ROANOKE -- The State Medical Examiner's office has determined that Randall Lee Smith, who died in a Pulaski County jail four days after shooting two men just off the Appalachian Trail, died of a blood clot in a vessel in his lungs.

The medical examiner's office in Roanoke ruled that the clot, known as an acute pulmonary thromboembolism, was caused by injuries he sustained when he wrecked a pickup truck while fleeing the scene of the shooting.

"This medical examiner's report confirmed the initial findings of our investigation, which was that there was no foul play and his death was accidental," said Sgt. Michael Conroy of the Virginia State Police.

Smith, of Pearisburg, shot and killed two hikers on the Appalachian Trail in Giles County in 1981, a crime for which he spent nearly 15 years in prison. On May 6 in Giles, he shot and wounded two fishermen at their camp in Dismal Creek, not far from where he killed the hikers.

As Smith fled in one of the fishermen's trucks, he lost control and the truck flipped over. He was treated at a hospital in Roanoke and released on May 9. The following day at 4:55 p.m., he was found unconscious in his cell in the New River Valley Regional Jail.