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A fourth death has been connected to pot vaping after officials in Minnesota confirmed Friday morning that a 65-year-old person died in August after “vaping illicit THC products.” That rises the death toll to four after similar vape-related deaths were confirmed this summer by health officials in Oregon, Illinois, and Indiana.

The Minnesota case occurred in August and the person, who had an underlying lung disease, died after "a long and complicated hospitalization” that was complicated by other conditions, according to health officials in Minnesota.

Health officials across the country are racing to understand both the cause of the illnesses and what exactly these illnesses are. One young man in Utah was hospitalized with such severe lung damage that doctors had to pump oxygen directly into his bloodstream to keep him alive.

Cannabis vape cartridges, not cigarette-replacing nicotine vape cartridges, appear to be associated with a majority of the cases but many of the affected individuals may have used both types of vape cartridges.

Officials are warning people not to start vaping if they aren’t already using the products and to consider quitting if they currently vape. And then there’s the very obvious lesson in all of this: don’t fucking buy black market vape products. Dangerous solvents and flavorings are frequently added to black market vape cartridges and a few additives, including vitamin E oil which is used in edible hemp oil products, appear to be a possible cause.

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There is one silver lining for vape users as this epidemic swells to more than 450 cases. According to the New York Times, these health cases appear to be caused by a new change in vaping or vape products, not the long-term impact of vaping, which is still unknown.

Public health officials have underscored one fundamental point: that the surge in illnesses is a new phenomenon and not merely a recognition of a syndrome that may have been developing for years.