Emergency teams were summoned to a local high school to care for a 16-year-old girl who had suddenly collapsed. She was 5 feet 8 inches tall and weighed approximately 80 to 85 kg (176 to 187 lb). The patient had been in good health with no known history of medical problems.

She had started a low-carbohydrate/high-protein diet 1 or 2 weeks earlier in an effort to lose weight. She had learned about the diet from video tapes, purchased from an advertisement on television. Her mother had been on the same diet. She had complied with the dietary regimen, eating meat, cheese, and salads without fasting.

When the paramedics arrived, the girl was pulseless and apneic. The electrocardiogram revealed ventricular fibrillation. The patient's trachea was intubated and cardiopulmonary resuscitation was initiated. Resuscitative measures, including defibrillation, were without effect. On arrival in the emergency department, the patient remained pulseless, with no evidence of cardiac activity.