A mix-up in the tag numbers used to identify bodies led the D.C. medical examiner's office to release the wrong body to a District funeral home, which embalmed it and shipped it to a family in Central America several weeks ago.

Beverly Fields, a spokeswoman for the Office of the Chief Medical Examiner, acknowledged that the wrong body was sent and said the agency has since changed its practices as a result of the mistaken identification.

"We don't necessarily know what the actual mix-up was," Fields said. "We do know the wrong body was shipped by the funeral home."

The confusion involved the body of Oscar Javiera Rivera Ortiz, 35, who died Sept. 12 at Providence Hospital in Northeast, hospital sources said. He died from acute methadone intoxication, according to the medical examiner's office.

When Ortiz, who is Hispanic, was transferred to the city's morgue, his toe was tagged "05-2301." At some point he was put into a gray plastic body bag that was tagged with a similar number -- "05-2103" -- according to two sources familiar with the matter.

The decomposed body of an unidentified black man who was taken to the morgue Aug. 18 was tagged "05-2103." The body, one of about 75 unclaimed bodies the morgue receives every year, was put into a bag identical to Ortiz's that read "05-2301."

When Pope Funeral Home retrieved Ortiz's body from the morgue, neither the medical examiner's office nor the funeral home noticed that the toe tag on the body did not match the tag on the bag, sources said. A morgue employee released the decomposed body to the funeral home, which shipped it to Ortiz's family in El Salvador. The family buried the man, thinking it was Ortiz.

"What killed me is that they never verified that toe tag," said one of the sources, who said he could not be named because of confidentiality rules. "The bag and the toe tag numbers are supposed to match."

The mistake was discovered two weeks later by another technician who was asked to work on identifying the second man, Fields said. When the technician went to retrieve the body from the refrigerator, it wasn't there.

Once the medical examiner realized the mistake, Ortiz's family was contacted and the right body was shipped to El Salvador by another District funeral home Oct. 29. The mistake was reported Tuesday on WRC-TV (Channel 4).

Although the medical examiner's policy requires technicians and funeral homes to sign a form releasing and retrieving bodies, "obviously it broke down somewhere," Fields said.

"Everyone we talked to stated that they followed procedure," she said. "We weren't standing there with them. Obviously, there was some human error."

Alexander Pope, owner of Pope Funeral Home, did not return a call yesterday seeking comment. Pope's is one of several funeral homes that have contracts with the city to bury indigent people, according to Charles Young, who said he has worked for the funeral home for more than 40 years.

"I have made some mistakes, but not to the extent like this," Young said. "Stuff happens."

Fields said her office "enhanced" its policy on picking up and releasing bodies two weeks after the mix-up to ensure that it doesn't happen again. Now, employees and funeral homes must sign the toe tag, which requires opening the body bag to match the numbers, Fields said.

The mortuary technician who allegedly made the mistake is on sick leave. Fields declined to say whether disciplinary action will be taken against him.

Meanwhile, the body of the unidentified man remains buried in El Salvador while District officials and the Salvadoran government are sorting out who is responsible for exhuming the body and returning it to the United States, Fields said.