The cause of death for the Florida woman discovered inside a Dollar Tree freezer in Miami late last year has now been confirmed.
According to People, on February 11, the Miami-Dade County Medical Examiner’s Office ruled that 32-year-old Helen Massiell Garay Sanchez died from environmental hypothermia, with ethanol use listed as a contributing factor.
Toxicology results showed Sanchez had a blood ethanol level of 0.112%, which is above the legal limit to drive. An ocular fluid ethanol reading measured 0.156%.
Ethanol is the type of alcohol found in alcoholic beverages. Hypothermia occurs when the body’s core temperature falls below 95 degrees. If untreated, it can cause the heart and respiratory system to fail and can ultimately result in death.
Authorities previously stated that surveillance footage showed she entered the store on December 13 without making a purchase. Investigators said she then entered a restricted, employee-only area and the freezer on her own, remaining there overnight.
An employee discovered her body around 8 a.m. the following morning.
Police previously said they reviewed both store surveillance footage and video obtained from a family member. “This is why we know there was no foul play,” a spokesperson said at the time. “She went into the freezer on her own.”
An officer also said that mental illness was ruled out as a factor in her death.
In January 2026, Sanchez’s family filed a wrongful death lawsuit in Miami-Dade County against Dollar Tree and the store’s manager, seeking more than $50 million in damages.
The lawsuit alleges negligence, claiming the company failed to prevent her from accessing the freezer. It also states that the manager had been made aware that Sanchez was missing and had not exited the store but “failed to take reasonable action to locate or assist” her.
The case was filed on behalf of her husband and two children.
Dollar Tree has said it is cooperating with authorities. “Our thoughts continue to be with the individual’s family and loved ones,” a spokesperson said earlier this month. The company added that it does not comment on active legal matters.
Sanchez was originally from Nicaragua and worked as an anesthesiologist specializing in congenital heart disease. A GoFundMe created to support her family described her as someone who “brought hope and healing to countless children and families.”
Her two children remain in Nicaragua. The fundraiser states that donations will go toward repatriation, transportation, and funeral services so she can be laid to rest at home.