Based on the Tabinid maggots' pupal casing, Hodgins determines that Nestor ingested a heavy dose of ketamine, a dissociative anesthetic, before he died. However, the team cannot be certain if the boy had taken the drug involuntarily but Dr. Brennan is able to give a scenario of Nestor's death involving the ketamine. Combined with the ketamine, the choking would have caused Nestor to regurgitate stomach acids, which would have been trapped in the throat and weakened the hyoid bone. The weight of Nestor's body could then break his hyoid.