A17“Sounded like someone was skinning a live cat,” the neighbor told us. She sniffed, wiping her eyes. “Then loud crashing and banging, then… everything went quiet. I waited a while, didn’t hear nothing more, so I went and checked and found him dead on the floor.” 

I was in my first year of coroner understudy and shadowing my mentor, senior coroner Barbara McCormick. We were in the kitchen of a tiny suite on the poor side of town, standing over this skinny, old guy who was in a semi-fetal position with one arm wrapped around his abdomen and his other hand clutching his throat. I’ll never forget his wide-open eyes or the gritting grimace of teeth—the expression of excruciating pain etched in a cold, deathly stare.

“Heart attack or brain aneurysm, Barb?” I asked, ready to flip a coin. I was new to the coroner service, but no stranger to dead bodies after a career as a homicide cop. There was zero sign of foul play at this scene and my experience told me people only drop dead from one of these two natural events.

A19Barb was bent over, starting the head-to-toe examination that coroners do before removing a body for a thorough autopsy back at the morgue. “Wouldn’t bet on either.” Barb was trying to pry his jaw for a look down the throat. “Check his color. Blue-gray. He’s asphyxiated. I’m thinking he might have choked on something but, for the life of me, I don’t know how he could let out a curdling cat-scream if something was stuck in his yap.”

While Barb was messing with his head, I snooped around. It was typical digs for a single pensioner—a bachelor suite crammed with junk. Empty booze bottles and overflowing ashtrays testified to a lifestyle that suggested he should be dead of something by now. I checked for meds, which was routine. The pathologist would want to know what was likely in his system and the toxicology lab would want it for sure.

A20I found the usual pill vials indicating treatment for coronary and respiratory ailments that heavy drinkers and smokers all have. The place was relatively clean, although cluttered, and didn’t reek of garbage and bodily waste like most of these places do. I saw a part-eaten sandwich on the table and a freshly cracked beer—seemed like the old boy was doing lunch when violently seized by the death monster and taken down hard to the mat.

Barb stood up, looking puzzled. “I have no idea. Should be an interesting postmortem.” We finished photographs, bagged the man, then stretchered him out to the transport van and drove him off to the morgue.

We’d recorded his personal details, which is part of a death investigation, but his real name never stayed with me. Most are like that. In the death business it’s not a good idea to get too close to your clients, but some you never forget because of how they checked out.

A15It’s normal—in black humor behind the scenes—for coroners to name their files by earned handles. I’ll always remember Capn’ Crab Bait, Voltage Vern, Methlab Mikey, Arachnoid Ann, Lawn Tractor Guy, Tarzan of the Caterpillars, Freight Train Ference, The Krosswalk Kidd, The Drill Sergeant, Pole Dancer, Cats-Sup, and… as long as I live… I’ll never forget The Electric Carving Knife Lady.

And, it came to pass, I’ll also never forget the dead little man we’d just rolled into the cooler. 

Next morning my favorite pathologist, Dr. Elvira Esikanian, was on the roster to autopsy our guy from the kitchen floor. I loved dealing with Elvira. She’s Bosnian with a wicked sense of dry humor and an equally wicked curriculum vitae, including exhuming mass graves for the UN and serving in some of the busiest morgues around the world where she’d often do a dozen different cuttings per day.

A21Although Elvira was exceptionally thorough, she was a go-to-the-throat prosector. She’d assess the circumstances, then head straight to the most likely cause.

“I’m suspecting an acute respiratory event,” Elvira stated. “Note the petechiae in the eyes.” She pointed to pricks of blood in his whites. “We normally see petechiae in cases of sudden and severe loss of oxygen, such as in strangulation, although on this man I see no sign of exterior trauma.”

We Y-incisioned the thorax/abdominal cavities and began removing organs.

A16“His lungs are clear, with the exception of tobacco effects.” Elvira had cross-sectioned them. “And his airway is unobstructed. This man did not choke, nor was he suffocated by fluid.” She examined the heart, which showed expected signs of advanced coronary artery disease. “And he did not suffer a heart attack.” Elvira placed the gastro-intestinal tract in a plastic tub and set it aside on her bench.

She proceeded straight to a cranial exam, inspecting for the tell-tale bleed of a cerebral hemorrhage. “Nothing obvious here.” Elvira put the brain in a stainless bowl. “You indicated this man was eating lunch when he expired.” She looked at me. I nodded. She reached for her plastic tub. “I’m going to examine the stomach.”

A22For most pathologists and coroners, digging in the digestive tract is the most unpleasant part of the job. It was no different with this man. Elvira incised the stomach and poured its contents into a clear, glass tray. She flipped on her magnifiers and bent a gooseneck light overtop. Immediately, she let out a wolf-whistle. “Look at this!”

To me, it was a messy slime-goo of chewed bread mixed with some rude and red, pasty substance.

To Elvira, it was the smoking gun.

A25I watched Elvira excise a culture, fix it in a slide, and examine it under her microscope. “Have a look.” She directed me to the eyepieces.

What I saw was a squiggling biological mass of sub-terrain aliens—looking out-of-this-world like agitated, animated, turquoise tampons breathlessly mingling in a magnified mess of greenish-gray snot.

I swear they had heads, horns, and hoofs.

Clostridium  Botulinum,” Elvira announced. “Botulism. I’m sure this man died from the deadliest food poison known.” 

Now, I’d heard of botulism. Everyone has. That’s why my mum would sniff the tin cans when she opened them and why she’d boiled preserves for four hours. But this was the first time I’d seen a real case of botulism.

A12“We won’t know the strain or the severity level until we get toxicology results but I can tell you, given how quickly this poor fellow expired, it must be an extremely toxic ratio.” Elvira went on. “What happens is the neurotoxin produced by the botulinum bacteria acts as a blocking agent preventing neurotransmitters from issuing instructions to the muscles. Once this poison hit his system, every nerve in his body would have felt on fire and he’d quickly fall into total paralysis. That would soon stop his lungs and he’d fall into a state of anoxia, or lack of oxygenated blood to the brain. He’d be conscious throughout and would feel everything… but would be unable to react.”

She glanced at the cut-open cadaver on her examining table. “What a positively excruciating way to die.”

A8Barb McCormick already had her digital camera out and was scrolling through shots from the scene. “This might be it.” Barb enlarged a photo showing the kitchen. Evident was a jar with its top off, containing a reddish substance.

Realizing the lethality of the situation and the danger to others, Barb and I immediately went back to the apartment. There, on the counter, was a jar of red pepper paste with a label indicating it originated in China and was far past its expiry date. A tag showed it’d been purchased at the Dollar Store.

Cautiously, we peered inside.

And—I’m here to tell you—that red, peppery, pasty scum was actually moving.

A26It took over a month for the toxicology results to come back. They proved positive for Botulinum toxin—Type E—and the dosage was staggering.

Toxicology measures the presumed lethal dose of a substance in digital units of LD50/ (mg/kg) which translates to the Lethal Dose (LD) required to kill half of the tested laboratory animals in a controlled volume and time.

The LD for Botulinum toxin is 0.00001. Our red pepper paste man’s reading was over 0.02000—two thousand times the amount needed to kill a human being.

*   *   *

A27It’s been a few years since the red pepper paste case and I thought I’d review the pathology around Botulinum toxin. Here’s a quote from a paper by the World Health Organization on the medical process of how botulism works on the human body:

To understand the role of Botulinum toxin, it is necessary first to understand how the brain initiates a muscle contraction as it is in this process that Botulinum toxin intervenes.
Muscles are connected to the brain by the nervous system which is a complex network of neurons – these are long cells that can pass information using either electrical or chemical signals. Chemical signals pass between neurons and muscles through synapses, which are specialized connections linking cells. The chemicals that are used to pass these messages are called neurotransmitters.
A30In the case of a muscle contraction, the chemical signal is passed using a neurotransmitter called acetylcholine. This sits in the neuron in a vesicle, a small bubble surrounded by a membrane, until it is required. When the neuron receives a message from the nervous system to initiate a muscle contraction, the acetylcholine is released from the vesicle and passes through the synapse into the muscle fiber.
To achieve this, the vesicles need to be transported to, and fuse with, the neuron membrane that adjoins the synapse between the nerve and the muscle. This process is controlled by a group of proteins called the SNARE complex.
A29The three main proteins involved are Syntaxin (which connects to the nerve membrane), Synaptobrevin (which connects to the vesicle) and SNAP-25 (which helps the other SNARE proteins link up). These proteins join together to cause the vesicle to move to the nerve membrane and fuse with it. The acetylcholine can then be released across the synapse and pass into the muscle. This then triggers a chain of events that causes the muscle contraction.
Botulinum toxin prevents the release of acetylcholine through the synapse.
Botulinum toxin is produced by a bacterium called Clostridium Botulinum. This bacterium is associated with causing botulism, a rare but deadly form of food poisoning.
A33Botulinum toxin is exceptionally toxic but, when purified and used in tiny, medically controlled doses, it can be used effectively to relax excessive muscle contraction and is now commonly used in cosmetic surgery.

Hmmm… BOtulinum TOXin… BoTox. 

A23The same gruesome stuff in the red pepper paste that painfully killed our old man is commonly stuck into people’s faces to make them look younger and pretty.

I’m sure, for the most part, BoTox injections are perfectly safe. But… if you’re thinking of cosmetically shedding some years, remember the Excruciating Death of Mister Red Pepper Paste Man.


  1. John Lawe

    Garry, thoroughly enjoyed this post. I knew little of food poisoning and found this fascinating. One great reminder I found in your post was the value of the initial crime scene photos. They often offer the opportunity to quickly spot an item that hadn’t caught anyone’s attention during the initial visit. Thanx, John

    1. Garry Rodgers Post author

      Thanks for stopping by, John. It’s always nice to connect with others from a criminal investigation background. I’d say you’re about the same vintage as me and have seen a lot of technology changes in law enforcement over the years. Digital photography is a huge bonus over the 35mm print film we used when I started. It took forever to get the film developed and by then evidence could be lost or neglected to be followed up on. Today, it’s instantaneous. One of my last cases as coroner was some bones found in a rural area and I was uncertain if they were human or animal. I snapped some digital photos and emailed them right from the scene on my smartphone to a forensic archaeologist and had the answer in minutes – and, no, they weren’t human.

      BTW, I had a peek at your website — — it’s very professional. Nice job & well done!

    1. Garry Rodgers Post author

      Hi June! Thanks for stopping by. You know, ever since I met Mister Red Pepper Paste Man I’ve been paranoid about botulism. Once you’ve peered into a jar and watched a microbic ant-hill at work, you never look at preserved foods the same way. 🙂

  2. Julie Holmes, author

    So love this! I love how you step through the process from assessing the dead body on scene to the autopsy, and the discovery of the fatal food spread. And the explanation of why botulism toxin is so deadly is enlightening. Thanks, Garry!

    1. Garry Rodgers Post author

      Great! Thanks for commenting, Julie. You know, in all my time as a cop and a coroner this is the only food poisoning death I can recall. Botulism deaths are really rare but when they happen, the mechanism of death is horrific.

  3. Sue Coletta

    Wow, Garry. That’s serious stuff. Why people do Botox, I have no idea. I’ve yet to see one person who looks natural after a procedure. No thank you. And now, after reading this case, my answer is hell, no! LOL

    1. Garry Rodgers Post author

      I got no idea either, Sue. In fact, I had no idea the brand name “BoTox” came from botulinum toxin. It wasn’t until I was researching this article that I was shocked to put 2 + 2 together. Makes me wonder who the first person was who thought “Hmmm, might be a good idea to inject a syringe full of botulism into my crow’s feet. That oughta fix things!”

          1. Craig Scott

            I may not be in law enforcement, but many in my family, including my Dad, were “on the Force” (back when they were called “polices forces” and not “police services”). I can definitely attest to the dark humour as a defense mechanism. I had no choice but to pick it up, which certainly made for interesting times with my high school counselor. 🙂

          2. Garry Rodgers Post author

            Yeah, some of the things that are said and go on behind the crime / death scenes would horrify the politically correct such as those that rename institutions in the fear that someone might be offended. I spend a lot of time at a nearby public university library and just noticed yesterday that they changed the sign on the “Smoking Area” shack to “Dedicated Tobacco Usage Facility”. Thing is – it’s not just a Sharpie on cardboard or an erasable on whiteboard – I’ll bet those new signs cost a least a grand and ultimately, as a public funded institution, you know who’s paying for them. Thanks for giving me a reason to rant, Craig. I try to keep it clean around here for fear of offending someone 😉

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