The Tucson Police Department, Tucson, AZ, has begun using the Polyshok Impact Reactive Projectile (IRP), a new type of shotgun ammunition that includes a lead bead core that travels within single, plastic-encased projectile. On impact, the core is released to distribute over a small area, thereby disintegrating on impact to reduce the likelihood of exit or collateral damage on missed shots. After a brief review of shotgun slug ballistics and wound characteristics and a discussion of the mechanism of the Polyshok IRP, we report the first death in the United States from this ammunition. Findings included a single entrance wound with plastic ammunition components and small lead particles recovered from the body, the combination of which normally would suggest a close-range shooting with birdshot. However, the characteristics of this ammunition create different patterns than are found with slugs or shot, so that a medical examiner unfamiliar with the Polyshok IRP could draw inaccurate conclusions about ammunition and range of fire. Because the single projectile fired from this ammunition is composed of both plastic and lead, plastic components are likely to be found within the wound at any range of fire, unlike traditional shot or slug ammunition. Also, the small size of lead particles found spread through the wound cavity would ordinarily suggest a small-size shot, whereas the external appearance of the wound (a single entrance with no dispersion of shot) and the pattern of tissue destruction are more consistent with the patterns of injury associated with shotgun slugs.