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Medical Examiner: Ledger Autopsy Inconclusive

1/23/2008 12:35 PM PST BY TMZ STAFF

Heath LedgerAn autopsy on Heath Ledger was inconclusive this morning, pending toxicology results.

The New York Medical Examiner's office tells TMZ it will take anywhere between ten days and two weeks to obtain test results. As TMZ first reported, the death appears to have been accidental.

97 COMMENTS

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76.

Tiffany    

I swear some people are rude and have no lives!!! He just died yesturday and you guys are already criticizing his death syaing that it was an OD. He has friends and family that are trying to cope with his death. Who cares if it was an OD, people go through that all the time, its not something to criticize him for. Deal with your own problems!

2410 days ago
77.

MarkToronto    

Doing a scene like hanging from a London Bridge at night is a very lengthy process to rig. If Heath was run down and sick in the first place,doing this scene was not such a good idea.

I'm not saying that's what killed him, but another piece of the puzzle that added his weakened state.

He was exhausted and sick as a dog. That's pretty much a known.

2410 days ago
78.

just me    

#60. He died of a pill/drug overdose. That's why they have to wait 10 days to 2 weeks for the results, just me!!!! Get real!

Posted at 12:40PM on Jan 23rd 2008 by ME

I am not dismissing that possibility, ME!!!! I am saying that an extensive autopsy is not complete. If toxicology tests do not prove cause of death, and if an extensive autopsy has not been completed by then it will be done and it is only on extensive examination of the body organs that a pulmonary embolism can be discovered. Time will tell, either toxicology or further autopsy.

2410 days ago
79.

Pilikane    

HE DID NOT OD AND THEY ALREAD SAID THERE WERE NO ILLEAGAL DRUGS I SUSPECT FOUL PLAY, MAYBE? WHY WOULD HE TAKE HIS OWN LIFE? HE HAD A DAUGHTER AND HE LOVES HIS FAMILY!! AND FOR ALL YOU PEOPLE WHO SAY HE WAS ON DRUGS SHAME ON YOU..HES NOT HERE TO DEFEND HIMSELF. HE LOOKS LIKE THAT BECAUSE ACTORS/ACTRESS' WORK 16 + HOUR DAYS AS THE GUY SAID ON LARRY KING LIVE IT MESSES UP THEIR SLEEP SCHEDULE, DUH. SHOW SOME RESPECT FOR THE GUY AND HIS FAMILY!! THIS WAS NOT A SUICIDE, I DON'T BELIEVE IT...SOMETHING ELSE HAPPEN HERE!!! MAY YOU RIP HEATH. YOU WERE A VERY TALENTED ACTOR AND WAY TOO YOUNG TO LEAVE US. MY THOUGHTS AND PRAYERS ARE WITH YOU AND YOUR FAMILY AT THIS TIME!!

2410 days ago
80.

Pilikane    

HE DID NOT OD AND THEY ALREAD SAID THERE WERE NO ILLEAGAL DRUGS I SUSPECT FOUL PLAY, MAYBE? WHY WOULD HE TAKE HIS OWN LIFE? HE HAD A DAUGHTER AND HE LOVES HIS FAMILY!! AND FOR ALL YOU PEOPLE WHO SAY HE WAS ON DRUGS SHAME ON YOU..HES NOT HERE TO DEFEND HIMSELF. HE LOOKS LIKE THAT BECAUSE ACTORS/ACTRESS' WORK 16 + HOUR DAYS AS THE GUY SAID ON LARRY KING LIVE IT MESSES UP THEIR SLEEP SCHEDULE, DUH. SHOW SOME RESPECT FOR THE GUY AND HIS FAMILY!! THIS WAS NOT A SUICIDE, I DON'T BELIEVE IT...SOMETHING ELSE HAPPEN HERE!!! MAY YOU RIP HEATH. YOU WERE A VERY TALENTED ACTOR AND WAY TOO YOUNG TO LEAVE US. MY THOUGHTS AND PRAYERS ARE WITH YOU AND YOUR FAMILY AT THIS TIME!!

2410 days ago
81.

beware of big dark HERPE caves    

he'll be forgotten in a month. gosh!!! i cant wait!!!!!!!!!!!!!!!!!!!

2410 days ago
82.

kelly and keith    

This is a sad case of a drug overdose probably accidental but still they need to respect his privacy and not make assumptions till the toxicology reports come back and see exactly what he died of and how he died...

2410 days ago
83.

MrB    

An accidental death makes sense- he had an appointment for a massage, and the position/state in which he was found indicate he was preparing for it.

I would have guessed asphyxia caused by vomit, since he was found face-down. But that would have been easily determined- as would any complication from pneumonia such as ARDS.

In fact, using the Pneumonia Severity Index Calculator, a 28 year-old male with no pre-existing disorders presenting a full-blown pneumonia lab would still only have a 26.7% mortality rate.

Reports indicate that he had pill bottles scattered around the apartment, so a drug interaction is likely. There are three possibilities: interaction with an antibiotic, interaction with a painkiller, and interaction with a sleep aid, which Ledger was reportedly taking due to his filming schedule.

-Amoxicillin is the most widely-used antibiotic for bacterial pneumonia. It doesn't interact notably with anything.

-Ibuprofen is the most widely-used painkiller. It significantly interacts with methotrexates, ACE inhibitors, diuretics, lithium and Warfarin- none of which he likely would have been taking, either for their prescribed use or for a 'high'.

-Zolpidem-based leep aids like Ambien react badly with rifampin, which is sometimes prescribed in two or three-course treatments of serious Mycobacterium infections. A clinical trial showed that an individual using a Zolpidem-based drug within 17 hours of rifampin would experience compromised drug pharmacokinetics- in other words, the body didn't absorb as well or keep Zolpidem for as long and it didn't work nearly as well. This could have posed a problem had he taken more Ambien, but his body would have just kept dumping it out.

-Zolpidem and sertraline caused a 43% increase in the Cmax of Zolpidem in one study. This means the short-term absorption of Zolpidem increased by almost half. What's sertraline? It's Zoloft- and we know Ledger was taking anti-depression medication.

Here's my theory: Ledger ingested a dose of rifampin along with his other pneumonia meds, which is prescribed as a once-a-day dose. Within 17 hours afterward, he tried to take Ambien in order to sleep. It didn't work due to the decreased effectiveness caused by the rifampin/Ambien interaction. Within 20 hours afterward, he tried to sleep again- this time taking more than the prescribed dose of Ambien. He also took Zoloft, as he would have daily. For every one Ambien, the body would immediately absorb the equivalent of 1.5. While a Swiss study found that an individual could ingest up to sixty Zolpidem before they might go into a coma, when combined with other CNS depressants, it would take just ten to potentially be fatal. CNS depressants are common- Dextromethorphan is found in cough Robitussin, and Chlorphenamine is found in Dimetapp. And guess what someone with a severe respiratory condition could be taking?

In conclusion: 1 Rifampin + 7 Ambien + 1 Zoloft + Robitussin + Dimetapp = death.

2410 days ago
84.

uuuhhooohh!!!    

Where was Howard K. Stern and the duffle bag?

2410 days ago
85.

Props to Mat Damon    

Damn it. Lets say he did do drugs, i didnt care cause hes gonna give the best portrayal of the joker that anyone has ever seen. Even better than Mark Hamils version in the cartoon. Point is , i was waiting for him to talk more about his performance as the JOKER when the release date for the film came closer, but that wont happen.

Why couldnt it be BRITNEY, PARIS or LINDSEY instead, no one likes them, and they dont contribute anything to the entertainment business. Sad , but im sure the next headline will be for Britney with her lifestyle.

2410 days ago
86.

Susie Darlene Bence    

I was in shock, then felt sad, because I felt he was more genuine person and genuine about his craft. Not like so many that only think look at me, look at me narcicsstic types. I loved that movie"10 things I hate about you"-very funny! I liked him in the Connor series, The Patriot with Mel Gibson, a lot of his stuff, especially his marvelous voice! He will be trully missed! My hopes and prayers go out to the family! Sincerely, Susie--Duarte, Calif.

2410 days ago
87.

heather    

god bless you heath ledgar ilve you and you will be missed sorry to your family

2410 days ago
88.

B    

WHY IS IT THAT HE IS A CELEBRITY AND EVERYTHING IS DONE SO FAST. I LOST A LOVED TO NATURAL CAUSES, THEY DID TOX SCREEN AND IT TOOK 12 WEEKS, THIS PISSES ME OFF!!!!

2410 days ago
89.

B    

WHY IS IT THAT HE IS A CELEBRITY AND EVERYTHING IS DONE SO FAST. I LOST A LOVED TO NATURAL CAUSES, THEY DID TOX SCREEN AND IT TOOK 12 WEEKS, THIS PISSES ME OFF!!!!

2410 days ago
90.

B    

WHY IS IT THAT HE IS A CELEBRITY AND EVERYTHING IS DONE SO FAST. I LOST A LOVED TO NATURAL CAUSES, THEY DID TOX SCREEN AND IT TOOK 12 WEEKS, THIS PISSES ME OFF!!!!

2410 days ago
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