Six weeks after Anna Nicole Smith's death, the Broward County, Florida, chief medical examiner announced on Monday (March 26) that the former model died of an accidental drug overdose attributed to a combination of prescription drugs that were in her system at the time of her death.
Seminole tribal police Chief Charlie Tiger said there was no evidence of foul play and the case is now closed.
Smith was pronounced dead on February 8 after being found unconscious in her hotel room at the Seminole Hard Rock Hotel & Casino near Hollywood, Florida (see "Anna Nicole Smith Dead At 39 After Collapsing At Florida Hotel").
While the accidental overdose is clear, exactly which drugs caused her death is not evident. Broward County Chief Medical Examiner Joshua Perper said Smith had nine different prescription drugs in her system at the time of her death, including three anti-anxiety medications, the antihistamine Benadryl and the drug thought to have been the main culprit in her death, the prescription sleeping medication chloral hydrate.
Prior to Perper's announcement in February, reports surfaced that police had found both illegal and prescription drugs in Smith's Florida hotel room, though Tiger said at the time that only prescription drugs had been found at the scene and that there was no evidence that any crime had occurred. He reiterated those findings on Monday during a press conference, after reviewing hundreds of hours of videotape and analyzing the contents of the computer belonging to Smith's longtime companion, Howard K. Stern.
Perper said the combination of drugs was the likely cause of Smith's death, but there was also evidence that a high fever she had suffered from in the days prior to her overdose was caused by an injection of a "longevity" medication that could have been human-growth hormone, vitamin B-12 or immunoglobulin. He explained that the autopsy revealed evidence that Smith had previously made injections into her buttocks, which showed signs of multiple abscesses, and that an injection she made prior to her trip might have ruptured an abscess and caused an infectious agent to enter her bloodstream.
Perper said interviews with members of Smith's entourage revealed that while she was traveling to Florida from the Bahamas on February 5, Smith was in good spirits and took a dance lesson, but complained of a pain in her buttocks when sitting down, likely tied to the infection caused by the injection. She then reported feeling very cold and having the chills, but refused to go to the hospital despite a 105-degree fever. She was given an antibiotic, put in a tub of ice to lower her fever and given some chloral hydrate to help her sleep.
Smith's temperature didn't spike again over the next few days, but she did report feeling weak on the morning of her death, Perper said, and the investigation didn't provide any evidence that there was a delay in the reporting of her death. CNN had previously reported that Smith attempted suicide after the death of her 20-year-old son, Daniel, in September, and Perper said interviews with Smith's inner circle confirmed that she had suffered from bouts of depression over her son's death, which occurred nine days after the birth of her daughter, Dannielynn.
Daniel died of a lethal combination of Zoloft, Lexapro and methadone.
No word was given on the results of DNA tests demanded by Smith's ex-boyfriend, photographer Larry Birkhead, who requested that officials take a DNA sample from her body as part of an ongoing paternity fight over Dannielynn, who is now 6 months old (see "Anna Nicole Smith Autopsy Inconclusive; DNA Test Ordered In Paternity Suit").