The official cause of death for actor Val Kilmer was revealed Thursday, with a death certificate issued by the Los Angeles County Department of Public Health and obtained by TMZ citing pneumonia as the immediate cause, with other underlying medical conditions.
The star of such hit movies as "Top Gun," "The Doors," "Tombstone," and "Batman Forever" had squamous cell carcinoma at the base of his tongue and suffered from hypoxemic respiratory failure and chronic respiratory failure, according to the document.
Other factors noted on the 65-year-old Kilmer's death certificate included malnutrition and a tracheocutaneous fistula, which can occur with those who have had a tracheostomy, a procedure to help air and oxygen reach the lungs by creating an opening into the trachea from outside the neck, according to the National Library of Medicine.
His body was cremated April 7, the document said.
The official cause of death corroborated a previous statement made by his daughter, Mercedes Kilmer, 33, who told The New York Times that her father died from pneumonia April 1 in Los Angeles.
Kilmer's health declined significantly after he was diagnosed with throat cancer in 2015, but in 2021, he declared he was cancer-free.
The cancer treatments took a toll on Kilmer's body, however. In addition to undergoing radiotherapy and chemotherapy, he had two tracheotomies to create an artificial hole in his neck to help him breathe. The surgeries permanently damaged his vocal cords and left him barely able to speak.
In his final film performance, reprising his role as Iceman in 2022's "Top Gun: Maverick," artificial intelligence technology was reportedly used to revive his voice.
Kilmer was also bed-bound "for years before his death," sources close to Kilmer's family told TMZ. His body "simply couldn't keep fighting at the end," they said, adding, "his body eventually shut down."