Val Kilmer's official cause of death revealed

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Val Kilmer’s official cause of death has been confirmed as pneumonia.

But according to his death certificate, which was obtained by PEOPLE, TMZ, Fox News and other media outlets, a variety of secondary causes also played a role in his demise, including acute hypoxemic respiratory failure, chronic respiratory failure, and squamous cell carcinoma of the base of the tongue.

Kilmer, who died on April 1 at age 65, was also suffering from malnutrition and a tracheocutaneous fistula.

The star of Heat and Tombstone was cremated on April 7.

Kilmer’s daughter, Mercedes, announced his death last week when she told the New York Times and Associated Press that her father died “surrounded by family and friends” after battling pneumonia.

TMZ reported that Kilmer had become “frail” and was bedridden in recent months.

Sources told the outlet he “had a lack of energy related to his cancer treatment — and, as a result, he was bed-bound for a long time.”

But insiders said Kilmer’s death wasn’t sudden. “His health seriously declined in the past week, and his friends and family came to Val’s side at the hospital in the days before his death,” TMZ reported.

The veteran actor, who played The Doors frontman Jim Morrison in Oliver Stone’s 1991 rock docudrama, had battled health issues for over a decade, including a fight with throat cancer in 2014.

After he recovered from the disease just a few years later, Kilmer underwent a tracheostomy which affected his ability to speak.

“I can’t speak without plugging this hole (in my throat),” he said in his 2021 autobiographical documentary, Val. “You have to make the choice to breathe or to eat.”

That same year, Kilmer announced he was teaming up with audio technology company Sonantic to regain his voice with the help of artificial intelligence.

The collaboration proved to be a success and he was able to reprise his role as Adm. Tom “Iceman” Kazansky from 1986’s Top Gun for a sequel opposite Tom Cruise in 2022.

Kilmer told PEOPLE returning to the role was “like being reunited with a long lost friend.”

Two days after his daughter confirmed her dad’s death, Kilmer’s family issued a statement thanking fans for their support.

“Thank you for honouring our extraordinary father’s memory,” they wrote in a message shared with PEOPLE. “We are so proud of him and honoured to see his legacy celebrated. At this time, we would like to grieve privately.”

After his death, Kilmer was feted by Cruise while his Top Gun co-star was promoting Mission: Impossible – The Final Reckoning in Las Vegas.

“I’d like to honour a dear friend of mine, Val Kilmer,” Cruise said from the stage at Caesars Palace, according to Variety. “I can’t tell you how much I admire his work, how grateful and honoured I was when he joined Top Gun and came back later for Top Gun: Maverick. I think it would be really nice if we could have a moment together because he loved movies and he gave a lot to all of us. Just kind of think about all the wonderful times that we had with him.”

Cruise concluded his salute with one final toast, saying, “I wish you well on the next journey.”

mdaniell@postmedia.com