Actress Hayden Panettiere died from an accidental overdose involving fentanyl and several other drugs, according to the Greenville, South Carolina, County Coroner’s Office.
Panettiere, 36, died Aug. 16 after she was found unresponsive and in cardiac arrest at an apartment in South Carolina where she had been temporarily staying. First responders attempted advanced cardiac life support measures, but the efforts were unsuccessful and she was pronounced dead that afternoon.
An autopsy and toxicology testing determined that the cause of death was the “toxic effects of” fentanyl, 4-ANPP, alprazolam, methocarbamol, and quetiapine. The coroner ruled the manner of death accidental. No signs of trauma were found that contributed to her death.
The findings provide the first official determination of what caused Panettiere’s death after authorities initially said the cause and manner of death were pending further investigation. The Drug Enforcement Administration assisted local police in the investigation.
Panettiere’s boyfriend Brian Hickerson and his brother, Zach Hickerson, were at the residence when she was found, according to a police report obtained by CBS News. The brothers called 911 and remained at the scene as emergency personnel attempted to revive her.
According to the report, Brian Hickerson showed an officer a “bag of medication” that Panettiere was taking, though the specific list was redacted from the document.
Police have not accused Hickerson of involvement in Panettiere’s death. Authorities previously said their preliminary investigation had found no signs of foul play or suspicious circumstances.
Panettiere was open about her struggles with substance abuse, including alcohol and opioids, throughout her career.
The actress, who rose to fame as a child and later starred in the television series Heroes and Nashville, discussed her addiction and recovery in her memoir, This Is Me: A Reckoning.
“As I got older, the drugs and alcohol became something I almost couldn’t live without,” Panettiere told People.
Hayden Panettiere, Heroes and Nashville star, dead at 36
She also described her experiences with postpartum depression, physical abuse, and recovery in the memoir.
“I had no idea that this was not an appropriate thing, or what door that would open for me when it came to my addiction,” she previously said of her substance use.