Support the show

Review the show where ever your listening

Get Messages from Toxo (Join the Newsletter!)

Join as a supporting member

1. Ad free episodes
2. Bonus content and early access
3. Discounts and give aways on GOTA PICCEM Mushroom card game

The GOTTA PICCEM Poisonous Mushroom Game!

The Poisonus Fungus Amongus Children's Book!

1. Full book reading (6 minutes!)

Tox trinkets (Rep the show at home!)

Reach the show

1. Email: [email protected]

More Show Resources

1. Ryan's Medical Games and Resources
2. Show Website

The Poison Lab: Outbreak – Markham Aconite Poisoning

On August 29, 2022, twelve diners at a Markham, Ontario restaurant fell critically ill with vomiting, numbness, and life-threatening arrhythmias. The culprit? A deadly plant toxin: aconite.

In this episode—the first of a new Poison Lab Outbreak series—we go inside the Markham mass poisoning case. Join host Ryan Feldman, clinical toxicologist and emergency medicine pharmacist, as he investigates how a rare and lethal toxin ended up in a restaurant spice jar and nearly cost lives.

You’ll hear firsthand from the experts who responded to the outbreak:

• Dr. Jessica Kent, toxicology fellow at the time at the University of Toronto
• Dr. Abinhay Sathya, intensivist at Markham Stouffville Hospital
• Dr. Margaret Thompson, toxicologist and on-call consultant for the Ontario Poison Centre
• Dr. Randy Purves, research scientist at the Canadian Food Inspection Agency (CFIA)
• Bryn Shurmer, MS- analytical chemist at the Canadian Food Inspection Agency (CFIA) 

Together, they walk us through the outbreak timeline—from the first patients in VT to the public health investigation that uncovered a mislabeled spice bag full of pure aconite root.

Looking for timestamps?

A fully timestamped version of the episode—so you can jump to any topic—is available to our supporting members.

💡 Key topics:

• Clinical presentation and toxic effects of aconite
• Challenges in mass poisoning recognition and coordination
• The crucial role of poison centers in outbreak response
• Public health trace-back to contaminated galangal powder
• Lessons for emergency departments and toxicologists

📍 Resources & Mentions:

• Case series about the incident written by Dr. Kent, Sathya, and Thompson
• Twitter/X post by Dr. David Juurlink that helped disseminate early info
• The Poison Lab previous aconite episode: Open and shut (Mystery Case #31)
• Paper written by Ryan, Dan McCabe, and Crissy Lawson

🎧 Listen now at: www.ThePoisonLab.com

💬 Have thoughts or questions? Connect on Instagram @tox_talk, Twitter @LabPoison, or email [email protected].