What happened to Anna Nicole Smith? Cause of death explored as Dannielynn Birkhead wears mom's iconic backless dress

Anna Nicole Smith’s daughter has honoured her mother’s legacy by wearing her iconic black gown. The 18-year-old accompanied her father, Larry Birkhead, to the 2025 Barnstable Brown Gala in a backless floor-length number previously worn by her mother to the same event in 2004.

The dress features a low back with a jewelled chain extending from one end to the other, which complements the embellishments on the bodice. Other details in the gown include a low neckline. Danielynn also replicated her mother’s hairstyle, which was a ponytail with bangs framing her face.

Anna Nicole Smith passed away when Danielynn was only five months old. The Hollywood beauty died on February 8, 2007, of an accidental overdose. Larry Birkenhead told reporters at the Barnstable Brown Gala that he was emotional seeing Danielynn in her mother’s dress:

"It was emotional because the last time I saw that dress was on Anna,"

He added:

"When Dannielynn "was a little girl, she walked over and she put her hand on the dress." He continued, "And now that she's actually old enough to wear it, it just seems surreal that we're at this moment."

Anna Nicole Smith’s cause of death explored as daughter honours her mother by wearing an old dress

In an appearance on the Wendy Williams Show in February 2017, Larry Birkenhead, who dated the model and shares a daughter with her, revealed that she was battling with chronic back pain during her lifetime. He added that her infamous slurred speech at the American Music Awards in 2004 was a result of her pain medication:

“The night before she did that award show, she actually suffered two seizures. She tried to take something to stay awake that her doctor had given her.”

He added:

“She also was very nervous around those things,”

Birkenhead also commented on the misconception that Anna Nicole Smith was using street drugs. He stated that she was using prescription medication. Although he seemed to infer that Smith wasn’t using the drugs like she was supposed to:

“I would see doctors coming in and saying: ‘This is legitimate for this issue …She had doctors treating her for these issues. Did she always take her medicine like she was supposed to? Probably not.”

According to People, a toxicology report from the coroner determined that the model was battling with flu and bacterial infection at the time of her death. Multiple substances, including Valium and methadone, were found in her system.

Although the drugs were estimated not to have been sufficient to kill her, a sleeping medication, choral hydrate, was found in her system— it is known to be deadly when combined with the sedative Lorazepam, also found in her system. Her death was ruled “an accidental overdose with no other criminal element present” by the Seminole Police Department in Florida.

In the months leading to her death, Anna Nicole Smith battled with the death of her 20-year-old son, Daniel. Daniel suddenly passed away while visiting Smith in the hospital in September 2006.

Birkenhead, in a report by People, shared that he believed Smith died from the pain of losing her son:

"Although her death certificate will list a different cause — an accidental overdose — in my mind, I think she truly died of a broken heart."

Also read:

1) How much are the Met Gala tickets? All we need to know so far about ‘Tailoring Black Style’ event

2) What is Met Gala? History of the event explored as event becomes the biggest fashion night of Hollywood

Anna Nicole Smith is remembered as a Hollywood fashion icon and for her time as a Playboy model. Danielynn, while wearing the black dress in tribute to her mother, described it as “the closest to a hug I can get from her.”

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