Hayden Panettiere’s cause of death remains a mystery after a preliminary autopsy found no signs of trauma that would explain the actress’s sudden death at age 36.
The Greenville County Coroner’s Office confirmed Monday that Panettiere’s autopsy had been completed one day after she was found unresponsive inside an apartment in Greenville, South Carolina.
Coroner Mike Ellis said additional testing will be needed before officials can determine exactly how the “Heroes” and “Nashville” star died.
“An autopsy was completed today. At autopsy no signs of trauma were discovered that would have contributed to the death,” Ellis said in a statement.
“The cause and manner of death remain pending further investigation and the completion of additional studies,” he added. “This investigation remains active and ongoing.”
No further details were released.
Panettiere was found unresponsive Sunday after emergency crews were called to a loft at the Judson Mill mixed-use residential and commercial complex in Greenville.
Authorities previously said an acquaintance placed the 911 call.
Dispatch audio reportedly included emergency workers discussing a possible overdose and cardiac arrest, though officials have not said that either was ultimately responsible for her death.
Paramedics attempted CPR, but Panettiere could not be revived and was pronounced dead.
Her death came after years in which the actress had spoken openly about her struggles with depression, alcohol and opioid abuse.
In one of her final major on-camera interviews, Panettiere sat down with Jay Shetty and described what she called a “horrible cycle” of depression, anxiety, alcoholism and substance abuse.
She said those struggles intensified after the birth of her daughter, Kaya, whom she shares with former fiancé Wladimir Klitschko.
Panettiere said she developed postpartum depression and spent years trying to escape what she described as a period of darkness.
“They didn’t know what was going on,” she said. “And so it became this horrible cycle for years of battling depression and anxiety and alcoholism and substance abuse and me just trying to find my way back, my way out of this darkness.”
Panettiere had previously checked into rehab in 2015 and again in 2021.
She later described experiencing serious physical symptoms she connected to years of substance abuse.
“My body was like, ‘enough,’” she said in a 2023 interview.
Panettiere said that by the time she reached 30, her face had become swollen, she developed jaundice, her eyes turned yellow and she needed to see a liver specialist.
She also said her hair became thin and began falling out in clumps.
In her 2026 memoir, “This Is Me: A Reckoning,” Panettiere revealed that a doctor had given her a frightening warning years earlier.
“A doctor told me that if I didn’t stop drinking, I’d be dead within five years,” she wrote, recalling the warning she said she received in 2020.
Panettiere had reportedly traveled from Los Angeles to South Carolina on Aug. 15 with boyfriend Brian Hickerson.
The couple first began dating in 2018 and had an on-and-off relationship.
Hickerson was arrested multiple times in connection with domestic violence allegations and received a 45-day jail sentence in 2021.
He ultimately served 12 days because of credit for time already served under a plea agreement.
It remains unclear why Panettiere and Hickerson were in Greenville at the time of her death.
Hickerson is from South Carolina and is believed to have family in the area.
For now, authorities have not announced a cause or manner of death.
The coroner’s office said toxicology and other additional testing will be required before investigators can make a final determination.
The investigation remains active.
