No. Lou Pizarro of the TruTV reality TV show Operation Repo has not died. He collapsed on an episode of the show in 2009, but it's uncertain what condition he was suffering from and/or if it possibly was just an act. He has fully recovered since then and is believed to be in good health at this time.
While the show depicts actual events, they are often filmed re-enactments by actors. Very few credible reports could be found about Lou's collapse on the show and it has never been fully explained to the public what condition Lou had suffered from or if he continues to suffer from it. Sadly, he retired in episode 6 of season 11.
On February 5, 2014, Operation Repo season 11 of the show ended as did the series itself. Catch up on full episodes right now online through TruTV's website.
Lou created and served as director and producer of the Mun2 series Fugitivos De La Ley Los Angeles.