CNN
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The death of Irvo Otieno has been ruled a homicide by asphyxiation, the Office of the Chief Medical Examiner of Virginia said in a statement to CNN affiliate WWBT.

The 28-year-old’s cause of death was officially ruled “positional and mechanical asphyxia with restraints,” the medical examiner’s office confirmed to WWBT.

Seven sheriff’s deputies and three hospital workers have been charged with second-degree murder in Otieno’s death on March 6 as he was being admitted to a state-run mental health facility. Otieno’s family has said he was in the midst of a mental health crisis.

The workers “smothered him to death” during the facility’s intake process, Dinwiddie County Commonwealth’s Attorney Ann Baskervill has said.

Otieno was being transferred to to Central State Hospital from the Henrico County jail, where he was being held after authorities allege he assaulted three officers while being hospitalized.

After hearing the medical examiner’s official ruling, Otieno’s mother, Caroline Ouko, was initially speechless, according to a statement from the offices of family attorneys Ben Crump and Mark Krudys.

“All must know what they did to my son,” Ouko said, according to the statement.

Crump and Krudys said in a separate statement that the medical examiner’s conclusions are “not surprising” as they align with the actions shown in surveillance footage released by prosecutors.

“The official declaration confirms what all could see in the video. Irvo, while facedown and handcuffed at his wrists and shackled at his ankles, was not permitted to breathe. For over 11 minutes, the ten officer/hospital defendants pushed down hard on every part of Irvo’s body until he was limp and lifeless,” Crump said.

“We cannot continue to treat the mentally ill with such brutality,” Crump added.

Otieno was an aspiring hip-hop artist who moved to the US from his birthplace of Kenya at the age of 4, Krudys has said.

Ouko, said last month that Otieno had a mental illness which necessitated medication. Her son would go long stretches of time when “(you) wouldn’t even know something was wrong,” Ouko explained, but then sometimes “he would go into some kind of distress and then you know he needs to see a doctor.”