Tyler Skaggs’ autopsy: Fentanyl, oxycodone and alcohol led to death by choking on vomit

Los Angeles Angels starting pitcher Tyler Skaggs towels off before a game against the Minnesota Twins at Angel Stadium on May 11, 2018 in Anaheim, California.
Los Angeles Angels starting pitcher Tyler Skaggs towels off before a game against the Minnesota Twins on May 11, 2018, in Anaheim.
(Gina Ferazzi / Los Angeles Times)

Angels pitcher Tyler Skaggs had the opioids fentanyl and oxycodone along with alcohol in his system when he was found dead in his Texas hotel room July 1, according to a toxicology report released Friday by the Tarrant County medical examiner’s office.

The cause of death is listed as a mixture of “alcohol, fentanyl and oxycodone intoxication with terminal aspiration of gastric contents,” meaning Skaggs, 27, essentially choked on his vomit while under the influence. The death, according to the report, was ruled an accident. He was found on his bed, fully clothed, and there were no signs of trauma.

The Southlake, Texas, Police Department is investigating the death, and a statement from Skaggs’ family issued Friday mentions that an Angels employee may have some involvement.


The statement: “We are heartbroken to learn that the passing of our beloved Tyler was the result of a combination of dangerous drugs and alcohol. That is completely out of character for someone who worked so hard to become a Major League Baseball player and had a very promising future in the game he loved so much.

“We are grateful for the work of the detectives in the Southlake Police Department and their ongoing investigation into the circumstances surrounding Tyler’s death. We were shocked to learn that it may involve an employee of the Los Angeles Angels. We will not rest until we learn the truth about how Tyler came into possession of these narcotics, including who supplied them. To that end, we have hired attorney Rusty Hardin to assist us.”

Major League Baseball plans to assign its investigative unit to probe the claim that an Angels employee might have been involved in Skaggs’ death.

“We were unaware of this allegation and will investigate,” MLB spokesman Pat Courtney said.

The Angels have hired Fort Worth trial attorney John Cayce to represent them, according to a person familiar with the matter but not authorized to discuss it publicly.

Cayce, a former chief justice of Texas’ Second Court of Appeals, has been working for several weeks as a liaison between the team and Southlake police during the investigation. He was hired to represent the Angels and not necessarily the employee mentioned in the Skaggs family statement.


The Angels were staying at a hotel in Southlake ahead of a four-game series against the Texas Rangers the night Skaggs died. The team arrived the evening of Sunday, June 30, and Skaggs’ body was found in his room at approximately 2:18 p.m. the next day after a teammate became concerned when Skaggs did not return repeated text messages and phone calls about joining him for lunch.

What authorities learned about Skaggs’ hotel room is not publicly known because police reports have not been released. The L.A Times and other news outlets requested police, fire department and emergency medical services records related to the incident, but an attorney representing the city of Southlake asked the Texas attorney general whether many of the records are exempt from disclosure. No decision has been reached.

The Southlake attorney said in the letter to the state attorney general that release of some of the materials requested could “interfere with the detection, investigation or prosecution of crime.”

Fentanyl is a powerful synthetic opioid similar to morphine but 50 to 100 times more potent on a weight-by-weight basis. When taken in uncontrolled concentrations by unsuspecting users, or by users whose opioid tolerance has not been heightened by long-term use, the drug is more likely even than prescription opioids to suppress respiration and cause death.

The synthetic drug is the leading culprit in the U.S. opioid epidemic. Most comes from Mexico, where traffickers have embraced it over heroin.

Sept. 1, 2019

Blood tests showed 3.8 nanograms per milliliter of fentanyl in Skaggs’ system, which experts said is a significant amount but not outrageously high. Autopsy blood tests have shown nanograms per millileter levels of over 100.

“The level of fentanyl is a significant amount that could produce death,” said Cyril Wecht, a Pittsburgh forensic pathologist with 40 years of experience. “In this case, oxycodone and alcohol were also present and would have contributed to the death because they are also central nervous system depressants.”

The autopsy report noted the absence of norfentanyl, a metabolite of fentanyl, which Wecht said “means that fentanyl was ingested not long before death occurred.”

Tests showed 38 nanograms per milliliter of the prescription-strength pain killer oxycodone, the use of which is prohibited by Major League Baseball’s Joint Drug Prevention and Treatment Program, and a blood-alcohol level of 0.122%. A 0.08% limit is considered legally impaired. Fentanyl is not specifically listed on MLB’s banned substance list, but as a “drug of abuse” on the federal Drug Enforcement Administration list, its use is automatically prohibited by MLB.

A dozen or so Angels players and a few broadcasters were on the 3 p.m. bus about to depart the Hilton hotel in Southlake, Texas, for Globe Life Park on Monday when traveling secretary Tom Taylor delivered the devastating news.

July 1, 2019

Skaggs was on a one-year contract for $3.7 million in his second year of arbitration. He would have been eligible for free agency after the 2020 season.

Hardin is a renowned Houston criminal defense attorney who has represented and won favorable verdicts for athletes such as Roger Clemens, who was accused of lying before Congress over alleged steroid use; Warren Moon, Scottie Pippen, Rudy Tomjanovich and Wade Boggs.

“I think the thing to keep in mind is they’re just still so devastated, both the wife and the family, about this young man’s death, and they just want to know what happened and how it happened,” Hardin said by phone from his Houston office. “We’re going to want to know how it came about that those drugs were ingested and whether or not others are responsible for what happened.”

Angels starting pitcher Tyler Skaggs walks through the dugout during a game against the Minnesota Twins in May 2018.
(Gina Ferazzi / Los Angeles Times)

Hardin said he has seen the autopsy report but has not seen police reports or spoken to investigators about the case. He said it’s “way too early for us to speculate” on whether there are grounds for legal action.

“You know, if you lose a son, or a husband, or a spouse, it’s just a tremendously horrible experience, and you want to know how it happened,” Hardin said. “So that’s where the family is right now. How did it happen? Was anyone else involved? They just want to get answers.”

Skaggs was found unconscious two days after his final pitching performance June 29, three days before he was scheduled to make his next start. His body was clad in black denim jeans, a decorated belt and dark brown western boots when it arrived at the medical examiner’s office, according to the autopsy report. The outfit appears to be the same one Skaggs wore June 30, when he coordinated a western-themed trip to Texas to celebrate his team’s back-to-back series against the Rangers and Houston Astros.

Skaggs was one of the most popular players in the clubhouse, and he was also one of the Angels’ most reliable pitchers this season, going 7-7 with a 4.29 ERA in 79 2/3 innings across 15 starts. He was 28-38 with a 4.41 ERA during a seven-year major-league career that was interrupted by an elbow surgery in 2014 and several other injuries in subsequent years.

The onslaught of injuries pushed Skaggs last offseason. He worked out with mobility coach Sarah Howard in Los Angeles and consulted with renowned strength coach Eric Cressey in Florida. Only two minor ailments slowed Skaggs in 2019: He experienced soreness in his forearm after experimenting with a new pitch during spring training and missed a start; and he rolled his ankle in an April game against the Chicago Cubs, leading to a 10-day injured list stint.

Skaggs’ death rocked the baseball world. Players around the league saluted Skaggs by etching his initials and jersey number onto their hats and into the dirt on mounds. Teammate Andrew Heaney opened his first start after Skaggs’ death by throwing Skaggs’ signature curveball.

Tributes continued in the July 9 All-Star game in Cleveland, where Angels Mike Trout and Tommy La Stella wore Skaggs’ number underneath their last names and others wore No. 45 patches like the ones the Angels have worn since Skaggs’ death.

The Angels paid homage to their late teammate in their first home game following his death by donning No. 45 jerseys with the name “SKAGGS” on the back in a July 12 game against Seattle. His mother, Debbie, followed a 45-second moment of silence by throwing a strike for the ceremonial first pitch, which was caught by Heaney.

Taylor Cole and Felix Pena threw the second combined no-hitter in franchise history that night in a 13-0 rout of the Mariners, Cole opening with two perfect innings and Pena following with seven no-hit innings. After the final out, players shed their jerseys and arranged them on the mound before saying a prayer. They left the jerseys there as they departed the field.

Angels starter Tyler Skaggs delivers against the Chicago Cubs on April 12.
(Matt Marton / AP)

“You can’t make this stuff up,” Trout said after driving in six runs and noting that the Angels scored seven runs in the first inning and 13 overall and faced 28 batters on the day before Skaggs would have turned 28. His birthday was July 13, or 7/13. “Tonight was in honor of him, and he was definitely looking over us.”

The Angels have set up Skaggs’ locker in every stadium they have visited since his death. Clubhouse managers even made him a throwback jersey when the Angels celebrated 1970s weekend and acquired the necessary materials in Houston last week to customize his Players Weekend jerseys with the nickname he chose for the festivities — “Slick.”

Many of Skaggs’ friends dedicated their Players Weekend jerseys last week in his memory, including Nationals pitcher Patrick Corbin, who was drafted by the Angels in the same year as Trout and Skaggs and was traded with Skaggs to the Arizona Diamondbacks in 2010.

In a memorial service at St. Monica Catholic Church in Santa Monica last month, hundreds paid tribute to a man described as passionate and caring. Skaggs’ wife, Carli, spoke of their love. His mother listened from the front pew as family members and Skaggs’ closest confidants shared their goofiest — and most heart-rending — memories.

The Angels did not make players available in their Angel Stadium clubhouse before Friday night’s game against the Boston Red Sox. Angels general manager Billy Eppler declined to comment on specific aspects of the police investigation.

“I can just say that we were saddened by that report that came out and completely heartbroken,” Eppler said. “Everyone is searching for facts, and everyone in the organization wants facts, which is why we are actively cooperating with an investigation.”

Eppler said the manner in which Skaggs died would not tarnish the pitcher’s memory in his mind.

“We miss Tyler every day. That clubhouse misses him every day,” Eppler said. “We miss him in our lives, and we pray for him and his family every day, and we pray for our own healing, as well, and nothing that we learned today changes those feelings, not one thing. But this is like a shot to our core, and it brings back a lot of pain from that tragic day.”

Heaney, one of Skaggs’ closest friends on the team, echoed Eppler after the Angels lost to the Red Sox in 15 innings, saying, “It’s heartbreaking either way.”

Heaney said he did not know whether Skaggs had issues with opioids. When asked if he was disturbed to learn of the allegations against an Angels employee, Heaney said he did not have enough information to formulate a response.

“It hurts, the circumstances around it,” said Heaney, who last saw Skaggs on the team bus from the airport to the Texas hotel where he died. “We don’t have answers. Nobody has answers.”

Times staff writers Nathan Fenno and Bill Shaikin contributed to this report.

Tyler Skaggs stood in front of an Angels logo a week ago, flanked by star teammate Shohei Ohtani and a translator.

July 1, 2019

Pitcher Tyler Skaggs died in his hotel room July 1 when the Angels visited the Texas Rangers. Now they are back in Arlington, and the memories are vivid.

Aug. 19, 2019