Hayden Panettiere's final cause of death confirmed

Hayden Panettiere’s cause of death has been revealed, more than a month after the actress was found unresponsive at a South Carolina home.

The Nashville star died at 36 on August 16, and the Greenville County Coroner’s Office has now determined that drugs in her system caused her death.

"The cause of death has been ruled as toxic effects of fentanyl, 4-ANPP, Alprazolam, Methocarbamol, and Quetiapine," the coroner’s office said in a release shared with E! News on September 22. 

"The manner of death has been ruled accident."

The report also stated, "At autopsy no signs of trauma were discovered that would have contributed to the death."

Panettiere was staying temporarily at the South Carolina apartment when authorities received a call about an unresponsive woman around 1:51 p.m. First responders found her in cardiac arrest and attempted life-saving measures, but she was pronounced dead at approximately 2:32 p.m.

Her ex Brian Hickerson and his brother Zach Hickerson were reportedly present at the apartment. A police officer described the incident as an "overdose" in dispatch audio obtained by People magazine and TMZ.

Panettiere had previously spoken openly about addiction and her struggles with opioids and alcohol. In her 2026 memoir This Is Me: A Reckoning, she recalled a doctor warning her, "If I didn’t stop drinking, I’d be dead in five years."

Her father, Alan "Skip" Panettiere, confirmed her death, saying, "She was an incredible light and a force of nature who brought immeasurable love and joy to all who knew her—and to the millions who watched her onscreen.”

The tragedy came three years after the death of her brother Jansen, who died from heart complications at 28.

Reflecting on his loss in 2023, Panettiere said, "I miss him all the time."

She added, "I didn't think I would have to do life without him, but I'm grateful that I had the time I had with him."