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Many products sold online are labeled for research use only. That means the product is not approved as a prescription medication and may not be held to the same quality or safety standards

Its diverse manifestations, erratic course and prognosis, and inconsistent responsiveness to therapy pose a challenge to its detection, diagnosis, and management (Sabella, 2018)

[PubMed: 25680499] (Extensive review of liver injury due to HDS mentions that kava has been implicated in more than 100 cases of clinically apparent liver injury including 9 instances of acute liver failure, 3 of which resulted in deaths)

The IV line is prepared under sterile conditions