An Accident, said the Medical Examiner: Anna Nicole Smith's Overdose/Drug Interaction

She wanted to live a long, long time. She had the money, and apparently she had a willing doctor to write the prescriptions for “longevity drugs”--vitamin B12, immunoglobulins and human growth hormone. But injecting them into her buttocks somehow caused an infection, and she developed a fever of 105 degrees while she was visiting South Florida. Refusing to go to an emergency room, Anna Nicole Smith instead took an ice bath, and took antibiotics and flu medicine. This helped her regain her strength over the next few days, according to the Medical Examiner, and she kept taking choral hydrate to help her get to sleep. The Medical Examiner found traces in her body of muscle relaxants, pain relievers like methadone, and several anti-anxiety medicines. He said combined drug intoxication—of prescription drugs--had been the cause of her death, particularly from the potent sedative chloral hydrate. Chloral hydrate was popularly used in the 1800s, but is rarely prescribed nowadays.

An intestinal flu and a bacterial infection, possibly from a contaminated needle, were contributing factors. No illegal drugs were found in her body. She had been in “outstanding general spirits” in the preceding days, so she had clearly not committed suicide. The police chief found no evidence of foul play.

Anna was 39 years old, and had been a former Playboy centerfold, model, and reality TV star.

Advice: If you have more than one doctor, make sure each of them knows all of the prescription and over-the-counter medications you are taking.

Read another adverse drug reaction story, or read Abby Goodnough’s story in today’s New York Times.