A report by doctors at New York’s Bellevue Hospital describes how 11 young people—10 of them under the legal drinking age of 21—were rushed to the emergency room after drinking the “alcopop” Four Loko. Some of the patients ended up in potentially deadly situations, according to NY1. One patient fell onto the subway tracks, another was unconscious at school, and a third was found alone in a park.

Four Loko and similar fruit-flavored alcoholic beverages contained caffeine at the time of the incidents. Last November, the Food and Drug Administration warned the makers of seven caffeinated alcoholic drinks, including Four Loko, that their products are a public health concern and cannot stay on the market as currently formulated. In late 2010, Four Loko’s manufacturer agreed to remove caffeine from the drink. However, other caffeinated alcoholic drinks remain on the market, according to a news release from the Annals of Emergency Medicine, which published the report.

The doctors note that the combined effect of caffeine with alcohol causes increased alertness and decreased awareness of physical impairment, a state known as “wide-awake drunk.” They said although Four Loko and many similar drinks no longer contain caffeine, they continue to be concerned about their high-alcohol content, and their attractiveness to young people.

Four Loko and another alcopop called Joose, contain 12 percent alcohol in a 23.5-ounce can—two to three times the amount of alcohol in beer, and about the same as a bottle of wine, according to NY1.

New York City Health Commissioner, Dr. Thomas Farley, told the news station, “These alcopops are particularly appealing to the younger teenagers. So among eighth graders who drink, three-fourths of them are drinking alcopops. It is particularly common among 14-year-olds and 15-year-olds.”