WASHINGTON — The death of a 45-year-old autistic Virginia man who died in April after struggling with police has been ruled an accident.

The medical examiner’s autopsy report said Paul Gianelos died of cardiac arrhythmia “associated with police restraint,” and listed the manner of death as an accident, according to a news release issued Friday by the Fairfax County Police Department.

Paul Gianelos struggled with police after wandering away from an outing with his group home to a Falls Church park on April 20. After police were alerted and located him, authorities said Gianelos became “physically combative.”

Gianelos sustained an abrasion after he was forced to the ground and handcuffed, but police said he remained alert and breathing. After emergency personnel were called to the scene, Police said Gianelos experienced a medical emergency after emergency personnel were called to the scene. He was transported to INOVA Fairfax Hospital where he was pronounced dead.

Gianelos’s brother later told The Washington Post his brother was “severely autistic” and couldn’t speak.

Fairfax County police said they recently completed a criminal investigation of the incident. The investigation was turned over on Aug. 4 to county prosecutors, who will determine whether to bring criminal charges. An internal investigation is still ongoing.