At least 25 poisoned, 1 dead from “Real Alkalized Water,” CDC report reveals (2024)

Tainted water —

What caused acute liver failure in some customers, including children, is still unclear.

Beth Mole -

At least 25 poisoned, 1 dead from “Real Alkalized Water,” CDC report reveals (1)

At least 25 people in two states were likely poisoned by toxic batches of the "Re2al Alkalized Water," including five children who suffered acute liver failure and one person who died.

That's according to a report published by the Centers for Disease Control and Prevention Thursday, which lays out the findings of a multistate investigation into the toxic water. Health investigators suspect additional poisonings went undetected. They noted in their report that hospital records indicated an unusual spike in unexplained "toxic liver diseases" around the time of the poisonings.

The toxic water made headlines earlier this year when health investigators initially linked alkalized water sold by Nevada-based water company Real Water to severe illnesses in five children in Clark County, Nevada. But the new report from the CDC offers the most complete look at the identified cases and illnesses.

Poisoned water

The saga began in November and December of 2020, when the five children—ranging in age from seven months to five years—became severely ill with acute liver failure after drinking the water. They were hospitalized and later transferred to a children's hospital for a potential liver transplant—though they all subsequently recovered without a transplant. Local health officials investigating the unusual cluster found that family members had also been sickened. The only common link between the cases was the alkalized water, which Real Water claimed was a healthier alternative to tap water.

In mid-March, the Food and Drug Administration contacted Real Water about the cases and urged the company to recall their water, which was sold in multiple states, including Nevada, California, Utah, and Arizona. Real Water agreed to issue the recall. However, by the end of the month, the FDA reported that retailers were still selling the potentially dangerous water, and the regulator tried to warn consumers directly. By then, Nevada health officials had linked the water to six additional cases, including three more children, bringing the total to 11.

Now, according to the new report, the tally has increased to 25: 18 probable cases and four suspected cases in Nevada, as well as three probable cases in California.

Further Reading

FDA slams “Real Water” linked to liver failure; water plant manager MIA

The 21 probable cases all had an inexplicable onset of liver inflammation, with no viral infection or other underlying disease to explain the illness. They also all drank Real Water's 5-gallon Re2al Water product. Most of the cases occurred in November 2020 and, apart from the children, were in people older than 30. Their common symptoms included fatigue, vomiting, decreased appetite, dizziness or vertigo, and unintentional weight loss. They all suffered from abnormal liver function, and multiple people were considered for liver transplants.

All 21 probable cases ended up hospitalized, and 18 required intensive care. One woman in her 60s with underlying medical conditions died of complications from her liver inflammation.

In May, the Department of Justice filed a lawsuit against Real Water Inc. on behalf of the FDA, alleging the company's officers—Brent A. Jones and his son, Blain K. Jones—were selling adulterated products that were made amid a slew of manufacturing violations. On June 1, the Joneses agreed to settle the case, and the DOJ bound them with a permanent injunction from ever preparing, processing, or selling water again.

Toxic manufacturing

At least 25 poisoned, 1 dead from “Real Alkalized Water,” CDC report reveals (2)
To date, it's still unclear what exactly was in the toxic water, though. According to the DOJ's complaint, the Joneses processed municipal tap water "by carbon filtration, reverse osmosis filtration, ultraviolet light filtration, and ozone filtration." Then they mixed the water with potassium hydroxide (a form of lye), potassium bicarbonate (sometimes used in baking powders), and magnesium chloride (a salt used in nutritional supplements and for de-icing roads).

Last, the company claimed to the DOJ that it used a "proprietary 'ionizer' apparatus to apply an electrical current to this mixture, which allegedly creates positively-charged and negatively-charged solutions. [The Joneses] then discard the positively-charged solution and store the negatively-charged solution."

Further Reading

Technician for water co. linked to liver failure says his dog got liver illness

But we may never know the exact step that went wrong, because—according to FDA investigations—almost everything about the company's manufacturing process was rotten. The DOJ lawsuit notes that Real Water failed to identify manufacturing hazards, implement preventative controls, or monitor for problems. The company also failed to adequately clean and sanitize its equipment and sample and test cleaning solutions—which it recycled and used to clean its 5-gallon water containers. Real Water didn't label products with production codes that could identify problematic batches or test product samples for quality.

The company didn't even have any documents of the ingredients and manufacturing process for the water products it made, which could—among other things—help ensure that excess amounts of ingredients weren't added or environmental contaminants didn't get in. There was "no written process control and/or supply-chain control procedures to ensure that the correct type and amount of chemicals are added to each batch of product water," the DOJ said.

While the mystery remains, CDC investigators note that unusual clusters of illness can be an early flag of dangerous products. When the investigators searched hospital billing codes for "toxic liver disease" or "hepatic failure, not elsewhere classified," they noted an unusual uptick in cases during October and November of 2020. "This investigation illustrates the importance of reporting unusual illnesses to public health authorities," they concluded.

Listing image by FDA

At least 25 poisoned, 1 dead from “Real Alkalized Water,” CDC report reveals (2024)


At least 25 poisoned, 1 dead from “Real Alkalized Water,” CDC report reveals? ›

The 21 probable cases all had an inexplicable onset of liver inflammation, with no viral infection or other underlying disease to explain the illness. They also all drank Real Water's 5-gallon Re2al Water product. Most of the cases occurred in November 2020 and, apart from the children, were in people older than 30.

What are the symptoms of alkaline water poisoning? ›

Metabolic alkalosis is a condition that can arise from a disruption of the body's normal pH through the consumption of alkaline water. This can provoke the emergence of serious health issues such as confusion, vomiting, nausea, hand tremors, muscle twitching, and tingling in the hands, face, or feet.

What is the downside of drinking alkaline water? ›

There are possible disadvantages from drinking alkaline water with pH levels above 9. The water will likely have a bitter taste. And for people who regularly take stomach acid production blockers called proton pump inhibitors (PPIs) to maintain a higher stomach pH, drinking strong alkaline water could be dangerous.

Is essentia water bad for you? ›

Essentia is purified drinking water with minerals added for taste. Essentia Water meets and exceeds the requirements set forth by the U.S. Environmental Protection Agency (EPA), the U.S. Food and Drug Administration (FDA), as well as local regulatory requirements.

Can alkaline water cause liver damage? ›

In late 2020, CDPH received reports from the state of Nevada of multiple children with acute liver disease from non-viral hepatitis A. Nevada determined that these illnesses were linked to the “Real Water” brand of alkaline water. Real Water had been distributed throughout the country, including in California.

What is the healthiest water to drink? ›

Mineral water and alkaline water may be some of the healthiest types of water because they provide your body with essential nutrients, but simply drinking safe, uncontaminated water should be your number one priority.

Why do I feel bad after drinking alkaline water? ›

Keep in mind that the goal of alkaline water is to balance pH levels out and when you drink too much alkaline water you run the risk of having similar symptoms that too much acidity within the body can present such as nausea, headaches, fatigue, muscle twitching, confusion, and more.

Is alkaline water good for your kidneys? ›

While some studies on alkali therapies (like drinking alkaline water) suggest that they may be helpful for patients with kidney disease, the bottom line is that there isn't a conclusive body of evidence supporting those claims.

Which bottled water has the lowest PFAS? ›

PFAS between 0 and 1 ppt
  • 365 Everyday Value (Whole Foods) Spring Water.
  • Absopure Purified Water.
  • Alkaline88 Natural Alkaline Water.
  • Aquafina Natural Purified Water.
  • Core Hydration Natural Enhanced Water.
  • Crystal Geyser Natural Spring Water.
  • Dasani Natural Purified Water.
  • Essentia Natural Purified Alkaline Water.

Is it good to drink 9.5 pH water? ›

Even if the PH is greater than 8.5, the water is still probably safe, but you may want to acidify the water if you are noticing skin problems. Lastly, whether bottled or from your own well, continue to drink water.

What is the lawsuit about real alkaline water? ›

Five children and three adults sued Real Water, alleging that their alkaline water contained a toxic chemical known as hydrazine that ultimately led to liver damage for all plaintiffs.

Does the FDA approve alkaline water? ›

The FDA is reiterating that it is crucial that consumers, restaurants, distributors, and retailers not drink, cook with, sell, or serve “Real Water” alkaline water. FDA also advises that this water not be served to pets.

What is the Costco water lawsuit? ›

Manufacturer Takeya USA Corp. and retailer Costco Wholesale Corp. failed to warn consumers that ThermoFlask stainless steel water bottles can burst when filled with hot liquids that cause pressure increases inside the bottle, a new suit alleges.

What are the symptoms of too much alkaline in the body? ›

Symptoms of alkalosis can include any of the following:
  • Confusion (can progress to stupor or coma)
  • Hand tremor.
  • Lightheadedness.
  • Muscle twitching.
  • Nausea, vomiting.
  • Numbness or tingling in the face, hands, or feet.
  • Prolonged muscle spasms (tetany)
Nov 19, 2023

Can you have a reaction to alkaline water? ›

Side effects of alkaline water consumption can include nausea and vomiting.

Can alkaline water make you feel ill? ›

Drinking extensive amounts of alkaline water may result in digestive issues like nausea, vomiting and stomach pain, says Smith, though this effect is unlikely.

What happens if water is too alkaline? ›

If the alkalinity of the drinking water is too high, the water can have a salty, soda-like, or chalky taste, dry your skin, or be associated with the formation or creation of a chemical scale or precipitate which would clog piping or form a scale on filters and other heat exchange systems.

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