Norton, 75, a renowned film fight choreographer and martial artist, died at the Alfred hospital in Melbourne on March 30, 2025. The coroner found that Norton suffered a cardiac arrest after injecting prescribed but unapproved peptides CJC1295 and ipamorelin. Ryan recommended that the TGA consider shifting these peptides from Schedule 4, which allows prescription use, to Schedule 10, which restricts them to clinical trials or experimental use. “It is not clear to me how their safe use can be clinically indicated given the acknowledged uncertainties as to their therapeutic benefit and their risks… to the safety of patients,” Ryan said.
The timeline of Norton’s final days reveals a progression of treatment and adverse reaction. In March 2025, Norton consulted Dr. Jerzy Muchnicki regarding peptide therapy. The coroner’s report notes that the two discussed the experimental nature of the treatment, potential risks, and the lack of TGA-approved alternatives for Norton’s fatigue, shoulder pain, and loss of muscle mass. Following baseline blood tests and an informed consent process, Muchnicki prescribed CJC1295 and ipamorelin injections on March 19. Norton reported feeling improved one week later but was found by a nurse on March 28 to be administering double the prescribed doses. The nurse advised him to return to the prescribed dosage. Shortly after injecting the peptides on the same day, Norton reported feeling hot and flushed before becoming unresponsive.
Dr. Muchnicki was subsequently investigated by the Medical Board of Australia. An independent expert determined that there was insufficient evidence that CJC1295 or ipamorelin is safe, effective, or beneficial for human use. The expert also criticized the doctor’s clinical notes as “sparse, inadequate and perfunctory,” stating they fell below the expected standard. Muchnicki accepted accountability for his actions and expressed sorrow for the impact on Norton and his family. He pledged to stop prescribing peptides unless supported by robust clinical evidence. While the board did not pursue further regulatory action against the doctor, it mandated that Muchnicki undergo one-on-one training for clinical record keeping and management.
Peptides are increasingly promoted online for weight loss, muscle growth, anti-aging, and performance enhancement. The TGA has previously warned consumers about the risks of importing and using unapproved peptides. The coroner’s findings now place formal pressure on the TGA to potentially reclassify these substances, limiting their availability to strictly controlled research environments rather than general medical practice. The TGA has not yet announced a decision on whether to adopt the coroner’s recommendation to move these peptides to Schedule 10.
