During the carousing, one of the women, a 26-year-old aspiring actress named Virginia Rappe, became seriously ill and was examined by the hotel doctor, who concluded that she was merely intoxicated.
In truth, Rappe had been a sick woman for some time. She suffered from chronic cystitis, which would cause her to become violently ill after drinking alcohol. She was also widely rumored to be a carrier of venereal disease. Significantly, while in San Francisco she allegedly asked Arbuckle to help pay for an (illegal) abortion. In her book Frame-Up!, author and researcher Andy Edmonds theorizes that the after-effects of an illegal abortion may have contributed to Rappe's illness at the party.
Rappe died three days later of peritonitis caused by a ruptured bladder. Rappe's companion to the party, Maude Delmont, tried to blackmail Arbuckle over his involvement in the matter, claiming that he'd crushed Rappe's innards while raping her. Arbuckle, confident he had nothing to be ashamed of, refused to be intimidated. Delmont then made a statement to the police in an attempt to get money from Arbuckle's attorneys, but the matter soon got out of her hands. Newspapers, particularly those controlled by William Randolph Hearst, made a fortune endlessly crucifying Arbuckle in spurious and surreally vicious articles and editorials (the New York Times stated that Rappe was lucky to be crushed to death during the rape before having to consciously endure "a fat man's foulness").
Roscoe Arbuckle's career is seen by many film historians as one of the great tragedies of Hollywood. The Arbuckle trial was a major media event, and stories in William Randolph Hearst's newspaper empire made Arbuckle appear guilty. After two trials resulted in hung juries, the third resulted in an acquittal and a written apology from the jury—a gesture unprecedented in American justice.