The Tarrant County Medical Examiner’s Office in Texas released the official autopsy report for professional surfer Andy Irons Friday, confirming that he died from a heart attack and that two powerful narcotics contributed to his death.
Although the "primary and underlying cause" of his death was listed as a heart attack associated with severe coronary heart disease, "the presence of both methadone and cocaine is a significant finding especially in a death due to a sudden cardiac event and is listed as contributing to the death but not resulting in the underlying cause. The death is ruled as ‘natural,’" the medical examiner’s office said in a news release.
The official report came two days after Irons’ family sent out its own summary of the autopsy, disputing the role that drugs played in his death while acknowledging that the three-time world champion from Kauai had used both prescription and "recreational" drugs.
Irons, 32, was found dead Nov. 2 in his room at the Grand Hyatt hotel at Dallas-Fort Worth International Airport. He had been on his way back to Hawaii after withdrawing from a pro surfing competition in Puerto Rico.
The medical examiner had been under a court injunction not to release its findings until June 20, but released it Friday after the family leaked an unsigned copy this week to the New York Times. A Texas court granted the family’s request for a delay in the release of the autopsy report.
"They can’t speak (about) protection of the injunction and release it on their own. There was no need to wait any longer to release it," Tarrant County Assistant District Attorney Ashley D. Fourt said in a phone interview.
The official report, signed Friday by Chief Medical Examiner Dr. Nizam Peerwani, stated Irons’ primary cause of death was a "sudden cardiac arrest" associated with heart disease. The secondary cause was listed as "acute mixed drug ingestion."
In their summary, the family cited Dr. Vincent Di Maio, a forensic pathologist and retired chief medical examiner from Bexar County, Texas, who reviewed the autopsy report on their behalf and concluded that the drugs found in Irons’ system were not a secondary cause of his death.
According to autopsy results, Irons suffered from atherosclerotic cardiovascular disease, or hardening of the arteries. The medical examiner determined that he suffered from "severe occlusive coronary atherosclerosis," a 70 percent to 80 percent narrowing of his left anterior descending coronary artery. In their statement, relatives said there is a history of congestive heart failure in Irons’ family.
Toxicology tests indicated Irons’ recent use of methadone and cocaine, according to the medical examiner.
The prescription drug alprazolam (Xanax) was also found in his system. Relatives said this week that Irons was prescribed Xanax and Ambien to treat anxiety and occasional insomnia due to a bipolar disorder.
The family’s experts contend that the drugs found in his system were not a factor in his death. "This is a very straightforward case," Di Maio said, adding that the severity of Irons’ heart disease "is commonly associated with sudden death."
The medical examiner’s report, however, noted that the presence of cocaine and methadone, commonly used to treat opiate addiction, is "a significant finding especially in a death attributed to a sudden cardiac event."
"It is well established that cocaine has cardiotoxic effects," the report said.
Immediately after his death, the family said Irons was suffering from possible dengue fever, which led him to withdraw from the competition in Puerto Rico. The autopsy report said he tested negative for dengue.
The report indicated that 11 tablets of methadone and 26 tablets of zolpidem (Ambien) were found in a plastic prescription container in Irons’ hotel room. Another prescription container with five tablets of alprazolam (Xanax) was also found.