Hayden Panettiere’s cause of death has been linked to fentanyl and other medications

More than a month after Hayden Panettiere was found unresponsive in a South Carolina apartment, officials have revealed what killed the 36-year-old actress. The Greenville County Coroner’s Office ruled that the Heroes and Nashville star died from the toxic effects of fentanyl, 4-ANPP, alprazolam, methocarbamol, and quetiapine, according to People. The manner of Panettiere’s death has been ruled an accident.

Alprazolam is the generic form of Xanax that treats anxiety and pain disorders. Methocarbamol is a prescription muscle relaxant. Quetiapine is an antipsychotic typically used to treat schizophrenia, bipolar disorder, and major depression, while 4-ANPP is a chemical used to make fentanyl illegally. The autopsy at the Greenville County Coroner’s Office has found no signs of trauma that would have contributed to Panettiere’s death.

A 911 call reported a woman in cardiac arrest at the Greenville apartment where Panettiere had been temporarily staying. “First responders and Emergency Medical Services arrived on scene and located a female in cardiac arrest,” said the coroner. She was pronounced dead about 40 minutes after the call, as paramedics could not revive her. Her on-again, off-again boyfriend Brian Hickerson and his brother Zach were with her when she died.

The investigation is still ongoing, with questions about where the fentanyl came from 

Since then, the coroner’s office has closed its case as the cause and manner of death are now established. However, the Greenville Police Department said its own investigation is still active. Police previously said the preliminary investigation showed no signs of foul play or suspicious circumstances. Brian Hickerson directed officers to a bag of medication the actress had been taking, according to a police report.

A detailed coroner’s report states Panettiere had left a rehab facility in Malibu, California, just weeks before her death. Investigators reportedly believe Panettiere took a fentanyl-laced oxycodone pill on the morning she died. Panettiere had spoken openly about substance abuse for years, saying she became addicted to alcohol and opioids as a teenager. Authorities have not publicly named anyone or announced charges, as the effort to trace the pill to an alleged dealer in Southern California continues.

Panettiere leaves behind her only child, Kaya, a daughter she welcomed in 2014 with then-fiancé Wladimir Klitschko. However, in 2018, Panettiere made the “incredibly difficult” decision to grant Klitschko full custody of their daughter. One commenter, saddened by the news, expressed their grief, stating, “Another tragic, needless fentanyl death, this time the multi-talented and said by one & all a lovely, insightful person.” Many other commenters similarly expressed their condolences to the star.