by JENN WOOD
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Nearly four months after the suspicious disappearance and death of 39-year-old Elena Katherine Moore captured national attention, Lexington County coroner Margaret Fisher has announced Moore died of natural causes — while raising pointed questions about the circumstances surrounding her release from a mental health facility just hours before she vanished.
During a press conference on Friday (October 9, 2026), Fisher noted that Moore died from complications of cardiac dysrhythmias with premature ventricular contractions — a condition involving abnormalities in the heart’s rhythm.
The determination followed an extensive investigation involving forensic pathologists, years-old medical records, toxicology testing and a review of Moore’s final movements.
While the medical findings provided an explanation for how Moore died, Fisher said the circumstances leading up to her death deserve attention — particularly a decision to discharge her from inpatient psychiatric care despite what the coroner described as an ongoing mental health crisis.
Asked directly whether she believed Moore had been released prematurely, Fisher answered “in my opinion, yes.”
She emphasized, however, that she did not know the facility’s discharge criteria or protocols – and could not say with certainty whether keeping Moore hospitalized would have prevented her death.
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WHAT THE AUTOPSY REVEALED
According to Fisher, the autopsy was performed at the Medical University of South Carolina (MUSC) in Charleston, with forensic pathologist Dr. Ellen Riemer overseeing the examination.
The findings identified complications of cardiac dysrhythmias with premature ventricular contractions as Moore’s cause of death. Her manner of death was classified as natural.
Fisher said the medical investigation uncovered an irregular heartbeat history dating back to Moore’s teenage years.
At approximately 14 years old, Moore reportedly underwent a school-related medical examination that identified an irregular heartbeat. Her medical history later included episodes of shortness of breath, heart palpitations and decreased exercise tolerance.
By June 2025, physicians had documented cardiac dysrhythmia, sinus tachycardia and hypertension. Additional cardiac testing and monitoring were ordered.
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Despite Moore’s public image as a fitness enthusiast and bodybuilder, Fisher said investigators learned from family members and friends that she had experienced difficulty with cardiovascular exertion.
The coroner also described several factors that may have complicated Moore’s underlying condition, including high temperatures, possible dehydration and an extended period without prescribed cardiac medication.
According to Fisher, the medication was not detected in Moore’s toxicology results, although medical records indicated it had been administered at least once during her psychiatric hospitalization.
Toxicology testing also identified ethanol, although Fisher cautioned that decomposition could have affected the reported alcohol concentration, making it impossible to determine Moore’s precise level of intoxication prior to her death.
The autopsy found no evidence of traumatic physical injury, broken bones or sexual assault. Meanwhile, Fisher said investigators found no evidence suggesting Moore had been murdered.
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RELATED | Elena Moore Investigation: Cause of Death Unknown
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A MEDICAL CRISIS BEFORE HER DISAPPEARANCE
The press conference also provided a more detailed account of the days immediately preceding Moore’s disappearance.
According to Fisher, Moore first came to the attention of emergency responders on June 5, 2026, when a 911 caller reported finding her sitting outside a residence. The incident occurred around the same time surveillance footage circulated online showing Moore apparently behaving unusually during an encounter involving a food delivery.
Fisher said emergency personnel found Moore barefoot, with dirt on her clothing, complaining of chest pain and exhibiting an altered mental status.
She was transported to a local hospital, where medical personnel evaluated her condition and consulted psychiatric and social work professionals. According to Fisher, physicians determined that Moore was experiencing a significant psychiatric crisis and initiated an involuntary commitment.
Moore was subsequently transferred to an inpatient mental health facility.
Medical records reviewed by the coroner’s office documented diagnoses including unspecified psychosis with paranoia and delusions, anxiety, attention-deficit/hyperactivity disorder, mood disorder, alcohol use disorder and cannabis use disorder.
Fisher said those records indicated Moore continued experiencing psychiatric symptoms during her stay at the facility. Nevertheless, she was discharged on June 11, 2026.
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THE DISCHARGE AND UNANSWERED QUESTIONS
Moore’s release from psychiatric care became one of the most significant points of discussion during Friday’s press conference, with Margaret Fisher questioning whether the 39-year-old should have been discharged while still experiencing what she described as a serious mental health crisis.
According to Fisher, Moore’s husband, Brannon Slice, told investigators he was contacted by the facility on June 11, 2026 and informed his wife would be discharged. Slice reportedly offered to pick her up but was told the facility would arrange transportation because her release time had not been established.
Fisher emphasized this account came from Slice and that she did not have independent details explaining the transportation decision. Instead of arriving home, Moore was transported by taxi to a CVS pharmacy at 5608 Sunset Boulevard in Lexington — a location where Fisher said she had previously worked.
That stop was documented in the initial missing-person report obtained by FITSNews through a Freedom of Information Act request.
According to the report, Moore asked the cab driver to stop at CVS. When she failed to return to the vehicle, the driver entered the store in an attempt to locate her.
Friday’s press conference provided additional context…
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Fisher said Moore told a store manager that the cab driver was following her and trying to hurt her. The manager contacted the Lexington Police Department (LPD), but Moore had already left on foot before officers arrived.
The coroner also described an encounter involving wine and water that Moore reportedly took from the store after telling an employee she had forgotten her wallet.
Those details were not included in the unredacted portion of the initial missing person report previously obtained by FITSNews.
Moore was subsequently documented at Planet Fitness, where the initial police report indicated her membership information was used to check in at approximately 6:38 p.m. EDT on June 11, 2026.
Additional surveillance footage later placed her near the Publix parking lot and Old Cherokee Road. Fisher said the final known surveillance footage of Moore depicted her crossing North Lake Drive toward Old Cherokee Road at 9:17 p.m. EDT on June 11, not far from where her body was eventually discovered.
The coroner believes Moore likely died that evening – the same day she was discharged from psychiatric care, although an exact time of death could not be established. Her body was recovered six days later, on June 17.
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While Fisher’s office has now determined Moore’s cause and manner of death, the coroner made clear that she remains troubled by the circumstances surrounding her discharge.
She questioned how a patient involuntarily committed following a documented psychiatric crisis could be released several days later and transported home without a family member.
Asked directly whether she believed Moore had been released prematurely, Fisher responded, “In my opinion, yes.”
However, Fisher acknowledged that she is not a physician and does not know what clinical criteria the facility used to determine Moore was ready for discharge. She also could not establish whether the facility followed its own protocols or whether a different decision would have prevented Moore’s death.
Fisher expressed frustration with what she characterized as missed opportunities to intervene, pointing to the broader challenges families face when seeking treatment for loved ones experiencing serious mental health crises.
The coroner also emphasized that Slice had attempted to obtain help for his wife. Addressing public speculation surrounding him, Fisher said he had never been considered a suspect or person of interest in the investigation.
The coroner’s office worked alongside the S.C. Law Enforcement Division (SLED), which assisted in investigating the circumstances of Moore’s death. Fisher said SLED was aware of and agreed with her office’s findings. When asked whether the agency had formally closed its investigation, however, she referred that question to SLED.
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THE QUESTIONS THAT REMAIN
The medical findings bring an important measure of clarity to a case that generated widespread speculation following Moore’s disappearance.
Her death has been classified as natural, and investigators identified no evidence of a violent assault.
But the press conference also raised questions extending beyond the autopsy itself.
Why was Moore discharged from inpatient psychiatric care despite the symptoms described in her medical records? What clinical assessments supported that decision? Why was she transported by taxi rather than released to a family member who reportedly offered to retrieve her?
Fisher acknowledged that she did not have answers to those questions.
And while she believes Moore’s discharge came too soon, she stopped short of asserting that a different decision would have saved her life.
“Would that have saved Elena’s life had they kept her? Nobody knows the answer to that,” Fisher said.
For a case that began with a missing-person report, a cab ride and surveillance footage of a woman walking alone through Lexington, the official findings now provide an explanation for Moore’s death.
Whether the circumstances preceding it could have unfolded differently remains a separate — and unanswered — question.
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ABOUT THE AUTHOR …
As a private investigator turned journalist, Jenn Wood brings a unique skill set to FITSNews as its research director. Known for her meticulous sourcing and victim-centered approach, she helps shape the newsroom’s most complex investigative stories while producing the FITSFiles and Cheer Incorporated podcasts. Jenn lives in South Carolina with her family, where her work continues to spotlight truth, accountability, and justice.
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