Medical examiner Michael Graham said at a news conference Friday that the 29-year-old reliever was dead "within seconds" from head injuries in the crash early Sunday on Interstate 64 in St. Louis. His vehicle hit the back of a tow truck parked on the highway to assist a driver from a previous accident.
"There is nothing at all that could have been done for him," Graham said.
Hancock's blood-alcohol level was 0.157, nearly twice Missouri's legal limit of 0.08, Graham said.
Police chief Joe Mokwa said 8.55 grams of marijuana and a glass pipe used to smoke marijuana were found in the rented Ford Explorer. Toxicology tests to determine if drugs were in his system had not been completed.
"I think there was an expectation that alcohol was involved, so I'm not sure what was said today is going to make [Hancock's family] feel worse or suffer more or feel differently about Josh," Cardinals manager Tony La Russa said at a news conference at Busch Stadium. "The marijuana part, I don't know how to answer that part."
An accident reconstruction team determined Hancock was traveling 68 mph in a 55 mph zone when his SUV struck the back of a flatbed tow truck stopped in a driving lane. Mokwa said there was no evidence Hancock tried to stop. He did swerve, but too late to avoid the collision.
Hancock was not wearing a seat belt, but Graham said the belt would not have prevented his death.
Mokwa said Hancock was speaking with a female acquaintance about baseball and baseball tickets and that the conversation ended abruptly, apparently when the accident occurred. A police report said Hancock told the female acquaintance he was on his way to another bar and that he planned to meet her there.
Hancock, a key bullpen member on the World Series championship team last season, was driving alone.
Teammate Jim Edmonds said he didn't think Hancock had a drinking problem. He believed that by eliminating one of several elements -- alcohol, talking on the cell phone, speeding, a tow truck parked in a traffic lane with somewhat limited visibility -- Hancock probably would have made it to his destination.
"I didn't think he had a problem, no," Edmonds said. "Were we concerned when he didn't show up on time for a day game? I can say I was. I wasn't concerned with him being out."
Houston Astros manager Phil Garner, whose team opened a three-game series in St. Louis on Friday night, referred to the circumstances as a "perfect storm."
Cardinals officials expressed sadness at the news and said the team will re-examine what it can do to warn players of the dangers of drinking and driving.
"I think it's probably a wakeup call to everybody," general manager Walt Jocketty said at a news conference at Busch Stadium. "The one thing they have to understand is they're not invincible. They have to conduct themselves and make better decisions. Unfortunately, Josh didn't make very good decisions that night."
Before the game, the team banned alcohol in the clubhouse in what La Russa termed a largely symbolic move. The Cardinals were also considering banning alcohol on the road.
"It's meaningful," La Russa said. "But it's not a significant factor in our clubhouse because our guys don't stay in the clubhouse to drink."
La Russa was arrested on a drunken-driving charge in Jupiter, Fla., in March, when police said they found him asleep at the wheel at a traffic light. His blood alcohol level was measured at 0.093 -- Florida's legal limit is 0.08. His lawyer waived La Russa's arraignment last month and requested a trial. No trial date has been set.
Hancock, who pitched three innings of relief in last Saturday's 8-1 loss to the Cubs, left Busch Stadium around 6:30 p.m. and arrived about two hours later at Mike Shannon's Steaks and Seafood, a restaurant and bar owned by the former Cardinals third baseman who is now a team broadcaster. Police said Hancock left Mike Shannon's shortly after midnight.
Around 12:30 a.m. Sunday, the tow truck came upon a disabled Geo Prism and stopped behind it with its yellow lights flashing to protect the car. A few moments later, Hancock's SUV struck the rear of the tow truck. The tow truck driver, who honked his horn to try to get Hancock's attention prior to the crash, was not hurt.
"If you drink, don't drive," Mokwa said. "Use a taxi. Have a designated driver. Call a friend."
Graham said Hancock had severe chest injuries as well as the fatal head injuries.
An estimated 500 mourners turned out Thursday for a memorial service for Hancock in Tupelo, Miss., recalling the pitcher as a goodhearted prankster. Among the mourners were Hancock's teammates, coaches, La Russa and Jocketty. Hancock was buried Wednesday in rural Itawamba County, Miss.
On Friday, the Cardinals placed a tribute to Hancock, his initials and uniform number in a black circle, in the bullpen. It's just a few feet away from an identical tribute to Darryl Kile, who died in 2002.
Hancock, who joined the team in spring training in 2006, was also honored with a short video, followed by a moment of silence. About a dozen of his teammates gathered at the warning track just below the video board in center field to watch the video.
Hancock made his major-league debut in September 2002 and played for four major-league clubs. He went 3-3 with a 4.09 ERA in 62 regular-season appearances for the Cardinals last season, leading the bullpen in innings, and pitched in three postseason games.
He was 0-1 with a 3.55 ERA in eight games this season.
Hancock joined the Cardinals in spring training last season after Cincinnati released him for violating a weight clause in his contract. He also pitched for Boston and Philadelphia.
The Cardinals postponed a home game the day of the accident against Chicago and haven't won since. They were swept in a three-game series in Milwaukee and had a day off Thursday.
Three days before the fatal wreck, Hancock was involved in another accident. The front bumper of his SUV was torn off in a crash with a tractor-trailer that happened at 5:30 a.m. on April 26 in Sauget, Ill., when Hancock moved forward into an intersection to make a left turn.
Hancock showed up late to Busch Stadium for that day's game against the Cincinnati Reds, which started at 12:10 p.m. He said he thought the game time was later and had overslept in a new bed. La Russa spoke to the pitcher afterward and hinted that he used the opportunity to remind Hancock about the importance of being responsible.
"When you sign a contract with the Cardinals, you're talked to about these issues [such as drinking and driving]," La Russa said. "I did have a very serious heart to heart with Josh on that Thursday and on Saturday he still drank and still crashed. Maybe I could have done a better job in my conversation, but I pulled out all the stops."
Hancock's death marked the second time in five years the Cardinals have mourned the loss of a teammate. Kile was found dead in his Chicago hotel room in 2002. Kile, 33, died of a coronary artery blockage.
Information from The Associated Press was used in this report.