Matthew Perry's ex-girlfriend calls for his doctors to be investigated over the deadly dose of ketamine he took before drowning in his hot tub and says its unlikely the late Friends star bought drug from the street

An ex-girlfriend of Matthew Perry has called for his doctors to be investigated after it was confirmed that ketamine caused his death.

Perry was found face-down in the hot tub of his Los Angeles home on October 28.

On Friday the medical examiner's report was released, revealing that he died from the 'acute effects of ketamine' and drowning - with the actor having similar quantities of ketamine in his system as a hospital patient under general anesthetic.

Perry had been undergoing ketamine infusion therapy for depression. But his final session was a week and a half before he died, meaning it did not directly cause his death.

Kayti Edwards, who dated him in 2006 and worked as his assistant in 2011 at the height of his drug addiction, said she had lots of unanswered questions.

Edwards, who used to buy Perry's drugs for him, said that she did not believe he bought ketamine from the street, and said his doctors needed to explain further.

'I'm pretty sure that in Matthew's brain, ketamine infusions at a doctor's would count as still being sober,' she told The US Sun.

'In his brain it's not the same as going on the street to buy crack or heroin.'

The medical examiner reported that Perry had been sober for 19 months, and there was no trace of heroin, cocaine, meth or fentanyl in his system.

Edwards said she felt that the ketamine treatment would have pushed him back to doing drugs beyond the doctor's office.

'That probably was the stepping stone for him to go back to doing drugs,' she said.

'I think the doctors who had been working with Matthew should be investigated.

'I'm pretty sure he would have had an in with a doctor.

'It's very hard to get ketamine on the street but it is very easy for a doctor or a nurse to get.'

Edwards said she was not surprised that he was found dead in the hot tub, because he often took drugs and then got in the water.

'I wasn't surprised when the medical examiner's report dropped,' she said.

'I already knew what it was so it wasn't shocking to me.

'I wasn't there so I don't know exactly what happened but I do know Matthew as a person and a friend and I know the patterns that led up to this. I could see it from a mile away, he didn't seem right during the last couple weeks of his life.

'The sober people who knew him have never hung out with him when he was getting high so they wouldn't know the signs.'

She said his final Instagram post, of him alone in the hot tub he would die in, was a sign that he was using drugs again.

Edwards, a mother of four who now runs a horse ranch in Yucca, California, said she last spoke to Perry when his autobiography was published last year, detailing his shocking lifetime abuse of drugs and years of rehab.

'Matthew loved to experiment with different drugs,' she said.

'He would want to try different things to see what worked best for him.

'I remember he got heroin at one point and one of his friends showed him how to smoke it.

'He was always down for trying different stuff but I'm pretty sure the ketamine was a new thing because I never saw him doing it.'

On Friday his cause of death was officially confirmed.

'The County of Los Angeles Department of Medical Examiner determined the cause of death for 54-year-old actor Matthew Langford Perry as the acute effects of ketamine,' the Los Angeles coroner's office said on Friday.

'Contributing factors in Mr Perry's death include drowning, coronary artery disease, and the effects of buprenorphine (used to treat opioid use disorder). The manner of death is accident.'

He was declared dead at the scene and the medical examiner conducted the autopsy on October 29.

Ketamine can be prescribed as a medical treatment, but it is unclear if the drugs in Perry's system were bought using a prescription.

'At the high levels of ketamine found in his postmortem blood specimens, the main lethal effects would be from both cardiovascular overstimulation and respiratory depression,' the medical examiner, Raffi Djabourian, concluded.   

Perry's blood ketamine levels were at 3,540 ng/ml in peripheral blood, and 3,271 ng/ml in central blood.

For a patient under general anesthetic, in a hospital, a blood ketamine level of 1,000 - 6,000 ng/ml would be normal, the medical examiner explained.

'Drowning contributes due to the likelihood of submersion into the pool as he lapsed into unconsciousness; coronary artery disease contributes due to exacerbation of ketamine induced myocardial effects on the heart.

'Buphrenorphine effects are listed as contributory, even though not at toxic levels, due to the additive respiratory effects when present with high levels of ketamine.' 

He had no alcohol, cocaine, heroin, meth or fentanyl in his system. 

The medical examiner said Perry had a history of emphysema, diabetes, and drug use - but he was 'reportedly clean for 19 months'.

He was described as a 'heavy tobacco user for many years but currently not smoking'.

The medical examiner also noted his ketamine infusion therapy.

A year before his death he released a tell-all memoir that included shocking details of his drug and alcohol addiction.

But he said in October 2022 that he was 18 months sober, though that was a year before his death.

Those who knew him maintain Perry was clean and sober at the time of his death. 

When investigators responded to Perry's home, they did not find any illegal drugs, but found prescription medication that was properly labeled and kept in storage bottles. 

The medical examiner did find evidence of his years of drug and alcohol abuse, however, with Perry suffering from 'chronic hepatic congestion, liver' - a precursor to cirrhosis of the liver - although it had not advanced into cirrhosis.

He also had nephrosclerosis of the kidneys - a hardening of the tissues, caused by long-standing, poorly controlled high blood pressure and long term drug use.

Perry's autopsy also found chronic pancreatic fibrosis - opioids are suspected of causing damage to the pancreas. 

His heart and lungs were also significantly damaged.

Perry weighed 216lbs, and was pronounced mildly obese. 

In the memoir, Friends, Lovers and the Big Terrible Thing, Perry wrote that after his colon exploded in 2018, he was prescribed opiates that he deemed insufficient to deal with his pain.

This prompted him to turn to street dealers to supply him with potentially fatal, possibly fentanyl-laced OxyContin. 

'The street pills were something like $75 per pill, so I was giving the guy $3,000 at a time, many times a week,' he wrote. 

Perry wrote that he spent $9 million trying to get sober, going to 6,000 AA meetings, 15 times to rehab, and was in detox 65 times.

At his lowest, he was popping 55 Vicodin a day to fuel his addiction.

He said he overcame addiction in 2021 and was leading a healthier lifestyle.

He took up pickle ball - a game similar to tennis and table tennis - and usually played it twice a day, friends said.

Perry was found underwater by his assistant who lifted his head up to try to get him some air, first responders earlier revealed.

Captain Erik Scott, with the LAFD said: 'Los Angeles City Firefighters responded [and] found an adult male unconscious in a stand-alone hot tub. 

'A bystander had brought the man's head above the water and gotten him to the edge, then firefighters removed him from the water upon their arrival. 

'A rapid medical assessment, sadly, revealed the man was deceased prior to first responder arrival.' 

Perry was laid to rest at an intimate ceremony at Forest Lawn Memorial Park in the Hollywood Hills attended by his Friends co-stars Jennifer Aniston, Matt LeBlanc, Lisa Kudrow, Courtney Cox, and David Schwimmer. 

Perry wrote in his memoir that throughout his drug addiction and recovery he was helped by a female personal assistant he considered to be his rock and 'best friend'.

Morgan Moses, referred to in the book only by the pseudonym 'Erin', first met Perry when he was admitted to a rehab where she was working.

The pair subsequently struck up a friendship that would last nearly a decade and came to be the closest and most loving – though always platonic – relationship in his life.

Moses, 37, is a 'sober companion' whom the troubled Friends star described as 'the single nicest person in the world'.

On her LinkedIn page, Moses says she has worked 'full-time' as a 'sober companion' since 2018. 

Among her skills listed are 'therapeutic crisis intervention', 'mental health first aid', 'behavioral intervention' and 'nutritional counselling'.

Originally a website designer, she is a graduate from Full Sail University in Florida, while her social media suggests she has also had her own addiction struggles and sobriety journey.