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Fatal "crack" cocaine ingestion in an infant
1University of New Mexico School of Medicine, Department of Pathology, Albuquerque, 87106, USA.
Insights
A 10-month-old infant died from cocaine poisoning after ingesting crack cocaine. This rare case highlights the dangers of child neglect and accidental drug exposure in young children.
Area of Science:
- Forensic toxicology
- Pediatric pathology
- Child endangerment
Background:
- Cocaine exposure in infants is typically through passive inhalation.
- Cocaine ingestion is rarely documented in children under five.
- Fatalities from cocaine ingestion in this age group are unreported.
Observation:
- A 10-month-old infant presented with apnea and ventricular fibrillation after alleged rat poison ingestion.
- Autopsy revealed crack cocaine in the infant's duodenum and high cocaine concentrations in specimens.
- The infant's brain showed a thinned corpus callosum, potentially linked to prenatal cocaine exposure.
Findings:
- The infant died due to cocaine poisoning, with ingestion confirmed by duodenal crack cocaine and high blood levels.
- The manner of death was classified as homicide due to willful neglect and delayed medical care.
- This case represents the first reported death from crack cocaine ingestion in an infant.
Implications:
- This case underscores the critical need for awareness regarding the risks of illicit drug accessibility in households with young children.
- It highlights the severe consequences of child neglect and the importance of timely medical intervention.
- Further research into the long-term neurological effects of prenatal and postnatal cocaine exposure in infants is warranted.
Abstract:
This report describes a 10-month-old infant girl who died of cocaine poisoning. The infant was found apneic and in ventricular fibrillation after the parents summoned rescue personnel and claimed she had ingested rat poison. The parents later admitted that 2 hours before calling for assistance, the infant's 2-year-old brother was found eating "crack" cocaine and also feeding it to the infant. Investigators found "crack" cocaine throughout the house and in the infant's crib. At autopsy, the infant had two pieces of "crack" cocaine in the duodenum. The brain exhibited a markedly thinned corpus callosum. Toxicologic examination showed high concentrations of cocaine in the blood and in other specimens. The manner of death was classified as homicide because the infant was willfully placed in a hazardous environment with an easily accessible toxic substance, medical attention was deliberately delayed for 2 hours, and medical personnel were deceived when they were falsely told she had ingested rat poison. These features were thought to constitute neglect. The toxicologic characteristics of this case are unique. There are numerous reports of passive cocaine inhalation in infants and children less than 5 years of age, but ingestion of cocaine in this age group has rarely been documented. This age group also has no reported deaths due to cocaine ingestion and no cases of "crack" cocaine ingestion. The high concentrations of cocaine seen in this case, combined with the "crack" cocaine found in the duodenum, indicate ingestion as the route of exposure. The thinned corpus callosum in this case may be a consequence of intrauterine cocaine exposure.