The final results from the autopsy of singer Shin Hae Chul have been released. Based on the results, the National Institute of Scientific Investigation (NISI) is leaning toward the likelihood that the perforation in Shin Hae Chul’s pericardium and small intestine occurred during surgery. However, it has reservations about determining exactly when those perforations occurred and is deferring judgement of malpractice to the Korean Medical Association.

According to the NISI, the perforations could have occurred during surgery or damage during surgery could have developed into the perforations. The perforation in the small intestine led to peritonitis [inflammation of the peritoneum, the tissue that lines the wall of the abdomen and covers abdominal organs] and the perforation in the pericardium led to pericarditis [inflammation of the pericardium, the tissue that covers the heart]. These led to cardiac tamponade [pressure in the heart] and abnormality in cardiac function. The cause of death was multiple organ dysfunction syndrome.

Regarding the singer’s stomach reduction surgery, which is at the heart of the controversy over Shin Hae Chul’s death, the NISI is deferring to the medical association. It stated, “While it is assumed that the surgery was to reduce the volume of the stomach, we will have to seek the expertise of the medical association and other experts to know why this surgery took place or if it was really just a surgery to strengthen the stomach walls as Director Kang is claiming.” Previously, Shin Hae Chul’s family claimed that the Sky hospital performed a stomach reduction surgery without their permission.

On October 17, Shin Hae Chul underwent intestinal surgery at the Seoul Sky Hospital. After the surgery, Shin Hae Chul complained of pain in his chest and abdomen, according to his wife Yoon Won Hee. He then suffered a heart attack on October 22, which left him comatose for five days. The singer eventually passed away on October 27. He was 46.

Shin Hae Chul’s family decided to have autopsy performed on the artist instead of just cremating him to determine whether his death was due to malpractice. Yoon Won Hee claims that the doctor who performed Shin Hae Chul’s surgery also performed stomach reduction surgery without the family’s consent.

In 2009, Shin had an adjustable gastric banding operation, a type of weight loss surgery, at the Sky hospital. Yoon Won Hee revealed recently through a SBS investigative TV program aired November 29 that the hospital removed the singer’s gall bladder during the operation without telling them beforehand.