Erie County Medical Examiner's Office deems Alam's death a homicide

The Erie County Medical Examiner's Office has released an official cause and manner of death of Nurul Amin Shah Alam, a visually impaired Rohingya refugee who died on the streets of Buffalo five days after being released at a closed coffee shop by Border Patrol.

"The Erie County ME’s Office determined that in this case, the cause of death was complications of a perforated duodenal ulcer precipitated by hypothermia and dehydration, and the manner of death was homicide," the release said.

Erie County Health Commissioner Dr. Gale Burstein clarified that homicide, for death certificate purposes, is a death resulting from the volitional act of another, which includes negligent acts or omissions.

"The manner of death determinations are neutral, so they're non-legal and they exist for vital statistic purposes only. They do not indicate criminality, which is the purview of the judicial system."

Full autopsy reports in New York State are not allowed to be released directly to the general public, according to Erie County Executive Mark Poloncarz. Alam's family was given a copy, but further releases can only happen with a judge's approval.

Poloncarz said this is frustrating, because the circumstances of Alam's death and life for Rohingya refugees has become part of national conversations.

"It should not have happened," he said. "Simple as that. The death was one that we believe could have been prevented."

The Erie County District Attorney's Office has requested a copy of Alam's autopsy, and DA Mike Keane said his office will review its findings and other medical records.

"We are committed to seeking the truth and upholding justice. As the District Attorney, I must preserve the integrity of the investigative process to ensure a thorough and impartial review of all evidence in this matter," Keane said in a written statement. "I appreciate the public’s interest in this case and their continued patience while our review remains ongoing.”

A perforated duodenal ulcer is one that would have required quick and intense medical care, said Burstein.

"We call it a stress ulcer, and that basically bores a hole into the wall of the in this case, duodenum, and then, as the acid continues to flow out, the wall becomes deeper and deeper, until finally it perforates, [it] bursts open," said the county health commissioner. "All that acid and other digestive secretions spill out into the perineum, into inside the individual's belly. And that is a medical emergency. And if that is not repaired in a short period of time, it can cause death."

When Alam's death first became public in February, the Buffalo Police Department had originally said homicide was ruled out, and cited the medical examiner's office. However hours later, the medical examiner publicly refuted that assessment, saying their work was still ongoing in determining cause and manner of death.

New York Attorney General Letitia James released a statement following the autopsy findings:

“My heart is with Nurul Amin Shah Alam’s loved ones today, as it has been since we first learned of his tragic death. Mr. Shah Alam fled genocide to build a life in this country. Instead, he was abandoned and left to suffer alone in his final hours. No New Yorker should be treated this way. My office is continuing our review of the circumstances and treatment that led to Mr. Shah Alam’s death.”

Governor Kathy Hochul also weighed in on X, calling the events surrounding Alam's death a "failure of basic humanity."

Alam, 56, arrived in Buffalo under legal refugee status in December of 2024 before he was taken into Erie County custody in February 2025 following a trespassing incident in Buffalo's Riverside neighborhood. Alam, who spoke little English, was turned over to Border Patrol on Feb. 19, 2026, when officers dropped him off at a Tim Hortons on Niagara Street that already had closed for the evening.

Alam's body was found on Perry St. — five miles from where he was dropped off — on Tuesday, Feb. 25.