ISSN: 0022-1198
CODEN: JFSCA
Page Count: 6

Heroin Body Packing: Three Fatal Cases of Intestinal Perforation
Williams, AW
Assistant medical examiner, deputy regional medical examiner, assistant medical examiners, and regional medical examiner, Regional Medical Examiner Office, Edwin H. Albano Institute of Forensic Sciences, NJ

Natarajan, GA
Assistant medical examiner, deputy regional medical examiner, assistant medical examiners, and regional medical examiner, Regional Medical Examiner Office, Edwin H. Albano Institute of Forensic Sciences, NJ

Hutchins, KD
Assistant medical examiner, deputy regional medical examiner, assistant medical examiners, and regional medical examiner, Regional Medical Examiner Office, Edwin H. Albano Institute of Forensic Sciences, NJ

Zaretski, L
Assistant medical examiner, deputy regional medical examiner, assistant medical examiners, and regional medical examiner, Regional Medical Examiner Office, Edwin H. Albano Institute of Forensic Sciences, NJ

Pierre-Louis, PJB
Assistant medical examiner, deputy regional medical examiner, assistant medical examiners, and regional medical examiner, Regional Medical Examiner Office, Edwin H. Albano Institute of Forensic Sciences, NJ

Lin, RL
Chief toxicologist, State Toxicology Laboratory, Edwin H. Albano Institute of Forensic Sciences, NJ

(Received 24 March 1999; accepted 24 May 1999)

Abstract

Death from heroin body packing has been well described in the forensic literature. Most fatalities are due to drug leakage and consequent acute heroin toxicity. Recently, drug traffickers have become more sophisticated in their packaging, and the risk of rupture of drug packets is more remote. Though intestinal obstruction is a recognized risk of body packing, rarely has this resulted in death. We describe four cases of heroin body packing presenting to the Regional Medical Examiner Office in New Jersey. Death in three of these cases was due to intestinal obstruction, with resultant intestinal rupture and peritonitis. Toxicologic evaluation in these three cases was negative for opiates or other drugs of abuse. In one case, death was due to acute heroin toxicity, validated by toxicologic analysis. We briefly discuss the differing drug packaging found in these four cases and the ramifications of packaging as it relates to intestinal obstruction.

Keywords:
forensic science, forensic pathology, heroin body packer, mule, intestinal obstruction, intestinal perforation, drug smuggling, death

Paper ID: JFS14639J
DOI: 10.1520/JFS14639J
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