Andy Irons died of heart, drug issues

Dr. Vincent Di Maio, a San Antonio-based forensic pathologist consulted and hired by the family, said, "This is a very straightforward case. Mr. Irons died of a heart attack due to focal severe coronary atherosclerosis, i.e., 'hardening of the arteries.' He had an atherosclerotic plaque producing 70-to-80 percent narrowing of his anterior descending coronary artery. This is very severe narrowing. A plaque of this severity, located in the anterior descending coronary artery, is commonly associated with sudden death."

But in the months following Irons' death, speculation fueled by an Outside Magazine article that exposed the open secret of Irons' drug use focused on what role, if any, drugs played in his death. This speculation, it appears, was not unfounded. Tarrant County Chief Medical Examiner Nizam Peerwani lists a second cause of death as "acute mixed drug ingestion."

Both Alprazolam (Xanax) and methadone were found in Irons' system, as well as benzoylecgonine, which Gary H. Wimbish Ph.D., DABFT, a forensic toxicologist consulted by the family, describes as a bi-product of cocaine use. Wimbish said that the level of benzoylecgonine found in Irons' system "is consistent with the use of cocaine at about 30 hours prior to his death."

Irons had been prescribed Xanax and Zolpidem to treat anxiety and insomnia. He also was diagnosed with bipolar disorder, and five years ago contracted typhoid fever, which may have damaged his heart. Prior to his death, Irons had been suffering from severe flu-like symptoms while at the Rip Curl Search in Puerto Rico and withdrew from the contest as a result.

Di Maio disputed that the levels of drugs found in Irons' system were potent enough to kill him.

"As we are not doctors, we have no choice but to accept that two respected pathologists have come to different conclusions about a secondary contributing cause of death," the Irons family said in a statement.