Whitney Houston was submerged in bathwater for nearly an hour before a personal assistant found her dead in the Beverly Hilton Hotel, an autopsy report released Wednesday said.
The report provided new details on the death of the 48-year-old singer who died of a combination of heart trouble and cocaine ingestion, the Los Angeles County coroner's office said in a 41-page final report.
Early on, authorities suspected that some combination of narcotic substances, prescription medications and alcohol played a role in Houston's death. Houston was last seen alive by her personal assistant Feb. 11 between 2:35 p.m. and 3 p.m., the report stated.
DOCUMENT: Final coroner's report on Whitney Houston
Houston had complained of having a lingering sore throat in the days leading up to her death. Before the assistant left, she told Houston to "take a bath to start getting ready for tonight," referring to a pre-Grammy party thrown by her mentor, producer Clive Davis.
The personal assistant then left to pick up items at Neiman Marcus and returned to the locked hotel room at 3:36 p.m. When she went into the bathroom, she found Houston face-down and unresponsive in the tub, the report stated.
She called out to a bodyguard, the report stated, and they pulled Houston out of the bathtub. The assistant then ran to call the front desk and told them to call 911.
Investigators found a white, crystalline substance and spoon with residue in the Beverly Hills hotel room where Whitney Houston died in February, the report said. It also showed that cocaine and heart disease contributed to her death.
On a bathroom counter were "a small spoon with a white, crystal-like substance in it and a rolled-up piece of white paper, along with other miscellaneous items," it said. In a nearby drawer were "remnants of a white powdery substance and a portable mirror on a base and on the bottom of that base were more remnants of a white, powdery substance."
Authorities collected several bottles of prescription drugs from Houston's suite at the Beverly Hilton Hotel, where she was found dead. But officials have said the amounts of drugs did not seem unusually large.
Houston had battled drug addiction for years, and the coroner's office found traces of several drugs — including marijuana, the anti-anxiety medication Xanax, the muscle relaxant Flexeril as well as Benadryl — in her system.
But the coroner's office concluded in March in a preliminary report that those drugs did not contribute to her death. Cocaine did play a role, though officials would not say how much of the drug was in her system.
Craig Harvey, the coroner's operations chief, said the toxicology findings "suggested chronic usage." "She could have had a heart attack," rendering her unconscious, and then become submerged in the filled tub, said Ed Winter, the coroner's deputy chief for operations.
A law enforcement source said that no cocaine was found in Houston's room at the Beverly Hilton Hotel but that bottles of various medications were recovered. The autopsy found that the singer suffered from a pre-existing condition known as atherosclerotic heart disease.
David Campbell, a retired captain for the coroner's office, said the disease is often linked to blockages of blood flow to the heart. Use of cocaine and other narcotics would intensify the dangers, he said. Cocaine can constrict blood vessels and reduce blood flow, he said.
In an interview with ABC News in 2002, Houston acknowledged using cocaine as well as marijuana and drinking heavily at times. She strongly denied using crack cocaine.
"Crack is cheap. I make too much money to ever smoke crack," she said in the interview. "Let's get that straight. OK? We don't do crack. We don't do that."
Last May, Houston's spokeswoman said the singer was going back into rehab.