Research

NAD IV Death: What the Medical Examiner Found

Creator: Julian Reyes, Health Writer
Published: 2026-09-23

The NAD IV death of a 27-year-old woman at a Bronx wellness business has been ruled a homicide. The reported cause was air in her IV line: a failure in how the drip was given, rather than a reaction to the drug.

Julian Reyes, Health Writer September 23, 2026 6 min read

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The short version

On September 21, 2026, police confirmed that New York City's medical examiner ruled a July 19 death after an NAD+ IV at a Bronx wellness business a homicide. The reported cause was a cardiac air embolism from air introduced into the IV catheter.
The cause named was how the drip was given, not a chemical effect of NAD+. The man who gave it told investigators he was not licensed to practice medicine in New York; the charges are allegations and he has pleaded not guilty.
Air embolism from an IV is rare and considered preventable. Case reports put a fatal amount in adults at roughly 200 to 300 mL, and routine steps such as primed tubing, air-free syringes and pumps with bubble detectors exist to stop it.
IV NAD+ given by the book still has side effects: in a 2026 records review, all six people given 500 mg a day reported moderate to severe stomach symptoms, a faster heart rate and chest pressure during infusions, which stopped when the drip ended.
What a prescribed route changes is accountability: a clinician licensed in your state reviews you first, a licensed pharmacy labels what is in the vial, and there is someone to call. Promise's NAD+ page lists an injectable vial, a nasal spray and a sublingual strip, not an IV infusion.

A 27-year-old woman died on July 19 after an IV drip of NAD+, a coenzyme the body uses to make energy, at a wellness business in the Bronx. On September 21, 2026, police confirmed that New York City's medical examiner had ruled her death a homicide. The reported cause was a cardiac air embolism: air got into her IV line and reached her heart. So, as reported, the finding in this NAD IV death is about how the drip was given, not about a toxic effect of NAD+. The man who gave it told investigators he was not licensed to practice medicine in New York. He has pleaded not guilty.

What happened in the NAD IV death

What follows comes from local news reports of police statements and the criminal complaint.

According to the complaint, the woman lost consciousness almost immediately after the infusion was started through a vein in her hand. She was taken to a Manhattan hospital and pronounced dead that afternoon. The man who gave the infusion was charged within hours with reckless endangerment and unauthorized practice of a profession. He pleaded not guilty and was released while the autopsy was pending (Gothamist, September 22, 2026).

The medical examiner's office gave the cause as a cardiac air embolism caused by air introduced into her IV catheter, the thin tube left in the vein. An embolism is a blockage inside a blood vessel. Here the blockage was air, and it blocked blood flow through the heart.

As of September 23, 2026, the day this article was written, reports disagree on what has happened to the charges since the ruling. News 12 reported a manslaughter charge; other outlets reported no new charges, and the Bronx District Attorney's office said the investigation was ongoing. The charges are allegations. His next court date is October 8.

What it means if you're prescribed NAD+

The reported cause sits in the line, not the molecule. Whatever passes through an IV line, air included, goes straight into circulation. That is why placing and watching one is medical work.

For anyone prescribed NAD+, two things follow. The first is the format. Promise's NAD+ page lists three: an injectable vial, a nasal spray and a sublingual strip, which dissolves under the tongue. It does not list an IV infusion.

The second is the person. At Promise, a licensed provider reviews every request before anything is prescribed, and not everyone qualifies; a provider who says no is doing the job. That clinician has to be licensed in the state where you are, and you can check the clinician's license on the state board's website in a few minutes.

What the ruling does not mean

It does not mean NAD+ is poisonous. Nothing in the reported ruling attributes the death to a chemical effect of the drug.

It does not mean anyone has been found guilty. To a medical examiner, homicide means a death caused by another person's actions. It is not a verdict and says nothing about intent, a point the man's lawyer made the day the ruling became public.

And it does not mean an NAD+ drip given by the book is trouble-free. One of the very few published looks at IV NAD+ tolerability is a 2026 records review from a commercial wellness chain. All six people who received 500 mg a day for four days reported moderate to severe stomach symptoms, a faster heart rate and chest pressure during the infusions, and every symptom stopped when the infusion ended (Reyna et al., Frontiers in Aging 2026). Six people is a signal, not a full picture.

What is in the bag matters too. In October 2024 the FDA warned compounders that some were making IV NAD+ from food-grade ingredient. It said it had received reports of severe chills, shaking, vomiting and fatigue after NAD+ injectable drugs, consistent with too much endotoxin (fragments of bacteria that can set off fever and shaking even when no live germs remain).

That is the other half of what a prescription changes. A licensed U.S. compounding pharmacy fills it, the label says what is in the vial, and there is a lot number to trace and a care team to call if something feels wrong. An unlicensed operator offers none of that.

NAD injection vs IV: where the air risk lives

The failure named in this case, air carried through an IV catheter into a vein, belongs to IV lines. Air embolism is rare but well understood. A 2016 review by interventional radiologists at Massachusetts General Hospital and the Mayo Clinic notes that its causes are shifting away from open surgery toward everyday procedures, including the ordinary IV in an arm or hand (McCarthy et al., Journal of Clinical Medicine 2016).

How much air is dangerous depends on the amount, the speed and where it ends up. Case reports put a fatal amount in adults at roughly 200 to 300 mL. Air that reaches the arteries, including through a small hole between the heart's chambers that some people have without knowing, can do damage even in small amounts.

The same review is practical about prevention: tubing is primed with saline so no air sits in it, syringes are kept free of air, and infusion pumps carry detectors that flag bubbles in the tubing. With appropriate precautions, the authors write, it can be preventable.

An IV is also a bigger exposure. In the 2026 review, each dose was diluted in 500 mL of saline and took about an hour and a half to run on average, with a nurse practitioner clearing each client beforehand. An injection is a small volume under the skin or into a muscle; a spray or strip involves no needle. Our guides cover what NAD+ injections are, their reported side effects and how a prescriber sets the dose.

Is NAD IV safe? Questions worth asking before any drip

For the drug itself, the human evidence is a handful of small studies. What the Bronx case shows is narrower and harder: an IV is only as safe as the trained, licensed person placing and watching it. Before any infusion, these questions are fair to ask:

Who assessed me, and are they licensed in this state?
Who ordered this, and is there a written prescription?
Who is placing the line and staying with me while it runs?
Which pharmacy made what is in the bag, and what is the lot number?
What happens if something goes wrong?

A business that cannot answer those plainly is telling you something.

What to watch next

The next date is October 8, when the man who gave the infusion is due back in court. The Bronx District Attorney's office has asked anyone who believes he harmed them to come forward. Whether prosecutors upgrade the charges is the open question.

So is how it happened. The reports give the cause of death but not how the air got into the line, how much there was, or what equipment was used. Those are the details the court case may bring out.

One fact does not change with the case. There is no FDA-approved NAD+ injection or infusion, and the compounded formulation offered here is not FDA-approved. A licensed provider may still prescribe it where they judge it appropriate; that decision is between you and your doctor.

Common questions

Did NAD+ cause the Bronx woman's death?

Not according to the reported ruling. New York City's medical examiner named a cardiac air embolism caused by air introduced into her IV catheter, which is a failure in how the drip was given. Nothing in the reported ruling attributes the death to a chemical effect of NAD+. That is different from saying IV NAD+ has no side effects: small studies report real discomfort during infusions.

What is an air embolism from an IV?

It is air that gets into the bloodstream and blocks blood flow. With an IV, air can enter through the catheter if the tubing or a syringe has not been cleared of it. Case reports put a fatal amount in adults at roughly 200 to 300 mL, though air reaching the arteries can do damage in small amounts. Priming tubing with saline, air-free syringes and pumps with bubble detectors exist to prevent it.

Is an NAD IV safe?

The evidence is thin. In a 2026 records review, all six people given 500 mg of NAD+ intravenously reported moderate to severe stomach symptoms, a faster heart rate and chest pressure during infusions, which stopped when each infusion ended. The FDA has also warned about IV NAD+ compounded from food-grade ingredient. And any IV depends on a trained, licensed person placing and watching the line.

What is the difference between an NAD injection and an NAD IV?

An IV runs NAD+ diluted in a bag of fluid into a vein through a catheter, often over an hour or more, and needs someone trained watching the line. An injection is a small volume given under the skin or into a muscle. Promise's NAD+ page lists an injectable vial, a nasal spray and a sublingual strip, and does not list an IV infusion. A prescriber decides whether any format fits.

Is NAD+ FDA-approved?

No. There is no FDA-approved NAD+ injection or infusion, and the compounded formulation offered here is not FDA-approved. Compounded medications are not reviewed by the FDA for safety, effectiveness or quality. A licensed provider may still prescribe a compounded formulation where they judge it appropriate, and that decision is between you and your doctor.

How can I check whether the person giving me an IV is licensed?

Get their full name and credential, then look them up on the licensing board's website for the state you are in: the medical board for physicians and physician assistants, the nursing board for nurses and nurse practitioners. A business license or a certificate on the wall is not a clinical license, and a clinician who will not give a name has answered the question.

What does it mean that the death was ruled a homicide?

It means the medical examiner found the death was caused by another person's actions. It is not a criminal verdict and does not mean anyone intended harm; the lawyer for the man who gave the infusion has said any homicide was an accident. Criminal responsibility is decided in court, and the charges in this case are allegations.