Anna Nicole Smith died of an "accidental overdose" of drugs, Seminole Police Chief Charlie Tiger announced on Monday.
But Smith is just one of thousands who lose their lives every year to drugs ranging from sedatives to prescription painkillers, making drug overdoses the second leading cause of accidental deaths in America.
In announcing the cause of Smith's death on Monday, Tiger said he authorities received the full cooperation of everyone involved, and that there was nothing to indicate any foul play. The authorities found no evidence of illegal drugs in her apartment, and nothing unusual in any hotel videotapes.
Smith's death more than six weeks ago set off a media and courtroom circus.
On Monday, the Broward County Medical Examiner Joshua Perper released the full autopsy.
Perper said Smith was taking a variety of drugs, including human growth hormones, anti-depressants, vitamin B-12 and anti-anxiety drugs. In the day before she died, Smith had a temperature that spiked to 105 degrees.
Perper said that extremely high fever was due to a perforation of an abscess in her buttocks that caused an infection in her blood stream. She was given an antibiotic, one of nine different prescription drugs found in her body at the time of death.
Perper’s final report said a “combined drug intoxication” killed Smith, who was found unresponsive on Feb. 8 at the Seminole Hard Rock Hotel and Casino in Hollywood. Chloral hydrate — a sedative used to treat insomnia, alcohol withdrawal and ease anxiety — combined with the cocktail of other drugs in her system contributed to her death, he said. The chloral hydrate by itself was not in lethal doses in her system, nor did she take enough for it to be considered a suicide attempt. He added that an intestinal infection and the blood infection were also contributory causes.
Before Perper’s announcement, rumors in publications such as Star Magazine and The Enquirer said Smith had a blood infection from dirty needles and she had also taken chloral hydrate.
But “it is very unlikely to die from chloral hydrate alone – in and of itself it would not cause death," forensic pathologist Dr. Michael Baden said before Perper’s Monday announcement.
Smith modeled herself after Marilyn Monroe, who died of combination of barbiturates and chloral hydrates, and always thought she would die young like Monroe, those close to her have said
But these starlets are not alone.
The day after Smith's death, the Center for Disease Control (CDC) released a report that said unintentional fatal drug overdoses as the second-leading cause of accidental death, just after automobile crashes. The rate of fatal drug overdoses nearly doubled from 1999 to 2004, from 11,155 to 19,833. CDC researchers say they believe sedatives and prescription painkillers were the chief cause of the increase.
The report also found the rate for white women rose more dramatically than for any other gender group, to five deaths per every 100,000 people.
Smith’s 20-year-old son Daniel also died unexpectedly — from a drug overdose — and under suspicious circumstances five months earlier. An investigation into Daniel's death is scheduled to start Tuesday in the Bahamas, where he died. Daniel died from an overdose of of illegally obtained methadone, which can only be prescribed by a doctor. Methadone was also one of the drugs found in his mother Anna Nicole’s body upon her death.
Perper, the medical examiner, said that while Anna Nicole Smith did attempt to drown herself late in 2006 after to a drug overdose, she was not suicidal at the time of her death.
After Daniel’s death last September, Smith had been suicidal, but Perper said she had not expressed suicidal thoughts since October 2006.
“If any of the drugs in her system were illegally obtained, the person who gave them to her could be held responsible,” Baden said.
Many people surrounded Smith in the days leading up to her death, including a nurse, whose presence has fed into the rumor about culpability in her death, even in light of the declaration of an accidental overdose.
Smith grew up in Texas and went from stripper to Playboy Playmate and model. She married 89-year-old J. Howard Marshall II, a union that sparked a battle for his estimated $500 million fortune after his death. She took her fight for that inheritance all the way to the Supreme Court. The battle is ongoing, and her daughter Dannielynn could be the benefactor to a lot of money. Howard K. Stern, who was with Smith in the days leading up to her death, is in a paternity battle for the infant daughter, along with photographer Larry Birkhead.
Dr. Manny Alvarez reviewed this article.
He is the managing editor of health news at FOXNews.com, and is a regular medical contributor on the FOX News Channel. He is chairman of the Department of Obstetrics and Gynecology and Reproductive Science at Hackensack University Medical Center in New Jersey. Additionally, Alvarez is Adjunct Professor of Obstetrics and Gynecology at New York University School of Medicine in New York City.