Background—A young medical student developed severe toxicity, including seizures, respiratory distress, hypotension, and asystole, and died after gargling with lidocaine before upper gastrointestinal endoscopy. Upper gastrointestinal endoscopy is usually a safe outpatient procedure before which the throat is often anaesthetised.

Case report—A 21 year old medical student presented with the symptoms of acid peptic disease and was referred for outpatient oesophagogastroduodenoscopy. He was of average build, did not smoke, and did not take any drugs; he had no history of …