Amy Winehouse died from accidental alcohol poisoning when she resumed drinking after a period of abstinence, a second coroner's inquest confirmed Tuesday.
Coroner Shirley Radcliffe ruled that the 27-year-old soul singer "died as a result of alcohol toxicity" and recorded a verdict of death by misadventure. She said there were no suspicious circumstances.
She said that Winehouse "voluntarily consumed alcohol - a deliberate act that took an unexpected turn and led to her death."
The Grammy-winning singer, who fought a very public battle with drug and alcohol abuse for years, was found dead at her London home on July 23, 2011, with empty vodka bottles scattered around her.
Radcliffe said a postmortem had found that Winehouse had a blood alcohol level five times the legal driving limit, and above a level that can prove fatal.
She said that that much alcohol could affect the central nervous system so much that a patient could "fall asleep and not wake up."
Pathologist Michael Sheaff told the inquest that Winehouse had likely suffered a respiratory arrest after consuming so much alcohol. The level in her blood was 416 milligrams per 100 milliliters, a blood alcohol level of 0.4 percent. The British legal driving limit is 0.08 percent.
Winehouse's family did not attend the 45-minute inquest, which was held after the original coroner was found to lack the proper qualifications for the job.
That coroner later resigned after her qualifications were questioned. She had been hired by her husband, the senior coroner for inner north London. But she had not been a registered lawyer in Britain for five years as required.
In Britain, inquests are held to determine the facts whenever someone dies unexpectedly, violently or in disputed circumstances.
Tuesday's verdict was the same as that produced by the first inquest in 2011.
The beehive-haired Winehouse shot to global fame with her 2006 album "Back to Black," which won five Grammys. But her erratic public behavior, turbulent private life and frequent health problems - which included seizures, emphysema and bulimia - often overshadowed her talent.
Tuesday's second inquest re-heard testimony from witnesses and experts including the bodyguard who found Winehouse dead, the police officer who investigated and a doctor who treated the singer as she tried to quit drugs and alcohol.
The doctor, Christina Romete, said Winehouse was "a highly intelligent individual, very determined and willful," who did not easily follow doctors' orders and resisted suggestions she seek psychological help.
She said the singer had successfully given up drugs after a period taking heroin, crack cocaine and marijuana, but had struggled to stop drinking, going through periods of abstinence followed by booze binges.
She started drinking a few days before her death, after being dry for almost two weeks.
"She said she started drinking again because she felt bored," said Romete, who saw Winehouse the day before she died.
"I asked Amy if she was going to stop drinking that evening, and she said she did not know," the doctor said.