Matthew Perry died from effects of drug ketamine, coroner says
LOS ANGELES (AP/PTI): Matthew Perry died from the acute effects of the anesthetic ketamine, according to the results of an autopsy on the 54-year-old “Friends” actor released Friday.
The Los Angeles County Department of Medical Examiner said in the autopsy report that Perry also drowned in “the heated end of his pool,” but that it was a secondary factor in his Oct. 28 death, deemed an accident.
People close to Perry told investigators that he was undergoing ketamine infusion therapy, an experimental treatment used to treat depression and anxiety. But the medical examiner said the levels of ketamine in Perry’s body were in the range used for general anesthesia during surgery, and that his last treatment 1 1/2 weeks earlier wouldn’t explain those levels. The drug is typically metabolized in a matter of hours.
The report says coronary artery disease and buprenorphine, which is used to treat opioid use disorder, also contributed.
The amount of ketamine detected “would be enough to make him lose consciousness and lose his posture and his ability to keep himself above the water,” said Dr. Andrew Stolbach, a medical toxicologist with Johns Hopkins Medicine who reviewed the autopsy report at the request of The Associated Press.
“Using sedative drugs in a pool or hot tub, especially when you’re alone, is extremely risky and, sadly, here it’s fatal,” said Stolbach, who noted that both ketamine and buprenorphine can be used safely.
Perry was declared dead after being found unresponsive at his home in the Pacific Palisades area of Los Angeles. Investigators performed the autopsy the following day.
The actor had taken drugs in the past but had been “reportedly clean for 19 months,” according to the report.
Perry had played pickleball earlier in the day, the report says, and his assistant, who lives with him, found him face down in the pool after returning from errands.
The assistant told investigators Perry had not been sick, had not made any health complaints, and had not shown evidence of recent alcohol or drug use.
Postmortem blood tests showed “high levels” of ketamine in his system, which could have raised his blood pressure and heart rate and dulled his impulse to breathe.
Buprenorphine, commonly used in opioid addiction and found in therapeutic levels in Perry’s blood, could have contributed to the breathing problem, the autopsy said. It would have been risky to mix the central nervous system depressant with ketamine “due to the additive respiratory effects when present with high levels of ketamine,” according to the autopsy report.
The report said his coronary artery disease would have made him more susceptible to the drugs’ effects.
Perry was among the biggest television stars of his generation when he played Chandler Bing alongside Jennifer Aniston, Courteney Cox, Lisa Kudrow, Matt LeBlanc and David Schwimmer for 10 seasons from 1994 to 2004 on NBC’s megahit sitcom “Friends.”
His castmates, like many of his friends, family and fans, were stunned by his death, and paid him loving tribute in the weeks that followed.
Perry was open about discussing his struggles with addiction dating back to his time on “Friends.”
“I loved everything about the show but I was struggling with my addictions which only added to my sense of shame,” he wrote in his 2022 memoir. “I had a secret and no one could know.”
A woman whose name is redacted in the autopsy report told investigators that Perry had been in good spirits when she spoke to him a few days earlier, but had been taking testosterone shots which she said were making him “angry and mean.” She said he had quit smoking two weeks earlier.
The woman said he had been receiving the ketamine infusions for his mental health, and that his doctor had been giving them to him less often because he had been feeling well.
Ketamine is a powerful anesthetic approved by U.S. health regulators for use during surgery, but in the past decade it has emerged as an experimental treatment for a range of psychiatric and hard-to-treat conditions, including depression, anxiety and chronic pain.
While not approved by regulators, doctors are free to prescribe drugs for these alternate uses if they think their patients could benefit, and hundreds of clinics across the U.S. offer ketamine infusions and other formulations for various health conditions.
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MP HC sets up judicial commission to probe water contamination in Indore
Indore (PTI): The Indore bench of Madhya Pradesh High Court on Tuesday set up a commission of inquiry comprising a former HC judge to probe the issue of water contamination in city's Bhagirathpura, saying the matter requires probe by an independent, credible authority and "urgent judicial scrutiny".
It also directed the commission to submit an interim report after four weeks from the date of commencement of proceedings.
A division bench of Justices Vijay Kumar Shukla and Alok Awasthi constituted the commission while hearing several public interest litigations (PILs) filed simultaneously regarding the deaths of several people in Bhagirathpura due to the consumption of contaminated water.
The HC reserved the order after hearing all the parties during the day, and released it late at night.
The state government on Tuesday told the HC that the deaths of 16 people in Indore's Bhagirathpura area was possibly linked to a month-long outbreak of vomiting and diarrhoea caused by contaminated drinking water.
The government presented an audit report of 23 deaths from the current gastroenteritis epidemic in Bhagirathpura before the bench, suggesting that 16 of these fatalities may have been linked to the outbreak of vomiting and diarrhoea caused by contaminated drinking water.
The report, prepared by a committee of five experts from the city's Government Mahatma Gandhi Memorial Medical College, stated that the deaths of four people in Bhagirathpura were unrelated to the outbreak, while no conclusion could be reached regarding the cause of death of three other people in the area.
During the hearing, the high court sought to know from the state government the scientific basis behind its report.
The division bench also expressed surprise at the state government's use of the term "verbal autopsy" in relation to the report, sarcastically stating that it had heard the term for the first time.
The HC expressed concern over the Bhagirathpura case, stating that the situation was "alarming," and noted that cases of people falling ill due to contaminated drinking water have also been reported in Mhow, near Indore.
In its order, the HC said the serious issue concerning contamination of the drinking water supply in Bhagirathpura area allegedly resulted in widespread health hazards to residents, including children and elderly persons.
According to the petitioners and media reports, death toll is about 30 till today, but the report depicts only 16 without any basis or record, it said.
It is averred that sewage mixing, leakage in the pipeline, and failure of civic authorities to maintain potable water standards have led to the outbreak of water-borne diseases. Photographs, medical reports, and complaints submitted to the authorities prima facie indicate a matter requiring urgent judicial scrutiny, the HC said.
"Considering the gravity of the allegation and affecting the right to life under Article 21 of the Constitution of India and the need for an independent fact-finding exercise, the Court is of the opinion that the matter requires investigation by an independent, credible authority," it said.
"Accordingly, we appoint Justice Sushil Kumar Gupta, former judge of the Madhya Pradesh High Court, a one-man commission of inquiry into the issues relating to water contamination in Bhagirathpura, Indore, and its impact on other areas of the city," the HC added.
As per the order, the commission shall inquire into and submit a report on the cause of contamination -- whether the drinking water supplied to Bhagirathpura was contaminated; and the source and nature of contamination (sewage ingress, industrial discharge, pipeline damage etc).
The panel will also probe the number of actual deaths of affected residents on account of contaminated water; find out the nature of disease reported and adequacy of medical response and preventive measures; suggest immediate steps required to ensure safe drinking water as well as long-term infrastructural and monitoring reforms.
It will also identify and fix responsibility upon the officers and officials found prima facie responsible for the Bhagirathpura water contamination incident, and suggest guidelines for compensation to affected residents, particularly vulnerable sections.
The commission shall have powers of a civil court for the purpose of summoning officials and witnesses; calling up records from the government department, hospitals, laboratories and civic bodies; ordering water quality testing through accredited laboratories; conducting spot inspections.
All state authorities involving district administration, Indore Municipal Corporation, public health engineering department and Madhya Pradesh Pollution Control Board shall extend full co-operation and provide records as sought by the commission, it said.
The state government shall provide office space, staff, and logistical support to the commission, it said.
During the hearing in the day, the state government also presented a status report to the court in this matter.
According to reports, a total of 454 patients were admitted to local hospitals during the vomiting and diarrhea outbreak, of whom 441 have been discharged after treatment, and 11 are currently hospitalised.
According to officials, due to a leak in the municipal drinking water pipeline in Bhagirathpura, sewage from a toilet was also mixed in the water.
