The case of a 26-year-old Maryland man with Down syndrome who died last month in police custody after he was removed from a theater for refusing to leave a movie he had already seen has been ruled a homicide after an autopsy revealed he was asphyxiated.

Death of Man With Down Syndrome While in Police Custody Ruled a Homicide

Robert Ethan Saylor (Photo via Frederick News Post)

Frederick County Sheriff’s Office Cpl. Jennifer Bailey said Robert Ethan Saylor died on Jan. 12 after resisting arrest by three deputies at a Frederick movie theater. The Frederick News Post reported that Saylor, who was in handcuffs for refusing to leave or purchase another ticket, experienced a medical emergency and was taken to the hospital where he was pronounced dead.

The News Post reported former law enforcement officer Dr. George Kirkham, who is a professor of criminology at Florida State University, saying it seems Saylor might have suffered from positional asphyxia:

Positional asphyxia is typically the result of an intense struggle and often involves a person who is handcuffed and lying on their stomach after the struggle. Kirkham said people often panic and can’t catch their breath. People with larger stomachs are particularly vulnerable, he said, because their bellies will push into their sternums, making breathing even more difficult.

“People get into almost like a drowning swimmer panic, and they’re just fighting for their lives,” Kirkham said. “Their cardiovascular system is just going wild.”

Kirkham also noted to the News Post that the phenomenon is well-known and that those who are on drugs or who have mental issues might be more susceptible. Bailey told the News Post officers at the sheriff’s department are trained about positional asphyxia.

The officers involved remain on duty with the department while the investigation is underway. No charges will be made, if any, until the investigation is complete and the Frederick County State’s Attorney Charlie Smith has reviewed the details, the News Post reported.

According to Saylor’s obituary, he actually had a strong interest in learning about police and security agencies.

“More than anything, Ethan loved his family, his friends, his loyal and caring staff, and his cat Gracie (Fireball),” Saylor’s obituary read. “Ethan was a loved and cherished member of Damascus Road Community Church, where he participated in the men’s Choir. Ethan was known by the congregation as ‘the best hugger’ and was warmly embraced by all.”

The Associated Press contributed to this report. 

(H/T: Buzzfeed)