UK Coroner Links California Law Student's Death to Weight Loss Drug Tirzepatide

A coroner in East London has concluded that a 19-year-old California law student died of a cardiac arrhythmia connected to tirzepatide, the weight loss drug marketed under the brand names Mounjaro and Zepbound.

Josephine Nasr, a second-year law student studying abroad at the University of East London, was found dead in her dorm room on September 23, 2025, according to the Daily Mail's reporting on the inquest, cited by the New York Post. An empty vial of tirzepatide was discovered in her room.

The inquest at East London Coroners Court heard that Nasr had been prescribed the drug by her doctor in California. Her BMI reportedly indicated she was overweight, not obese.

The night she died, Nasr told her father George Nasr, her mother Lorin Mansour, and her sister Anastasia Nasr that she felt nauseous and had been vomiting. Anastasia, worried about dehydration, called a private healthcare provider to arrange IV fluids for her sister.

When Josephine stopped responding, Anastasia called the university for a welfare check. Security staff and a nurse found her on the bathroom floor. A London Ambulance Service paramedic pronounced her dead at the scene.

Pathologist Alan Bates determined Nasr had a congenital condition called myocardial bridging, in which a section of a coronary artery runs through the heart muscle instead of over it. That condition can cause arrhythmia on its own.

Bates told the court that tirzepatide-induced vomiting could trigger hypoglycemia and a resulting electrolyte imbalance, and that the stress of that imbalance likely worsened her underlying heart condition. Bates described Nasr as an otherwise healthy young woman.

Coroner Graeme Irvine's official conclusion: Nasr died of cardiac arrhythmia caused by myocardial bridging combined with an electrolyte imbalance stemming from hypoglycemia, which in turn resulted from her prescribed tirzepatide.

This is a coroner's finding in a single case, not a large-scale clinical study. Nasr had a pre-existing congenital heart defect that most people don't know they have. The coroner didn't rule that tirzepatide alone killed her. He ruled that a chain of events, starting with a known side effect of the drug, set off a fatal cascade in someone whose heart already had a structural vulnerability.

That distinction matters. Nausea and vomiting are well-documented side effects of tirzepatide, according to the Mayo Clinic. Severe or prolonged vomiting can cause dehydration and electrolyte imbalances in anyone. What's notable here is that a coroner formally tied that common side effect to a death in a legal proceeding, which is a higher bar than an online adverse-event report.

Tirzepatide is a dual GIP and GLP-1 receptor agonist, sold as Mounjaro for type 2 diabetes and Zepbound for weight loss and obstructive sleep apnea. Millions of Americans are now on GLP-1 and GIP drugs, and the sheer scale of usage means rare side effects will surface in aggregate even when the drugs are working as intended for the vast majority of patients.

The family called a private healthcare provider for IV fluids rather than emergency services when the vomiting started, according to the inquest testimony reported by the Mail. By the time anyone realized something was seriously wrong, it was too late. The question of whether Nasr was told to watch for signs of severe dehydration or electrolyte problems, and whether she or her family recognized the warning signs early enough, remains significant.

No redesign of drug labeling or new regulatory action has been announced by the UK's Medicines and Healthcare products Regulatory Agency or the U.S. Food and Drug Administration in connection with this specific case. Nasr's death adds to a small but growing body of individual case reports, mostly from coroners' inquests and case studies, examining whether GLP-1/GIP drugs' gastrointestinal side effects can be dangerous for patients with undiagnosed heart conditions.

Her father, George Nasr, described his daughter as full of joy who always helped others before herself, according to the Mail's account of the inquest.

For now, this remains one coroner's ruling in one case in London. Anyone on tirzepatide with a family history of heart problems, or anyone experiencing severe or prolonged vomiting on the drug, has a concrete reason from this case to seek medical evaluation rather than home remedies for dehydration.