"2025-08-05","aiSystem":"ChatGPT","aiProduct":"ChatGPT","aiCompany":"OpenAI","severity":"high","verificationStatus":"credible","harmCategories":["method_provision"],"harmOutcomes":["medical_deterioration","hospitalization","psychiatric_deterioration"],"harmOutcomeSummary":"One man was poisoned with bromide, developed paranoia and hallucinations, was held involuntarily and spent three weeks in hospital; he attributed the salt substitution to what he read in a ChatGPT consultation, which his clinicians could not inspect.","frameworkFacets":[],"pathwayDirection":"inward","causationStatus":"alleged","participantUsersAffectedMin":1,"otherPeopleHarmedMin":0,"affectedCountStatus":"exact","affectedCountEvidence":"The case report describes one patient.","victimAgeRange":"adult","platformType":"assistant","outcomeType":"media_coverage","outcomeStatus":"resolved","primarySourceUrl":"https://www.acpjournals.org/doi/10.7326/aimcc.2024.1260","primarySourceLabel":"Annals of Internal Medicine: Clinical Cases (Eichenberger, Thielke, Van Buskirk), 5 August 2025: A Case of Bromism Influenced by Use of Artificial Intelligence","firstPublishedAt":"2026-01-12T00:34:09.409015+00:00","updatedAt":"2026-10-11T07:53:07.295887+00:00","scopeVersion":"facts-v3","tags":["chatgpt","openai","bromide","poisoning","hospitalization","case-report","health-advice","psychosis"]}]}