A visually impaired refugee found dead on the cold streets of Buffalo, New York died from complications from an ulcer precipitated by hypothermia and dehydration, according to a medical examiner.
The manner of death was homicide, according to the report from the Erie County Medical Examiner’s Office.
Nurul Amin Shah Alam, a 56-year-old Rohingya refugee from Myanmar, was picked up by Border Patrol agents from a local jail and dropped off outside a Tim Horton’s coffee shop on February 19. He wasn’t seen again until five days later, when a woman called 911 to report his body on the street more than five miles away.
The medical examiner’s report “confirms our understanding that Shah Alam was placed into a hostile environment” from which he could not remove himself, according to Terrence M. Connors, who is representing his family.
“Border Patrol had the ability to place him in a non-hostile environment so that is why the medical examiner designated the manner of death as homicide,” he told The Independent.
A determination of homicide indicates a death that resulted from the volitional act of another, which includes negligent acts or omissions, the medical examiner clarified.
The designation does not necessarily suggest an intent to cause harm or death.
An ulcer formed when hypothermia set in and decreased his blood flow, weakening the lining of his intestines, while dehydration built up stomach acid that eroded his digestive system, according to Dr. Gale R. Burstein, Erie County’s health commissioner
“The symptoms of a perforated ulcer are severe pain,” she said during a news conference Wednesday. “It’s a medical emergency.”
Erie County District Attorney Mike Keane said his office is reviewing the autopsy report and other medical records.
“We are committed to seeking the truth and upholding justice,” he said in a statement shared with The Independent.
“While I recognize the demand for answers sought by Mr. Shah Alam’s family and our community, it would be inappropriate to comment on the specifics of the autopsy report or the status of any investigation,” he said. “I appreciate the public’s interest in this case and their continued patience while our review remains ongoing.”
New York Governor Kathy Hochul, a Buffalo native, pledged that “every individual involved in the death of Mr. Shah Alam must be held fully accountable.”
The death of Shah Alam, who was nearly blind and spoke only little English, shocked Buffalo’s Rohingya community and outraged residents and advocates who have raised alarms for months about the conditions of vulnerable immigrants, refugees and their families.
The office of New York Attorney General Letitia James is continuing to review legal options, and members of Congress are demanding investigations.
“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,” James said in a statement. “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.”
Homeland Security said his death “has NOTHING to do with Border Patrol” and pointed to his “serial violent criminal rap sheet.”
“Another hoax being peddled by the media and sanctuary politicians to demonize our law enforcement,” according to a statement from Customs and Border Protection.
Shah Alam and his wife spent 20 years in Malaysia, where they raised their five sons while waiting for safety and stability after fleeing violence and persecution in Myanmar.
In 2014, they applied for resettlement in the United States. After 10 years of waiting, they arrived in the country as refugees in December 2024.
But the family was split up; the couple’s three oldest sons, because they were adults, applied separately. Trump effectively froze refugee admissions immediately after taking office, stranding Shah Alam’s three eldest sons in Malaysia.
Two months after the family entered the U.S., on the morning of February 15, 2025, he had wandered into a person’s backyard in the Riverside neighborhood. He was arrested and charged with assault and trespassing.
His bail was lowered to $5,000, but Shah Alam’s family decided to keep him in the jail where they could visit him, fearing that Immigration and Customs Enforcement would pick him up and send him to a detention center outside of Buffalo, or deport him, should he be released.
He spent the next year in jail.
In February, he agreed to plead guilty to reduced charges of criminal possession of a weapon in the fourth degree and one count of criminal trespass in the third degree, according to the district attorney’s office.
His sentencing was scheduled for March 24.
On February 19, sheriff’s deputies at the Erie County Holding Center handed him over to Customs and Border Protection officers, according to a timeline from the Buffalo Police Department.
Keane, the district attorney, was not aware of his release into immigration custody until the day he died, he said. His family was never contacted.
When Border Patrol agents picked him up, they shortly realized he wasn’t supposed to be deported.
Officers instead offered him “courtesy ride” to a Tim Horton’s coffee shop, which was “determined to be a warm, safe location near his last known address,” according to a statement from the agency.
The coffee shop was closed, and video surveillance footage does not show him entering the shop. It appears he wasn’t wearing shoes, only the orange booties that were issued by the jail.
His family filed a missing person’s report, and police and community members began canvassing the area.
On February 25, a woman called 911 to report an “unresponsive male,” roughly five miles south from where he was dropped off by border agents.
In her first public remarks after his death, Shah Alam’s widow Fatimah Abdul Roshid said she remains heartbroken that she could not be with him as he died alone.
“On his dying bed, I couldn’t even see him,” she said. “I didn’t even know how he was. I didn’t know where he was. That’s what breaks my heart. That’s the regret that will last forever.”
