Two fatal cases of endothall poisoning

Background Endothall is a protein phosphatase 5 inhibitor used as an herbicide however scant reports of human exposure are associated with high lethality.Case series: We describe two cases of endothall toxicity in Melbourne, Victoria. Case 1 was a 75‐year‐old male who had died following an accidental ingestion of a mouthful of endothall (175 g/L). He developed a severe metabolic acidosis with cardiac arrest following a gastroscopy demonstrating severe haemorrhagic gastritis and oesophagitis. Case 2 was a 29‐year‐old male, who was presented after ingesting 100 mL of endothall (175 g/L) with suicidal intent and who died in less than 24 h despite intensive treatment including continuous renal replacement therapy.Discussion Endothall is a rare but lethal poisoning in humans post ingestion that causes both corrosion and multi‐organ failure. Whilst there are limited data, early intensive care management appears necessary, no published cases have survived longer than 24 h.Conclusion Endothall is highly lethal in small quantities despite current best measures; therefore, public health measures to restrict access are strongly recommended.