Sarah Katz wanted to ride a roller coaster.
In a high school essay she once recalled a time in second grade, when her mom took her to the Six Flags in her native New Jersey. She wrote about how desperately she’d wanted to ride “the biggest and scariest” coaster in the park, how she wanted to feel “what it would be like to fly.”
Sarah’s heart condition mandated she go through life slightly on alert. She never did get to ride the roller coaster, or play team sports. She was technically allowed to drink coffee, but she didn’t.
Instead, she took her daily nadolol, a beta-blocker to keep her heart rate low, and steered clear of the only other thing her doctors told her to avoid: Energy drinks.
Her parents and their lawyers insist she never veered from that advice. At least, not on purpose. But then, in 2022, she died at age 21.
In the aftermath, Sarah’s parents filed a wrongful death lawsuit against Panera Bread, alleging that the restaurant chain’s 30-ounce Charged Lemonade induced the cardiac arrhythmia that ultimately killed their 21-year-old daughter.
Hers was the first of several suits related to the drink that have since been filed against Panera.
Today, Sarah’s parents have also taken their advocacy to Capitol Hill.
As of January 2024, they partnered with their congressional representative, Robert Menendez (D), to draft the bipartisan Sarah Katz Caffeine Safety Act, which would require clear caffeine content labels on energy drinks and require restaurants to flag menu items containing more than 150 mg of caffeine.
Sarah’s Charged Lemonade contained 390 mg of caffeine, just shy of the recommended total maximum daily intake for adults (400 mg), and more than a Red Bull and a Monster Energy combined.
The lawsuit claimed that it had been advertised alongside “noncaffeinated and/or less caffeinated drinks” at the Panera location Sarah visited on University of Pennsylvania’s campus, where she had just started her junior year.
Paramedics arrived shortly after Sarah collapsed. But they weren’t able to save her.
“Very often the first episode is death”
Sarah and her family had been lucky before.
Her condition, Long QT syndrome, and others like it frequently go undetected in young children. Studies show that socioeconomic and racial factors also play a role in the likelihood of whether a child will experience, survive and recover from heart failure.
But when, at age 5, Sarah suffered a seizure during a swim lesson and was rushed to a nearby hospital, her medical team left no stone unturned — with some nudging from her mother, Jill Katz.
Jill recalls the doctor telling her how “‘lucky’” she was.
“Very often the first episode is death,” she told The Post.
The doctor assured the Katzes that from there on out, the condition would be manageable. All Sarah needed to do was take her pills and avoid forbidden triggers.
“Once you find it, it’s just like any other type of condition that you need to manage, like diabetes or a food allergy,” Jill says. “It can be life-threatening in some cases, but if you do the right things you’ll be ok.”
Though no one in the Katz family has much of a coffee habit, moderate amounts of caffeine didn’t concern the doctor.
“They just said stay away from energy drinks,” Jill recalls.
Caffeine regulations are murky
Two years after Sarah’s death, a cardiologist at the Children’s Hospital of Philadelphia — where Sarah had worked as a research assistant — published a report titled “Cardiovascular Toxicity of Energy Drinks in Youth: A Call for Regulation.”
In it, Dr. Victoria L. Vetter noted that despite the 38 energy drink-related deaths and 14,000 toxicity cases reported to the FDA and the National Poison Data System between 2008 and 2015, the US remains one of the least regulated (and most profitable) energy drink markets in the world.
High doses of caffeine can be dangerous for anyone, regardless of underlying conditions. But caffeine is categorized by the FDA according to its different forms, which receive varying degrees of regulation.
The tightest is reserved for over-the-counter drugs (required to list caffeine content and any risks) and carbonated beverages with added caffeine (subject to a caffeine level limit).
Dietary supplements are the least regulated, and can easily surpass the limits set for carbonated beverages. Many energy drinks qualify for this category if they’re formulated with plant-based herbs or stimulants like ginseng and guarana.
“Conventional” foods and beverages like coffee are also loosely regulated.
Medical experts have been warning about this lack of oversight for three decades, urging the FDA to impose stricter regulation on the production and sale of energy drinks since at least 1997. Red Bull was introduced to the US the year before, the first of its kind here.
“I don’t want to see in teeny, tiny black print whether it’s a bunny hill or a double black diamond that I’m about to go down.”
Jill Katx
Today, the market is saturated with more than 500 different types of energy drinks. Many sponsor professional athletes and gamers.
Jill, a lawyer, has immersed herself in the legality of energy drink marketing since her daughter’s death.
“It’s history repeating itself with the tobacco industry,” she says. “They actively target children and teens to get them hooked.”
Red Bull, Monster and Panera did not respond to The Post’s requests for comment.
A bipartisan bill to boost transparency
Potential detractors of the proposed caffeine safety bill may worry about a caffeine “ban.” But Menendez, who represents North Jersey’s 8th district, is adamant that this is not his aim.
“I assure you it’s not a ban,” the representative tells The Post. “I still drink Diet Cokes. I occasionally have a Celsius.”
It is, however, a call for transparency.
“Increasingly it’s not just caffeine [in energy drinks] but other stimulants that you might not be aware of,” he says. “That greater transparency is something people crave right now.”
When contacted by The Post, a representative from the American Beverage Association declined to comment on the bill but said its member companies “already voluntarily disclose the amount of caffeine on each bottle and can they sell.”
Red Bull’s website states that the product “meets and exceeds the safety and labeling requirements” of the FDA, adding that “Red Bull voluntarily places the caffeine content on its cans, showcasing its commitment to full transparency.”
As for Panera, the Charged Lemonade was removed from the menu in 2024. The restaurant now advertises a much less potent “Energy Refresher” on its website, using bold labels to denote caffeine content (28 mg per 20 fl oz, caffeinated with “green coffee extract”).
But Menendez believes those voluntary disclosures are no longer enough, especially considering the growth in the energy drink market.
Almost immediately after he began working on the bill, he was inundated with stories from others who had experienced similar losses themselves.
“Every time I see somebody with an energy drink I just cringe because I’m like, do you know what you’re drinking?”
Martha Lopez-Anderson, executive director at Parent Heart Watch
“This is a common issue in the young adult demographic,” he says. “Even for me, in law school I would have as many Red Bulls as I needed to study for a final exam, and I never thought twice about it.”
Jill dismisses any accusations of over-regulation as missing the point.
“It’s just like disclosures for calories or if something contains peanuts,” she says. “I don’t want to see in teeny, tiny black print whether it’s a bunny hill or a double black diamond that I’m about to go down.”
A sudden killer
Martha Lopez-Anderson, executive director at Parent Heart Watch, lost her 10-year-old son Sean to sudden cardiac arrest in 2004. While his death was unrelated to caffeine, she and the Katzes have formed what she calls an “unfortunate” friendship, in solidarity with their grief — and she has visited Capitol Hill to advocate for the bill.
“Every time I see somebody with an energy drink I just cringe because I’m like, do you know what you’re drinking? Half the time people don’t,” she tells The Post.
Much of Lopez-Anderson’s work is educating the public about the warning signs of an underlying problem that could turn fatal if met with a trigger like energy drinks.
Fainting, chest pain, shortness of breath during or after exercise, fatigue and getting more tired than their peers could all be signals of youth cardiac distress. Knowing family history is also important.
“I considered myself a resourceful and informed parent, but I was completely blindsided by SCA,” she adds. “Thinking my kid would collapse and die like turning off a light switch? Never.”
A legacy lives on in the bill
Sarah would have celebrated her 25th birthday this April, possibly with some mix of sushi and boba, two of her favorite snacks.
She presumably would have entered the next quarter of her life with a bright future ahead: She was interested in going into law, like her mother. She’d studied abroad briefly in China, where she learned fluent Mandarin, though she had to come home early because of Covid.
Back in pandemic-ravaged Philly, she volunteered for in-person CPR trainings in Germantown, at a rec center named for a 19-year-old boy, Daniel E. Rumph II, who died from SCA in 2005.
To carry on Sarah’s legacy, her parents are working with Penn to install more outdoor automated external defibrillators, and they’ve started a charitable foundation in her name.
They’re also trying to push this bill through Congress, confident it will prevent similar tragedies.
One of Jill’s favorite memories of Sarah comes from her bat mitzvah, when she paraphrased the Talmud: “Save one life, you save the world entire.”
By that measure — even in death — Jill and her daughter are saving the world together.
