The San Luis Obispo County Coroner’s Office ruling that a Ventura woman died of an accidental LSD overdose at a music festival in May is not just highly unlikely — it would be unprecedented if true, two medical experts told The Tribune.
The autopsy report for 20-year-old Baylee Gatlin, who died May 28 at Twin Cities Community Hospital in Templeton after attending the Lightning in a Bottle music festival at Lake San Antonio, said the specific cause of Gatlin’s death was acute lysergic acid diethylamide toxicity.
But medical experts who have studied LSD and were contacted by The Tribune to review the report criticized the finding, saying that the low level of LSD found in her blood could not have killed her and those involved in the investigation must have failed to identify substances that were more likely to have caused her death.
“It defies logic,” said Dr. David E. Nichols, a pharmacologist and medicinal chemist considered a global expert on hallucinogens. He retired from Purdue University after 38 years of research in the field and is now an adjunct professor at the University of North Carolina at Chapel Hill.
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“It’s just not logical or reasonable to conclude that she is the first of 30 million people who have safely taken LSD to have died (from that small amount). It’s not possible. There is something else. They did not analyze what they should have analyzed,” Nichols said.
The autopsy was performed by Dr. Gary Walter, a medical examiner contracted by the county who is facing discipline from the California Medical Board after he was arrested for driving drunk on his way to work last year. He did not respond to a request for comment.
Tony Cipolla, spokesman for the Sheriff’s Office, said “The Sheriff’s Office stands by our expert and his conclusion.”
LSD, or acid, is a hallucinogenic drug first synthesized in 1938 and used as a tool in psychotherapy for decades until it was made illegal in the United States in 1968. It has remained available as a street drug. Experts say LSD is extremely safe because an effective dose can be achieved with a small amount and because the brain receptor that the drug interacts with does not control any bodily life functions.
Nichols and others say it is more likely that Gatlin died after taking another drug, such as an NBOMe-type drug, which has been sold on tabs of paper as LSD. Or, she could have died after taking MDMA, commonly known as ecstasy, or PMA, another designer drug, he said. Those drugs are associated with hyperthermia, particularly when people dance intensely, which aligns with the symptoms Gatlin exhibited before her death.
It’s just not logical or reasonable to conclude that she is the first of 30 million people who have safely taken LSD to have died (from that small amount). It’s not possible. There is something else.
Dr. David E. Nichols, pharmacologist and medicinal chemist considered a global expert on hallucinogens
Both NBOMe and MDMA were present at the Lightning in a Bottle festival, according to Mitchell Gomez, executive director of DanceSafe, a nonprofit attending the event to promote health and safety.
Deaths related to these drugs are numerous and undisputed, unlike LSD. Nichols and others say they are unaware of any case reports that document LSD as medically causing any deaths.
“Physiologically, LSD is not toxic. Psychologically, it can be very risky. Deaths have occurred when individuals under the influence of LSD die of suicide or an accident,” said Dr. Charles Grob, a professor of psychiatry and pediatrics at the UCLA School of Medicine and the Director of Child and Adolescent Psychiatry at Harbor-UCLA Medical Center.
“The receptor that LSD hits is not involved in life functions. If someone overdoses and dies from cocaine, it’s increased blood pressure, and because it has local anesthetic effects, you could get cardiac arrest. Heroin or fentanyl activate opioid receptors that can shut down your breathing,” Nichols said.
Recreational doses of LSD are “way below any kind of dose that would kill you,” he said.
Gatlin’s last hours
There is no evidence that Gatlin took any more LSD than an average recreational dose.
According to an investigation summarized in the coroner’s report and additional information provided by the Sheriff’s Office, Gatlin took LSD around 4 p.m. at the festival where she had camped with friends and was seen dancing before she “overheated” and was taken to a medical tent at 9 p.m.
A friend said that she had “accidentally” taken a second dose, the coroner’s report says. Her temperature reached 105 degrees at one point, and she arrived by ambulance at 2:15 a.m. at the hospital, where liquid was removed from her lungs. She was pronounced dead at 3:42 a.m.
Gummy candies and a pill capsule found in her belongings tested positive by the Sheriff’s Office for LSD and methamphetamine, the report says.
The autopsy report says that her lungs appeared fully expanded and there were signs of gastrointestinal bleeding. No abnormalities were found with her heart, liver, spleen or kidney.
The toxicology report issued in Gatlin’s case shows a low level of LSD and no other illicit drugs. It includes a definition of LSD toxicity that an expert called “bogus.”
The amount of LSD measured by a lab in two blood samples taken from Gatlin’s system measured .22 nanograms per milliliter and .47 nanograms per milliliter.
“That’s not an overdose or toxic dose by any stretch of the imagination,” Grob said.
The Sheriff’s Office response to the low level found in her system was that “the LSD was at a much higher level in her blood during the approximate 12 hours prior to death.”
Nichols and Grob responded that the amount of LSD she took that day could not have been higher than one or two doses. They both independently pointed to a 2017 study in which 24 healthy adults were given high-grade doses of LSD. After 12 hours, the amount of LSD measured in their systems was about one-sixth of the peak amount.
“She could not have ingested more than two doses of LSD,” Nichols said. “There is a piece of this puzzle that’s missing.”
Cipolla said that in cases of overdose, the Sheriff’s Office orders tests for more than 200 drugs, and that was the case with Gatlin. He said Gatlin’s blood sample came back negative for NBOMe-type drugs and MDMA.
Central Valley Toxicology, which produced the toxicology report, declined to address the concerns raised by Nichols and Grob.
Its toxicology report includes a statement that the potential toxic blood level of LSD is 1 nanogram per milliliter. But it’s unclear where that measurement came from, as no one actually knows what a fatal dose of LSD would be, Nichols said.
“It’s totally bogus, and they need it to wipe it from their books,” Nichols said.
In response to the criticism, Cipolla said, “toxicity is a subjective term. What is toxic to one person may not be toxic to another person.”
How did she die?
If LSD did kill Gatlin, it’s unclear how. The autopsy report does not identify a physiological cause of death, which is often included in death certificates and coroner’s reports.
In the case of a 28-year-old who overdosed on heroin in 2014, for example, the cause of death is identified as respiratory arrest, due to acute heroin toxicity and other significant conditions, according to a county autopsy report.
In the case of a 29-year-old who overdosed on methamphetamine in 2014, the cause of death is cardiac dysrhythmia, due to acute methamphetamine toxicity, an autopsy report says.
In Gatlin’s case, the cause of death is listed as acute lysergic acid diethylamide toxicity. And that’s what has been documented on her county death certificate.
“I think the county’s wrong. I think it’s either NBOMe, MDMA or PMA. That would fit the description,” Grob said.
Nichols said the county’s stance is disturbing. He suspects that it would rather stick with its conclusion, “rather than doing more testing and having to admit that they got it wrong the first time. But it sure is disturbing that we don’t know what actually killed the young woman,” Nichols said.