The three men, who were residents in Japan, were hospitalized 1 week after returning to Japan from a 4-day trip to China. When hospitalized, all three men had abdominal pain, constipation, and advanced hyper-excitability. Abdominal radiography and computed tomography revealed numerous foreign bodies in their stomachs. From these observations, they were suspected of drug poisoning. Soon after being hospitalized, one of the men fell into a coma and died. The death of this 39-year-old man was caused by acute poisoning from approximately 20 grams of methamphetamine hydrochloride that had leaked from the plastic packages into his stomach. His plasma MA concentration was 8.6 mg/ml when he was hospitalized (17 hours before his death). Autopsy findings showed extreme pulmonary congestion and edema as well as moderate hepatic edema and many petechiae in several organs. Quantitative analysis was performed with gas chromatography/mass spectrometry. High concentrations of MA and its metabolite amphetamine were found in cardiac blood (63.5 mg/ml and 1.2 mg/ml); urine (4,518 mg/ml and 72.4 mg/ml); gastric contents (8,490 mg/ml and 16.9 mg/ml); and in all other autopsy samples. These high concentrations confirmed that the cause of death was acute MA poisoning. Analysis of the MA smuggled by the three men indicated it originated from the same batch. The two men who survived, one with a severe case of MA poisoning and the other with a mild case, had 21 MA packages (292 g) and 5 MA packages (73 g), respectively. The man who died was carrying 35 MA packages (498 g). 1 table, 3 figures, and 19 references