The world stood still on October 28, 2023. We all remember where we were when the news broke that Matthew Perry—our Chandler Bing—was gone. He was found face down in his hot tub at his Pacific Palisades home. Initially, everyone assumed it was a tragic, lonely accident. Maybe his heart gave out? Maybe he just slipped?
But as the months rolled by, a much darker, more predatory story started to leak out through the Los Angeles County Medical Examiner’s office and federal indictments. Honestly, it’s a lot worse than we thought.
How did matty perry die? The clinical answer
The official cause of death wasn't just "drowning." That was a secondary factor. The primary cause, according to the autopsy, was the acute effects of ketamine.
Now, if you’ve followed Perry’s journey, you know he was open about using ketamine infusion therapy to treat his depression and anxiety. But here is the kicker: the ketamine found in his system at the time of death couldn’t have come from his last legal doctor’s appointment. That session was a full week and a half before he died. Ketamine has a half-life of only a few hours. It leaves the body fast.
Basically, the levels in his blood were astronomical. We’re talking $3,540 ng/ml$. To put that in perspective, that is the amount used for general anesthesia during major surgery. He wasn't just "relaxing"; he was medically incapacitated.
The "Surgical" Levels in a Hot Tub
Imagine being so sedated you’re essentially under the knife, but you’re sitting in a heated pool. The medical examiner noted that Perry’s coronary artery disease and the presence of buprenorphine (a medication used to treat opioid addiction) made things even more dangerous.
The ketamine caused his heart to race and his blood pressure to spike, then it likely caused him to lose consciousness. He didn't have a chance. He slipped under the water and, because of the drugs, he never fought to come back up.
The "Ketamine Queen" and the Doctors
For a while, people wondered: where did he get it? The answer arrived in 2024 when federal prosecutors unsealed a web of enablers that looks more like a crime drama than real life.
It wasn't just one bad decision. It was a "broad underground criminal network," according to U.S. Attorney Martin Estrada. They saw a man struggling with addiction and saw a "payday."
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- Jasveen Sangha: Known as the "Ketamine Queen" of North Hollywood. Prosecutors say she ran a "drug-selling emporium" out of her home. She allegedly supplied the specific vials that killed him.
- Dr. Salvador Plasencia (Dr. P): This is the part that really stings. A licensed doctor who allegedly texted another physician, "I wonder how much this moron will pay." He was charging Perry $2,000 for vials that cost about $12.
- Kenneth Iwamasa: Perry’s live-in assistant. He had zero medical training but admitted to injecting Perry multiple times on the day he died.
In late 2025, the legal dominoes finally fell. Dr. Plasencia was sentenced to 30 months in federal prison in December 2025. He surrendered his medical license. Sangha, after initially fighting the charges, pleaded guilty to distributing the fatal dose and is facing a massive sentence.
A Month of Chaos
The final weeks of Perry’s life were far from the "clean and sober" image many of us hoped he had maintained. While he was reportedly clean for 19 months prior, he fell back hard.
In the 29 days leading up to his death, he reportedly spent over $55,000 on ketamine. He was being injected six to eight times a day. Think about that. That's not therapy; that's a total loss of control.
One of the most chilling details from the investigation involved a moment where Perry "froze up" and his blood pressure spiked during an injection from Dr. Plasencia. Instead of stopping, the doctor left more vials behind for the assistant to administer.
Why This Still Matters
It’s easy to look at a celebrity death and move on, but Perry’s passing changed the conversation about "boutique" drug treatments. Ketamine is a legitimate tool for mental health—it has helped thousands of people with treatment-resistant depression—but the "wild west" of at-home administration and rogue doctors is a death trap.
Perry wanted to be remembered as someone who helped people stay sober. His book, Friends, Lovers, and the Big Terrible Thing, was a lighthouse for addicts. The irony is that while he was teaching us how to survive, he was being preyed upon by people who should have been protecting him.
What we can take away from this
If you or someone you know is exploring ketamine therapy, there are a few non-negotiables to keep in mind:
- Never do it alone. Perry’s assistant left the house to run errands while Perry was in the water. That was the fatal mistake.
- Stick to clinical settings. At-home kits are becoming popular, but without a medical professional monitoring your vitals, the risk of a "respiratory event" is real.
- Check the credentials. If a doctor is asking for "cash and lots of thousands" outside of a standard billing practice, run the other way.
Matthew Perry’s death was an "accident" on paper, but the investigation showed it was fueled by greed and a catastrophic lapse in medical ethics. He wasn't just a star; he was a human being who deserved better than the "friends" he had at the end.
If you are struggling with substance use, you can reach out to the SAMHSA National Helpline at 1-800-662-HELP (4357). There is no shame in needing a hand, and you don't have to do it in the dark.