Harmful outputPI-0022
Case report links bromide poisoning to a patient’s reported ChatGPT consultation
University of Washington physicians published a case report describing a 60-year-old man who replaced table salt with sodium bromide for three months after consulting ChatGPT, and who was then hospitalized for about three weeks with bromism, paranoia and hallucinations, including an involuntary psychiatric hold. The authors did not have his chat logs, but when they asked ChatGPT a similar question it listed bromide without a specific health warning.
- Harm
- Harm: Severe harm, allegedAI role uncorroborated.
- Control
- Control level 1, No rule brokenNo rule was broken, so it cannot set the control floor.
Under review. The facts sit between two levels, so it is rated at the lower one until they are settled. The rating may change; every change is logged below.
Severe harm, alleged. The harm is alleged, and the AI system's part in it is not corroborated. It is shown at the level claimed and adds nothing to the index. This does not dispute that the harm itself occurred.
Sources
How we know
4 sources · unverified claim. Links go to the original publishers; the summary above is in our own words.
- researchA case of bromism influenced by use of artificial intelligenceAnnals of Internal Medicine: Clinical Cases · Aug. 5, 2025doi.org/10.7326/aimcc.2024.1260
- newsMan who asked ChatGPT about cutting out salt from his diet was hospitalized with hallucinationsNBC News · Aug. 14, 2025nbcnews.com/tech/tech-news/man-asked-chatgpt-cutting-salt-diet-was-hospitalized…
- newsChatGPT salt swap advice lands man in hospital with bromide poisoningBusiness Standard · Aug. 11, 2025business-standard.com/health/chatgpt-salt-swap-advice-lands-man-in-hospital-wit…
- newsBromine and bromism: what's old is new againPsychiatric Times · Dec. 1, 2025psychiatrictimes.com/view/bromine-and-bromism-what-s-old-is-new-again
Why this rating
Severe harm, alleged; control failure level 1
Two separate assessments. Only documented harm can count toward the index.
Observed harm
Severe harm, allegedHospitalization of about three weeks; the AI consultation is the patient's account without logs.
Health & safety: 1 to 9 deaths, or serious harm to health (hospitalization).
The harm scale
- 1 Negligible Inconvenience, easily remedied.
- 2 Minor Limited, recoverable harm.
- 3 Moderate Material harm needing significant effort to remedy.
- 4 Severe Severe harm to health, rights, property or essential services.
- 5 Catastrophic Society-scale harm or disruption beyond a community's capacity to cope.
Control assessment
No rule brokenFlawed advice; no rule broken or permission exceeded.
No rule was broken, so it cannot set the control floor.
The control scale
- 1 Negligible Behaved as instructed. The problem was an ordinary error or a flawed output, with no rule broken.
- 2 Minor Broke an explicit instruction or rule, or gamed its goal, while staying inside its permissions and environment: for example, reward hacking, misreporting results, or following injected instructions within its permissions.
- 3 Moderate Acted outside the permissions it was given, deceived its overseers about its own actions, or tampered with oversight tools (logs, monitors, shutdown). Stopped by normal controls within an hour.
- 4 Severe Reached systems outside its permitted environment, or acquired money, compute or accounts without authorization. The type and mechanism say how.
- 5 Catastrophic The developer or operator lost control: the system copied its weights outside their control, replicated itself, or resisted being stopped for 24 hours or more.
Rating rationale
The case report documents clinical poisoning, but the AI consultation is the patient’s account without original chat logs. A later prompt test does not establish the advice he received. AI-linked harm is as claimed and contributes zero points. Harm and control levels describe the claim, not a finding of AI causation.
Effect on the index
It does not count toward the Aug. 11 reading
The reading for the week to Aug. 11, 2025, with this record and without it. Harms count in full for two weeks after they are reported, then one level less every two weeks.
Not counted: AI role uncorroborated. 4 other records behind the reading for that week.
The arithmetic
| Step | With it | Without |
|---|---|---|
| Counts toward the index?documented, external, eligible evidence | No | — |
| Worst documented harm, ksets the band | — (none counting) | — (none counting) |
| Harms at that level, nposition in the band | 0 | 0 |
| Highest control level breachedsets the reading only when no harm counts | 3 | 3 |
| Readingrounded down | 3 Control failures only | 3 Control failures only |
Inside the window of 4 weekly readings
| Week to | Reading | Band |
|---|---|---|
| Aug. 11, 2025 | 3 | Control failures only |
| Aug. 18, 2025 | 3 | Control failures only |
| Aug. 25, 2025 | 3 | Control failures only |
| Sept. 1, 2025 | 3 | Control failures only |
Revisions
What we changed
5 logged. Every change to a rating is logged here, with the reason.
- v5Oct. 6, 2026
Ratings confirmed by the editor.
- v4Oct. 3, 2026
Audit corrections: event date 2025 → unknown (the hospitalization is not dated in the sources, and the manuscript's 2024 DOI suggests it may predate 2025). Case report dated 5 Aug 2025 (online publication; Crossref gives the August 2025 issue, the day comes from a secondary extract because the publisher page could not be opened); NBC dated 14 Aug 2025 (updated 18 Aug). Ratings unchanged.
- v3Sept. 30, 2026
Rated: impact alleged level 4; control type none.
- v2Sept. 30, 2026
Beta evidence review: AI-linked health-harm claim is uncorroborated; verification changed from Single source to Unverified claim, 12 to 0 points.
- v1Sept. 30, 2026
Backfilled from public reporting.
Cite and share
Use this record
Citation
Paperclip Index. “Case report links bromide poisoning to a patient’s reported ChatGPT consultation.” Record PI-0022. Reported Aug. 5, 2025; updated Oct. 6, 2026. Rated under methodology v0.6. https://paperclipindex.com/incident/PI-0022