Anna Nicole Smith's Autopsy

    On Monday evening, Larry King interviewed Joshua Perper, the medical examiner from Broward County, Florida, on the autopsy results of Anna Nicole Smith.

   Here is a partial transcript of the interview.

CNN LARRY KING LIVE

Accidental Overdose Killed Anna Nicole

Aired March 26, 2007     Entire Transcript

  We begin in West Palm Beach, Florida with Dr. Joseph Perper, a frequent guest on this program, the Broward County medical examiner, who performed the autopsy on Anna Nicole Smith.
You found the cause, Dr. Perper, to be -- of the death -- to be combined drug intoxication.
What does that mean?

PERPER: It means that the cause of death was a combination of chloral hydrate, which was the major component, plus four other drugs which were in therapeutic levels. And they were basically intended primarily for control of depression and anxiety. KING: When you call a death accidental, what leads to that conclusion? Like how do you know there wasn't any malfeasance involved?

KING: What do you make as a forensic physician and as a physician, of the amount of drugs she had in her system and the combinations itself?
PERPER: Well...
KING: Have you ever seen any like that prescribed?
PERPER: Yes, we have seen that and as a matter of fact this combination also points to accident because the therapeutic levels of the other prescribed drugs indicated that she did not really wanted to take her life because then we would have expected much higher levels from the other drugs -- of the anti-depression and anti-anxiety drugs.
And the only drug, basically, which was the major component was the chloral hydrate. By itself, it would could have caused the death, but perhaps not in a person who is used to the drug. But in combination with the other drugs, it definitely -- all of them together caused her unfortunate death.
KING: Any illegal drugs in the system?
PERPER: No, there were no illegal drugs at all. As a matter of fact, there was not even methadone in the blood, though it was in the bile -- that's a secretion of the liver -- indicating that some two or three days before her death, she used methadone.

KING: Could she have been saved if she were hospitalized sooner?
PERPER: Absolutely. And the reason is that she would have been hospitalized, she wouldn't have had the opportunity of taking the excess amount of chloral hydrate.
As a matter of fact, the antibiotic which we had given her for infection in the bottle (ph) were effective and basically cleaned the blood of the bacteria. But she still felt weak and unfortunately she had access to the chloral hydrate.
KING: Tamiflu was present, right?
Isn't Tamiflu an amazing drug?
PERPER: Well, it's reported to be quite effective in some cases and not so much in others.
KING: You have to get it early, though, when you have the flu?
PERPER: That's correct.
KING: Yes.
We have an e-mail question from Noni (ph) in Hammond, Indiana: "Why do you accept Howard K. Stern's account of events on the morning of Anna Nicole's death as bible oath? He says he didn't give her chloral hydrate or see her taking any medications. Why do you believe him?"
PERPER: You're asking me?
KING: Why do you believe the accounts of Howard K. Stern?
PERPER: Well, I believe -- I do not -- this is his statement. His statement is not contradicted by any other statement. The conglomerate of the facts indicated it was an accidental death. Even if she -- even assuming that he gave her the drug, it was obviously not against her wishes, because she liked the drug and she sometimes drank straight from the bottle.
KING: Another e-mail from Connie in Bedford, Virginia: "How can Anna Nicole's death be accidental when she had a doctor, a nurse, a bodyguard and a companion around her 24-7? Maybe negligence, but an accident?"
PERPER: Well, this doesn't make any sense because negligence can lead to an accident. I don't see how negligence excludes an accident. She had the ability to move and whether she took the chloral hydrate or somebody else, it was a non-intentional death. There is nothing to point to homicide. And, as I mentioned before, the police investigation reached the same conclusion.
KING: Is the case closed?
PERPER: The case is closed formally at this time. But any case can be opened if additional information which is credible and important surfaces.

 

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