Expert: Keith Patton - 8/4/2009

Question
QUESTION: We made iced tea in a closed pitcher, lots of sugar and added some
overripe lemons.  Because I had a GI bug and was drinking gingerale, it sat in the fridge for about a week.  My husband was on clear liquids for a test day before incident, NPO day of incident and then was allowed to take his transplant medicine with liquids....he finished the end of the pitcher of week old tea/lemon/sugar mixture to take the meds...ended up in the ER with
a panic attack, weakness and to our surprise a blood alcohol level
of almost 200.....neither of us are drinkers and people think we are crazy that it was the fermented lemons....

ANSWER: Kathy:

It was probably the spontaneous fermentation of the sugar in the tea, caused by the wild yeast present in the over ripe lemons.  It is common knowledge that grapes and other berry type fruit will spontaneously ferment.  The cloudiness on skin of purple grapes in a natural yeast called must. Birds can actually get drunk eating fermented berries that stay on the vine till they ferment.  I have had fermented grapes off my arbor that had fermented to a degree.  I am sure that the lemons were on their way to fermenting and by adding them to the sugar laden tea, the sugar also fermented.  White cane sugar has a high attentuation, meaning it will completely ferment out to CO2 and alcohol if given the chance.  So it is likely you had a potently alcoholic pitcher of iced tea, not from the lemons but from the sugar.  The lemons only supplied the wild yeast.

---------- FOLLOW-UP ----------

QUESTION:   
Because we are not really drinkers, maybe 1-2 a month, if that and the fact that my husband was on clear liquids the day before and then NPO
that morning until he drank the tea, could the blood alcohol ended up at
around 200...   that is what the medical people dispute...but I know my
husband drank nothing but that tea.

Answer
By 200 do you mean .200?  Blood alcohol is measured by percent and .200 is pretty high, twice that and you are dead.

The affect of alcohol is subject to many factors, weight, sex and body fat.  If your husband had not had anything to eat it is possible that he got intoxicatred from the tea.  You didn't say how much tea there was.  If it was say two quarts of tea and it had the average strength of home brew which is about 5% it would mean that he had the equivalent of 3.2 ozs of alcohol.  Not three shots of vodka, which is only 40%, but 3.2 oz of straight ethanol or grain alcohol. It would be the equilalent of 8 shots of vodka.  So on an empty stomach it is concievable that he got his .200 alcohol level from the tea. Even if the tea was a bit weaker, it does not take into account the effects of the transplant meds he was on, probably blood thinners and anti-rejection meds.  The blood thinners could have enhanced the transport of the alcohol, as alcohol usually causes the blood platelets to clump together, probably a mechanism to slow down the movement of it through the body allowing it to saturate the tissues and lessen its immediate affect on the brain.