03/27/2007 at 08:00 AM EDT
Anna Nicole Smith could have been saved if she had been hospitalized before her death, a medical examiner said Monday – but in a statement released that night, her companion Howard K. Stern said she had refused emergency care, fearing a "media frenzy."
After announcing Smith's autopsy results
on Monday, Broward County Medical Examiner Joshua Perper said Smith had been suffering from a stomach flu, a 105-degree fever and an infection from repeated drug injections.
At the same time, she was using a long list of medications, including the powerful sleeping drug chloral hydrate, methadone, valium, several antidepressant and anti-anxiety drugs, longevity medications, vitamin B12 and growth hormone, the Associated Press reports. She died from an accidental drug overdose.
If Smith, 39, had sought treatment for her flu, she might have been saved, Perper said, if only because her drug use could have been controlled: "If she would have gone to the hospital she wouldn't have died because she wouldn't have had the opportunity to take the excessive amount of chloral hydrate."
Both Stern and Smith's physician implored her to seek emergency treatment, but Smith "refused to go to the hospital because she wanted to avoid media," attorney Lilly Ann Sanchez said in a news release, the AP reports. "Anna called the shots in Anna's life and everyone close to her knows that."
Chloral hydrate, a rarely prescribed sedative, is known to be fatal if
combined with certain other drugs – including the sedative Lorazepam, which the autopsy showed Smith was taking, Dr. Chip Walls, a forensic toxicologist for the Miller School of Medicine at the University of Miami, told the AP.
"It's very toxic if you mix it with any other central nervous system depressant drugs," Walls said. "You could get profound sedation leading up to coma and respiratory arrest."
The AP reported Tuesday that Stern's lawyer said the chloral hydrate was prescribed for Smith by her friend and psychiatrist, Dr. Khristine Eroshevich, who also traveled with her to Florida. "She was having nightmares. She was having hallucinations. She was unable to sleep," Sanchez said, adding that Eroshevich turned to "an older, tried and true drug" because it was more effective for Smith than newer sleeping medicines.