Elena Marie Lisowski was a La Mesa resident when her body was found floating in Lake Murray on Feb. 7. Image via industry.co.

When the body of Elena Marie Lisowski was found floating three months ago in Lake Murray, her friends and former restaurant customers were shocked.

Who would kill the longtime waitress at Princess Pub in Little Italy or Antica Trattoria in La Mesa?

Autopsy report on Elena Marie Lisowski (PDF)

Now an autopsy has ruled out homicide. Cause of death most likely was a suicide or a psychotic episode turned tragic.

According to an 14-page report by the San Diego County Medical Examiner’s Office, the 44-year-old La Mesan wasn’t dumped in the lake.

“There was no evidence of homicidal violence or that another person intentionally drowned her in the lake,” said a report signed April 28 by Jessica Magana, medical examiner investigator.

“Given her extensively documented history of delirium tremens and acute psychosis with audio and visual hallucinations and exhibiting bizarre behavior, it is possible she could have accidentally drowned during an acute psychotic episode,” said the report.

But considering her history of depression and struggles with alcohol abuse, Lisowski — a capable swimmer whose body tested negative for mind-altering drugs — “the possibility of a suicidal drowning cannot be ruled out,” said Dr. Melanie F. Estrella and Dr. Bethann Schraber, pathologists in the case.

National Suicide Prevention Lifeline

Her body was found Feb. 7 fully clothed in a region of the lake with shallow edges on a cold day where swimming is not permitted but is known for suicidal drownings, the report said.

“No personal effects or items of identifying nature were observed on or near the decedent,” the report said. “No evidence of alcohol or illicit drugs was observed. No letters of a suicidal nature were observed.”

But Estrella gleaned through an interview with Lisowski’s sister that the childless woman’s medical history showed alcohol abuse with periods of sobriety.

“She had episodes of psychosis with paranoia secondary to alcohol withdrawal,” the doctors said. “She had a history of depression with no known suicide attempts. The decedent knew how to swim. She had a remote history of illicit drug abuse.”

In the six months before her death, Lisowski had three hospital admissions for acute psychosis and delirium tremens, the report said.

From July 2019 to May 2020, it said, paramedics or police officers brought her to the emergency department multiple times for alcohol intoxication where she was either found unresponsive, having auditory and visual hallucinations, or exhibiting bizarre behavior.

“During her psychotic episodes, she frequently become paranoid and thought people were chasing her,” the report said.

But the autopsy demonstrated a normally developed, well-nourished woman with pulmonary edema, foam in the airways, and immersion artifact of the hands and feet, consistent with being submerged in water.

“The liver showed fatty changes, consistent with a history of alcohol abuse,” said the report. “Other than very minor faint contusions on the left forehead, right shoulder, and lower extremities, no additional trauma was seen.”

Bottom line: The cause of death was listed as drowning, and the manner of death was classified as undetermined.

A GoFundMe drive collected nearly $3,600 toward a memorial expense fund.

It said she is survived by her twin brother, Eric, her sister, Maria, and her niece and nephews.

“Elena, you now have your angel wings and we pray that you find happiness and rest peacefully,” said the GoFundMe page. “You are missed and loved and will never be forgotten.”