Anna Nicole Smith's death was accidental, caused by combined drug toxicity, the Broward County, Fla., Medical Examiner said Monday.
Smith, who died on Feb. 8, had evidence of nine drugs, including valium and antihistamines that were at therapeutic levels, said medical examiner Joshua Perper during a news conference in Fort Lauderdale, Fla.
Toxicology tests also found the presence of chloral hydrate, a sedative, which when combined with the other drugs in her system, led to Smith's death, Perper said. He said her medications included anti-anxiety and anti-depression prescriptions and longevity drugs, such as human growth hormones.
Perper said a viral infection and an infection in Smith's buttocks were contributing factors. He said Smith had a fever of 105 degrees two days prior to her death, but refused to go to the hospital for treatment.
"I do not see ... evidence of homicide" he said, although he did not dismiss "criminal culpability."
Perper also said "the indications of suicide were not strong enough" when balanced against the evidence of an accidental death.
Seminole Police Chief Charlie Tiger said his investigation determined that this was "an accidental overdose."
Monday's ruling, Tiger said, "effectively closes the case on Anna Nicole Smith."