Lynne Sladky, Associated Press Dr. Joshua Perper -- the Broward County, Fla., medical examiner and former Allegheny County coroner -- talks to reporters yesterday about the inconclusive results of an autopsy performed on Anna Nicole Smith.

By Michael A. Fuoco
Pittsburgh Post-Gazette Twice in five months, a former Allegheny County coroner has become a key player in the international media scrutiny of Anna Nicole Smith's celebrity.

Now in the spotlight is Dr. Joshua A. Perper, the Broward County, Fla., medical examiner, who yesterday performed the autopsy on Ms. Smith.

John Heller, Post-Gazette Dr. Cyril Wecht -- He performed an autopsy on Ms. Smith's son in September. Click photo for larger image. See an interactive timeline on the life of Anna Nicole Smith, from the Associated Press

Also involved in the media feeding frenzy is Dr. Cyril H. Wecht, who in September performed a privately commissioned autopsy on the body of Ms. Smith's 20-year-old son, Daniel.

The Associated Press reported yesterday that Dr. Perper said no illegal drugs were discovered in Ms. Smith's room at the Seminole Hard Rock Hotel and Casino in Hollywood after the 39-year-old pinup collapsed there Thursday.

But CNN quoted a law enforcement source as saying there were large amounts of prescription drugs, including Valium and antibiotics, as well as over-the-counter cold and flu medication.

Dr. Perper said there were no pills in Ms. Smith's stomach and no other immediate signs of an overdose, but officials "do not exclude any kind of contribution of medication to the death." He reported signs of inflammation in Ms. Smith's heart, "Something which looks a little bit unusual," but added, "It may be nothing."

He said it would take three to five weeks to conclude the investigation. Authorities also planned to interview a nurse and others and examine medical records before settling on a cause of death.

Seminole police Chief Charlie Tiger said there was no signs of foul play.

"There are a number of possibilities" as to the cause of death, Dr. Perper said, including natural causes, a drug reaction or some combination of the two.

Dr. Perper said she had been sick for several days with some kind of stomach flu.

Dr. Perper took the Florida post in 1994, while serving his fourth elected term as Allegheny County coroner, a position that since has been changed to an appointed medical examiner. In all, he had a 21-year career with the office.

When Ms. Smith's son died Sept. 10, while visiting his mother and her newborn daughter at a hospital in the Bahamas, Dr. Wecht determined the young man had low levels of three drugs in his system.

Because of that connection to Ms. Smith, Dr. Wecht has been in high demand for TV, newspaper and radio interviews about the former model.

Dr. Perper's tenure as coroner here was sandwiched between terms that Dr. Wecht served, from 1970 to 1980 and 1996 to 2006. In fact, Dr. Wecht met Dr. Perper at a medical convention, and in 1972 hired him as Allegheny County's chief forensic pathologist.

In 1981, Dr. Perper's relationship with Dr. Wecht was abruptly severed during a preliminary hearing for Dr. Wecht, who was charged with using the public morgue for private gain. Dr. Wecht was later acquitted of all charges in that case. During questioning, Dr. Wecht's chief defense lawyer accused Dr. Perper of perjury, and Dr. Perper criticized his former boss.

The two haven't interacted since.

"It's nothing of an active, hostile nature, we've just not had any contact," Dr. Wecht said. "He is a competent, experienced forensic pathologist and I have no doubt his office will do a thorough job. That office is completely capable of doing everything that needs to be done."

Under Dr. Perper's tenure, there were so many technological advances in the Allegheny County coroner's office that it became one of only a handful in the country that was totally computerized.

A more professional image was created by requiring all deputy coroners to wear uniforms. A family room was built so relatives of the deceased could identify a body on a black-and-white video monitor.

Guidelines were instituted to make sure valuables of the deceased were safe. To avoid a mix-up in the morgue, a video camera attached to a photographic printer was installed to record the date and time of arrival of all bodies.

The office was active in forensic research, with Dr. Perper publishing books and articles in professional journals. Review panels were set up to examine certain types of deaths, such as those from medical errors or industrial accidents.

Dr. Perper became acting coroner when Dr. Wecht was elected county commissioner. That brought about one of the more bizarre scenes ever witnessed in the county morgue.

In February 1981, Republican Sanford Edberg was nominated as coroner by then-Gov. Dick Thornburgh and confirmed by the state Senate to fill Dr. Wecht's unexpired term. But when Dr. Edberg attempted to enter the coroner's office, he and Dr. Perper engaged in a shoving match as TV cameras rolled.

Dr. Perper had the last laugh, defeating Dr. Edberg in general elections in 1981 and 1985. He was unopposed in 1989, and in 1993 trounced Republican Joe Mulvihill.

Like Dr. Wecht, Dr. Perper was accessible to the media; his distinctive accent became a mainstay of news sound bites during his tenure.

He came to Allegheny County via Romania, where he was born, and Israel, where he earned medical and law degrees from Hebrew University in Jerusalem.

Dr. Perper may be new to the international media glare but Dr. Wecht is experienced in that arena.

In one way or another, he has been involved in post-mortem examinations in such high profile cases as the deaths of John F. Kennedy, Robert F. Kennedy, Elvis Presley, Tammy Wynette, Jon Benet Ramsey, Laci Peterson, Nicole Brown Simpson and Ron Goldman.

Dr. Wecht said that performing autopsies on celebrities may "add a new and additional dimension" to a forensic pathologist's job, but it has no effect on procedure or analysis. For example, his medical conjecture that Ms. Smith's death may be due to drugs had nothing to do with her celebrity but with her age and apparent good health.

"Everything I said medically as a forensic pathologist would be applicable to the homeless guy or anybody," he said.