On February 24, the body of 56-year-old Nurul Amin Shah Alam was discovered in Buffalo, in northeastern New York state, sparking a public outcry against the Trump administration’s harsh immigration crackdown to expel undocumented migrants.

Local media reported at the time that US Border Patrol agents had dropped off Shah Alam – described as almost blind and unable to speak English – in frigid weather five days earlier at a restaurant. He was found dead four miles (six kilometers) away.

After an investigation, the Erie county medical examiner’s office determined that the cause of death was “complications of a perforated duodenal ulcer precipitated by hypothermia and dehydration,” the county’s department of health said in a statement.

The manner of death – how the cause came about – was homicide, it said.

“ For death certification purposes, ‘homicide’ refers to death resulting from the volitional act of another, which may include negligent acts or omissions. The designation of homicide does not imply intent to cause harm or death,” it said.

Shah Alam’s next of kin were notified about the findings, the county health department said.

Buffalo mayor Sean Ryan called it “deeply disturbing and a dereliction of duty” by immigration agents.

But customs and border protection said immigration agents established that Shah Alam could not be deported and therefore offered him a lift to a “warm, safe location near his last known address.”

“He showed no signs of distress, mobility issues or disabilities requiring special assistance,” the agency said at the time.