MILWAUKEE (AP) — The death of Black man who was pinned to the ground by security guards outside a Milwaukee hotel has been ruled a homicide, according to an autopsy released Friday.

D’Vontaye Mitchell suffocated while being restrained on June 30 and was suffering from the effects of drugs in his system, according to findings issued by the Milwaukee County Medical Examiner’s office.

The findings state that Mitchell’s immediate cause of death was “restraint asphyxia and toxic effects of cocaine and methamphetamine.” The homicide ruling confirms the medical examiner’s office’s preliminary finding made last month that Mitchell’s death was a homicide

The Milwaukee County District Attorney’s office said previously that it and police investigators were awaiting full autopsy results and that the case was being reviewed as a homicide.

The Associated Press sent an email and left a phone message Friday for the district attorney’s office seeking comment on the autopsy report and asking whether its findings would be taken into consideration when decisions on charges are made.

The autopsy, signed Wednesday by assistant medical examiner Lauren A. Decker, states that Mitchell’s “injury” happened while he was “restrained in prone position by multiple individuals after drug (cocaine, methamphetamine) use.”

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It also states that Mitchell had the “significant conditions” of hypertensive cardiovascular disease and morbid obesity. A separate demographic report released by the medical examiner’s office states that Mitchell was 6 feet (1.8 meters) tall and weighed 301 pounds (137 kilograms).

The medical examiner’s office also released an investigative report on Friday that said Mitchell “was restrained by four people after being combative in the hotel lobby.”

“He reportedly went unresponsive while staff awaited police arrival,” the report said.

Mitchell died after he was held down on his stomach by security guards outside a Hyatt Regency hotel. Police have said he entered the hotel, caused a disturbance and fought with the guards as they were escorting him out.

Relatives of Mitchell and their lawyers had previously reviewed hotel surveillance video provided by the district attorney’s office. They described seeing Mitchell being chased inside the hotel by security guards and then dragged outside where he was beaten.

Civil rights attorney Ben Crump, who is part of a team of lawyers representing Mitchell’s family, has said video recorded by a bystander and circulating on social media shows security guards with their knees on Mitchell’s back and neck. Crump has also questioned why Milwaukee authorities had not filed any charges related to Mitchell’s death.

Crump and Mitchell’s family said Friday in a statement that the autopsy findings and homicide ruling “demand immediate charges against” those involved in Mitchell’s death.

“Mitchell was in the midst of a mental health crisis and, instead of abiding by their duty to protect and serve, the security officers and other Hyatt staff used excessive force that inflicted injury resulting in death,” the statement says. “We will not rest until we achieve justice for Mitchell and his grieving family.”

Aimbridge Hospitality, the company that manages the hotel, said previously that several employees involved in Mitchell’s death have been fired.

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