Sudden Death Due To Acute Cocaine Toxicity—Excited Delirium in a Body Packer

Excited delirium denotes a life‐threatening medical condition characterized by the acute onset of agitated and violent behavior that often results in a sudden and unexplained death. Cocaine‐induced excited delirium refers to fatal cocaine intoxication with the following symptoms occurring sequential...

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Bibliographic Details
Published in:Journal of forensic sciences 2015-11, Vol.60 (6), p.1647-1651
Main Authors: Shields, Lisa B. E., Rolf, Cristin M., Hunsaker, John C.
Format: Article
Language:English
Subjects:
body packer
Cocaine
Delirium
excited delirium
Forensic pathology
forensic science
sudden death
Toxicity
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Summary:Excited delirium denotes a life‐threatening medical condition characterized by the acute onset of agitated and violent behavior that often results in a sudden and unexplained death. Cocaine‐induced excited delirium refers to fatal cocaine intoxication with the following symptoms occurring sequentially: hyperthermia, delirium with agitation, respiratory arrest, and death. We present a case of cocaine‐induced excited delirium in a cocaine “body packer” or a “mule”, specifically an individual who attempts to smuggle cocaine within the body. Investigators at the scene initially suspected homicide due to the victim's sharp and blunt force injuries. Three rubber packets containing cocaine were removed from the victim's rectum. Blood toxicological analysis revealed an alcohol concentration of 0.016 g/100 and cocaine >1 mg/L. The forensic pathologist should consider cocaine‐induced excited delirium when an individual exhibits aggressive behavior, unexpected strength, and resistance to pain who dies suddenly. Further analysis should be performed during the scene investigation and autopsy for evidence of body packing.
ISSN:0022-1198
1556-4029
DOI:10.1111/1556-4029.12860