CHAMBERS COUNTY, Texas (KTRK) -- A Texas widow's husband, whose death set off a deeper examination into his wife's checkered past, died of complications of toxic effects of insulin, the Harris County medical examiner ruled.
Joseph Hartsfield's manner of death, though, was ruled undetermined, which may impact how Chambers County prosecutors proceed with their murder charge against wife Sarah Hartsfield.
The Hartsfield saga has risen to national media attention after ABC13 learned Sarah Hartsfield was married four previous times, and through interviews and reports outside of Texas, she allegedly left behind a pattern of spousal abuse and threats against her former partners.
Sarah Hartsfield, 48, is behind bars on a $4.5 million bond.
SEE MORE: What we know about Texas widow Sarah Hartsfield, under suspicion for death of her 5th husband
On Jan. 7, Sarah Hartsfield made a 911 call regarding a medical emergency with her husband. Medics responded to the home in a gated community in Beach City and began administering aid. Joseph was transported to Houston Methodist in Baytown.
Later that day, the sheriff's office received a call from the hospital about the patient's suspicious illness.
Officials told ABC13 that 46-year-old Joseph Hartsfield had diabetes and said his insulin levels were extremely high four to six hours before Sarah Hartsfield called 911. They said that his glucose monitor had sounded an alarm for quite some time before action was taken.
Authorities arrived at the hospital and began investigating due to what they described as inconsistencies in the information provided by the hospital staff.
"The story that the wife gave the hospital, the deputies, the detectives do not match up to the forensic evidence," Chambers County Sheriff Brian Hawthorne said back in February.
According to authorities, Joseph Hartsfield was in a coma for a week before death.
It wouldn't be until a month after her husband's death that the Chambers County district attorney moved to charge Sarah Hartfield for murder.
In the weeks following the arrest, Eyewitness News uncovered at least one case that paints a picture of Sarah Hartsfield's behavior with significant others. Documents out of Minnesota state she was under investigation for the death of former fiancé David Bragg, whom Sarah Hartsfield shot to death in 2018, claiming self-defense.
Douglas County, Minnesota, investigators at the time determined the killing was what she claimed and closed the case. But since the Chambers County case emerged, detectives reopened it.
SEE ALSO: Brother of man killed by Chambers County woman charged with another murder speaks only to ABC13