Tragic Details From Tammy Wynette's Autopsy

When Medical Examiner Dr. Bruce Levy performed the autopsy on Virginia Richardson, she had been dead for a year. The embalmed body lying before him at the Forensic Sciences Center in Nashville on the morning of April 14, 1999, was that of a 55-year-old woman better known as Tammy Wynette, the "First Lady of Country Music," though Levy thought she looked much older. The examination came about based on the concerns of three of the singer's daughters about how their mother had died. Her fifth husband, George Richey, agreed to an autopsy in order to put the issue to bed.

Wynette had died while napping at her Nashville home on April 6, 1998. Richey found her body, and her personal physician, Dr. Wallace Marsh, told Levy that he believed Wynette had died of a blood clot in her lung. For several years Wynette had dealt with serious medical issues, mainly an intestinal condition called dysmotility, but she also had a prescription drug dependency and her children believed she had been overprescribed, just part of the tragic story of Wynette's life.

On that day in 1999, Levy would find the truth, or at least as close to the truth as he could get at that late date. He determined Wynette had actually died of a heart attack. And while the autopsy found two different sedatives in her system, Levy was unable to determine if they contributed to her death.

Tammy Wynette, born Virginia Wynette Pugh in 1942, had come from poverty in Mississippi to rise to the top of the country music charts, selling more than 30 million records during her lifetime with such hits as "Stand By Your Man" and "D-I-V-O-R-C-E." But there was a traumatic side to her story, with broken marriages, including to fellow county star George Jones, and a complex medical history that began when she was 28 and only escalated over the years. After a doctor removed her uterus without her consent following the birth of her fourth child, an ensuing infection led to extensive intestinal scarring resulting in chronic issues.

One of these was dysmotility, a condition in which her intestinal muscles become impaired causing "problems with adequate nutrition and blood clotting," according to the autopsy report. At the time of her death, Wynette had undergone 30 different surgeries and doctors had implanted a catheter in order to give her pain medication and nutritional support. During the April 1999 autopsy on Wynette. Dr. Bruce Levy noted Wynette's many surgical scars and when examining her digestive system found that her stomach and small and large intestines were "matted together with marked fibrous adhesions." While he didn't find any blot clots in Wynette's lungs, he found evidence of past blood clots.

Before Tammy Wynette's body had been disinterred from the Woodlawn Cross Mausoleum in Nashville and autopsied, three of her daughters, Jackie Daly, Tina Jones, and Georgette Jones Lennon, spoke with Dr. Bruce Levy about the narcotics their mother had been receiving before she died. The daughters believed Richey was using the drugs to control Wynette and that Dr. Wallace Marsh mishandled her care. Levy later contacted Marsh about why he hadn't told the police about the drugs Wynette had been administered. Marsh told him it had been a miscommunication, but Levy suspected "there may have been an attempt to provide minimal information to the authorities that evening," he wrote.

During the autopsy, Dr. Levy collected tissue samples for toxicology tests. The tests revealed the presence of two sedatives, Versed and Phenergan, but the tests were unable to find any traces of the painkiller Dilaudid, which embalming fluid can dissolve. Because the autopsy happened so late, Levy later told CNN that it was "virtually impossible to determine the exact drug levels at the time of Wynette's death or to what extent, if any, these drugs contributed to her heart failure and death." While he believed it was a heart attack that killed the First Lady of Country Music, questions remained. "The relative contributions to her death from the underlying natural diseases and the medications present in her body at the time of her death cannot be ascertained," Levy wrote in the autopsy report. "Therefore, the manner of her death cannot be determined."