Carolin Wosnitza was undergoing her fifth breast enhancement procedure, this time to increase her breast size from an F to a G cup, when the 23-year-old suffered a heart attack at a plastic surgery clinic in Hamburg.
According to a forensic report seen by the Bild newspaper, her main cause of death was a botched resuscitation attempt when her heart stopped beating during the operation.
The assessment said doctors incorrectly used a defibrillator device and failed to give Wosnitza a needed cardiac massage, Bild reported on Wednesday.
However, the report found no fault with how doctors had administered Wosnitza anaesthetics – something many suspected had contributed to her death.
Prosecutors had been investigating the doctors involved in the surgery on suspicion of negligent homicide, but there's not yet word if authorities will issue an indictment. The defendants' lawyers will have a chance to respond to the report before that decision is made.
Wosnitza became famous last year on the German version of the reality television show Big Brother. She went on to release several popular music singles.
But she was also as a prolific porn actress who had to be rushed to the hospital during one shoot after she struggled to perform fellatio on 200 men in one day – what would have been a world record. She only got to the 75th man before falling ill.
In 2010 she was honoured with an award for her dedication to porn at the Venus erotic industry trade fair.