Not surprisingly, acetaminophen remains a major cause of overdose and overdose-related liver failure and death in the United States and many other countries [ 12,18 ]. If overdose is identified early enough, mortality rates are extremely low. However, once acute liver failure has developed, morality is approximately 28 percent, and a third of patients require liver transplantation [ 19 ]. A national network established in 1998 to track cases of ALF in the United States found that nearly half the episodes of ALF are attributable to acetaminophen [ 13,20 ]. Data from this group demonstrate that intentional (suicidal) and unintentional (chronic) poisonings account equally for cases of acetaminophen-associated hepatic failure [ 13,20 ].