Panettiere, 36, was found unresponsive at an apartment in Greenville on Aug. 16. Emergency medical personnel attempted advanced resuscitation before she was pronounced dead.

The coroner’s office said an autopsy found no signs of trauma that contributed to her death. Toxicology identified fentanyl, 4-ANPP, alprazolam, methocarbamol and quetiapine in her system.

What the coroner found

The coroner identified the cause of death as the toxic effects of the five substances and classified the manner of death as an accident.

4-ANPP is a chemical byproduct associated with fentanyl production. Alprazolam is commonly known by the brand name Xanax. Methocarbamol is a muscle relaxant, while quetiapine is a prescription medication used for several medical conditions.

The presence of multiple substances was reflected in the coroner’s determination rather than a finding that fentanyl was the only substance involved.

The findings establish the medical cause and manner of Panettiere’s death. They do not, by themselves, establish how she obtained the fentanyl or the circumstances surrounding its use.

Police investigation continues

The medical determination does not end the separate investigation into the circumstances of Panettiere’s death.

Greenville police confirmed that their investigation remains ongoing. Authorities have previously said the preliminary investigation did not indicate signs of foul play or suspicious circumstances.

An acquaintance of Panettiere placed the 911 call, according to police. Her on-and-off boyfriend, Brian Hickerson, and his brother, Zach Hickerson, were at the apartment when she was found, according to reporting based on the police investigation.

No conclusion about a potential supplier or other criminal responsibility has been announced by investigators.

Panettiere’s mother, Lesley Vogel, said the accidental classification did not resolve questions about the source of the lethal dose and called for justice for her daughter. Her statement was a family response to the coroner’s finding, not an official determination about the source of the drugs.

A career that began in childhood

Panettiere began working as an actor while she was a child and became widely known through television roles.

She played Claire Bennet on the NBC science-fiction drama Heroes and later starred as country singer Juliette Barnes on Nashville. Her film credits included Remember the Titans, Ice Princess, Scream 4 and Scream VI.

Her performance on Nashville earned her two Golden Globe nominations.

Panettiere also appeared in commercials and soap operas early in her career, including Guiding Light, before moving into larger television and film roles.

Panettiere had spoken publicly about addiction

Panettiere had previously discussed her struggles with alcohol and opioid addiction and her efforts to recover.

In her 2026 memoir, This Is Me: A Reckoning, she wrote about addiction, postpartum depression, trauma and the pressures associated with becoming famous at a young age. She had also previously entered rehabilitation as she sought treatment for substance-use problems.

Those earlier struggles provide context for her life but do not establish the circumstances that led to the fatal overdose.

The coroner’s findings provide the first official determination of what caused her death.

Investigation remains open

The release of the toxicology and autopsy findings answers the immediate medical question surrounding Panettiere’s death: the manner was accidental, and the cause was the toxic effects of fentanyl and the four other identified substances.

Questions surrounding the source of the fentanyl and whether anyone else could face legal consequences remain separate matters for investigators.

Greenville police have not announced arrests or charges connected to her death.

Panettiere died nearly three decades after beginning her professional acting career and at a time when she had continued speaking publicly about recovery and the difficulties of her earlier years.

The coroner’s ruling establishes the medical cause of death while the broader investigation remains unresolved.

Reporting Credit: Greenville County Coroner’s Office — autopsy, toxicology findings and official cause and manner of death; Greenville Police Department — death investigation and circumstances surrounding the Aug. 16 emergency response.

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