Intentional heroin administration resulting in homicide in a 10-month old infant

Homicide occurs in approximately one in five injury-related deaths among infants in the United States and studies suggest that male caretakers (fathers or mothers' intimate partners) are the perpetrators of the majority of infant homicides. Opioid abuse is common and it is estimated that between 26.4 million and 36 million people abuse opioids worldwide. In this case report, we add to the literature the first reported homicide by intentional heroin administration in a 10-month old infant. Toxicology revealed morphine 1092 ng/L, codeine 74 ng/mL, and 6-monoacetyl-morphine 359 ng/L in cardiac blood. Morphine 803 ng/g, codeine 54 ng/g in liver tissue, and morphine 181 ng/mL was found in vitreous humor. With the prevalence of opioid abuse on the rise accidental opioid ingestions in the pediatric population have increased. However, forensic personnel must recognize the possibility of intentional poisoning in this vulnerable population.