I'm a cardiologist. On July 19th, a healthy 27-year-old woman walked into a Bronx wellness center for an "anti-aging" IV drip. She went into cardiac arrest immediately. She was pronounced dead at 1:09 that afternoon, with the IV catheter still in her right hand. Her name was Elizabeth Baron. And I want to be precise about what killed her, because the lesson is not the one most people are drawing. The man who placed that IV, Luis Rojas Cabrera, 55, held no license to practice medicine in New York. He told police he was a doctor in the Dominican Republic. Prosecutors say he had no legal authority to administer NAD+ — which in New York requires a prescription from a licensed medical professional. His words to police: "I gave her a NAD+ IV. She went unconscious immediately. I called 911." And then: "I made a very big mistake. I need to call my family because I have a feeling I will not be home for a while." He's charged with reckless endangerment and unauthorized practice of a profession. The homicide bureau is investigating. Charges could be upgraded when toxicology returns. Let me tell you what the science on IV NAD+ actually says, because millions of people are being sold this. NAD+ is real biology — a coenzyme central to cellular energy production and DNA repair, and levels genuinely decline with age. That part is solid. Everything after that is marketing. There are no randomized controlled trials showing intravenous NAD+ slows aging, improves cognition, treats addiction, or extends healthspan in humans. None. What the small pilot data does show is frequent moderate-to-severe infusion reactions — abdominal cramping, nausea, vomiting, flushing, racing heart rate, throat tightness, chest pressure — often severe enough that the infusion has to be slowed or stopped. And the FDA has specifically warned about endotoxin contamination in sterile-compounded NAD+ products. Endotoxins are bacterial cell wall fragments that survive sterilization. Inject them and you get fever, rigors, and systemic inflammatory collapse. Here's the pharmacology nobody selling this will explain: injected NAD+ acts largely extracellularly and is cleared rapidly. It does not simply "refill" your cells the way the marketing implies. Bloodstream NAD+ is not mitochondrial NAD+. The oral precursors — NMN and NR — actually have more human data, and even those results are mixed and modest. But here is the part I most need you to understand. The molecule is almost beside the point. What killed this young woman was an unlicensed person putting a needle in her vein in a lifestyle boutique, with no screening, no prescription, no verified pharmaceutical-grade product, and no capacity to manage a cardiac arrest when it happened. That is not a bad apple. That is the predictable output of an unregulated wellness industry selling unproven infusions as medicine — with influencer endorsements, celebrity testimonials, and no one in the building who can run a code. An IV is not a spa service. It is a direct line into your circulation that bypasses every defense your body has. Three rules before anyone puts a needle in you. If any one fails, walk out. One: the person holding the needle is licensed to practice medicine in that jurisdiction. Verify it yourself — every state medical board has a free public lookup. It takes two minutes. She could have done it from the waiting room. Two: it is a real clinical setting, with emergency equipment, oxygen, and staff trained in resuscitation. Ask directly: what happens if I have a reaction? If there's no clear answer, there's no plan. Three: the product is pharmaceutical-grade, properly sourced, and prescribed for you specifically after an actual evaluation. And I'd add a fourth: anyone who is annoyed by these questions has just answered them. Here's what makes this so painful. Muscle mass. Metabolic health. Sleep. Blood pressure. Blood sugar. Those have the strongest evidence base in existence for extending healthspan. They cost almost nothing. They require no IV, no clinic, and no monthly membership. No drip replaces them. There has never been one that did. A 27-year-old is dead in pursuit of anti-aging. The marketing was never the science. It was always the risk. Verify the license. Ask what happens if something goes wrong. And when someone promises you a shortcut past the boring things that actually work — remember the IV was still in her hand.