Liberace died as a direct result of having AIDS, the Riverside County coroner said Monday afternoon, contradicting statements by the entertainer's family and the death certificate signed by his physician.
Coroner Raymond Carrillo said Liberace died of cytomegalovirus pneumonia, an "opportunistic infection" that is a frequent cause of death in AIDS patients.
Reporting the results of an autopsy performed on the famed pianist, who died Wednesday, Carrillo told a news conference on the front steps of the county administrative offices here that the 67-year-old entertainer had also suffered from pulmonary heart disease and calcification of a heart valve. Carrillo said these conditions contributed to, but were not related to, the immediate cause of death.
Liberace, perhaps more famous for his flamboyant costumes and stage manner than for his keyboard skill, died in his Palm Springs home amid reports that he was suffering from the deadly acquired immune deficiency syndrome. But his agent and family denied the reports.
Later, his physician, Dr. Ronald Daniels of Whittier, gave as the cause of death heart failure brought on by subacute encephalopathy, or degenerative brain disease.
But Riverside County officials refused to accept the death certificate because Carrillo had not been contacted, as required in the case of a possible contagious disease.
A Riverside County coroner's supervisor, Sabas Rosas, told The Times on Friday that blood tests at Eisenhower Medical Center in Rancho Mirage showed that Liberace had been exposed to the AIDS virus before he died, although that did not necessarily mean he had developed the disease.
Asked Monday whether he believes that attempts had been made to mislead officials, Carrillo responded: "I firmly believe that somebody along the line wanted to pull a fast one on us. They probably pulled something they thought they could get away with."
Carrillo said his office does not plan to pursue any legal action against Daniels. Rather, he said, Liberace's death certificate and related medical records will be referred to "the appropriate policing agencies," including the state Board of Medical Quality Assurance, the medical licensing and disciplining agency in California.
But what actions, if any, the board may take is far from certain.
"When a person dies of multiple problems, any one of which can cause death, it would be difficult to prove that a death certificate contained outright false information," said Steve Wilford, the board's assistant executive director. He said that in cases where information is "blatantly false," the board may pursue the matter.
Daniels declined to comment Monday.
In recent years, the nation's medical experts have lamented the falling autopsy rate in general, saying that autopsies can be a great learning tool because doctors often misinterpret the true cause of death.
On Friday, Liberace's embalmed body was returned to Riverside from Forest Lawn Memorial-Park in Hollywood when Carrillo ordered an autopsy to determine the underlying cause of the encephalopathy. The autopsy was performed by Dr. F. Rene Modglin, a Riverside physician.
Liberace was entombed as scheduled at Forest Lawn on Saturday. That afternoon, Carrillo announced that the initial autopsy results had failed to show whether death was caused by AIDS.
Some of the entertainer's fans went to the tomb over the weekend, expressing anger and dismay that the inquiry was being conducted. "They should let the man rest in peace," one 54-year-old man said.
A spokesman for the Riverside County Health Department said that to his knowledge it is the first case there involving possible AIDS in which the death certificate has been challenged and an autopsy performed.
He said that as of Jan. 31, the county had recorded 110 cases of AIDS since 1982.
With the possibility that many AIDS cases go unreported at death, Carrillo was asked why the death certificate was questioned in Liberace's case. He said it was because "the original cause of death didn't make sense. Encephalopathy doesn't necessarily cause heart failure."
Carrillo, who is not a physician, was just elected in November. Before that, he served as a coroner's investigator. Many lay people in California serve as coroners, including 15 sheriff-coroners, such as in Orange County.