An accidental prescription drug overdose killed Anna Nicole Smith last month, the medical examiner who performed her autopsy said Monday.
Dr. Joshua A. Perper, the Broward County medical examiner, said he found traces of many drugs in Ms. Smith’s body, including muscle relaxants, pain relievers like methadone and several anti-anxiety medicines. Dr. Perper described her cause of death as combined drug intoxication, the primary drug being the potent sedative chloral hydrate.
An intestinal flu and a bacterial infection, possibly from an injection with a contaminated needle, were contributing factors, Dr. Perper said during a news conference in Dania Beach. No illegal drugs were found in her system.
A private nurse found Ms. Smith, a former Playboy centerfold, model and reality television star, unconscious on Feb. 8 in her suite at the Seminole Hard Rock Hotel and Casino in Hollywood. After several resuscitation attempts, she was pronounced dead that afternoon at a nearby hospital.
Ms. Smith was 39 and still mourning her son, Daniel, 20, who died from a lethal drug combination last September, days after Ms. Smith gave birth to a daughter, Dannielynn.
Dr. Perper ruled out suicide as a cause. He said that according to her friends, Ms. Smith was in “outstanding general spirits” in the days preceding her trip from the Bahamas to South Florida for what was to be a four-night stay. Before leaving the Bahamas on Feb. 5, she even had a dance lesson in preparation for a music video and an event for TrimSpa, a diet supplement she was paid to promote.
Chief Charlie Tiger of the Seminole Police Department said he had found no evidence of foul play.
Dr. Perper would not identify the doctors who prescribed Ms. Smith the various medications, saying it was a private matter. But he did say that on the night she arrived in South Florida, Ms. Smith had a fever of 105, probably because of the infection she had from injecting “longevity drugs” — a combination of vitamin B12, immunoglobulins and human growth hormone — into her buttocks.
Ms. Smith refused to go to the emergency room that night; instead, she broke her fever in an ice bath, took antibiotics and flu medicine and went to sleep. She regained her strength over the next few days, Dr. Perper said, but kept taking chloral hydrate, a drug that was popular in the 19th century but is rarely prescribed these days, to get to sleep at night.
“When many drugs act together,” he said, “they may often have unpredictable and dangerous effects.”
After Ms. Smith’s death, a court fight raged in Broward County over who should have control of her remains: her companion at the time of her death, Howard K. Stern, or her mother. A judge ultimately gave custody of her body to the court-appointed guardian for her infant daughter, who had Ms. Smith buried next to her son in the Bahamas.
Court battles persist over who Dannielynn’s biological father is and whether she is entitled to part of the estate of Ms. Smith’s former husband, a Texas oil billionaire who died in 1995.
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