An Ohio coroner, abiding by family wishes, has performed an external examination instead of a full autopsy on the body of the US student who was held prisoner in North Korea for 17 months and sent home in a coma.



The Hamilton County coroner’s office was conferring with doctors at a Cincinnati hospital who treated Otto Warmbier, 22, before reaching any conclusions about his death a day earlier, investigator Daryl Zornes said.

Investigators were reviewing radiological images and awaiting additional medical records requested by the coroner, Zornes said.

He declined to estimate how long it would take for the coroner’s office to complete its inquiry. Preliminary autopsy findings had been expected on Tuesday or Wednesday.

There was no immediate word from the family about why relatives declined an autopsy, which may have shed more light on the cause of the neurological injuries that left him in a coma.

Warmbier died days after he was released by the North Korean government and returned to the United States suffering from what US doctors described as extensive brain damage.

Warmbier, an Ohio native and student at the University of Virginia, was arrested in North Korea in January 2016 while visiting as a tourist. He was sentenced two months later to 15 years of hard labor for trying to steal an item bearing a propaganda slogan from his hotel in North Korea’s capital, Pyongyang, the nation’s state media said.

The circumstances of his detention and what medical treatment he received in North Korea remain unknown. Washington has demanded North Korea release three other US citizens it holds in detention: Kim Dong Chul, a missionary, and two academics, Tony Kim and Kim Hak Song.

What do we know about how Otto Warmbier's health deteriorated? It is impossible to get reliable information about the welfare and treatment of foreigners detained in North Korea, and the Ohio coroner’s office has not been able to determine the cause of death after carrying out an external examination. We do know that the student was medically evacuated from North Korea on 13 June and flown to the US, where he died on 19 June. No evidence has emerged to support North Korea’s claim that Warmbier fell into a coma after contracting botulism and taking a sleeping pill. Doctors in the US have said his condition was probably caused by a heart attack that cut the blood supply to his brain. His parents, who have asked doctors not to conduct an autopsy, did not cite a specific cause of death but blamed “awful, torturous mistreatment” by North Korea. But doctors in the US said there was no evidence that Warmbier had been beaten. Any number of factors could be behind the deterioration in Warmbier’s health during his time in prison: poor hygienic conditions, malnutrition or lack of proper medical care may have been responsible for a coma that North Korean doctors were unable to treat. Read more

Warmbier’s death has heightened US-North Korean tensions aggravated by dozens of North Korean missile launches and two nuclear bomb tests since last year in defiance of UN security council resolutions. The North Korean government has vowed to develop a nuclear-tipped intercontinental missile capable of hitting the US mainland.

Warmbier’s family has not specified how he slipped from a comatose state to death, but said in a statement on Monday that the “awful torturous mistreatment” he endured while in captivity meant “no other outcome was possible.“

Relatives have said they were told by US envoys that North Korean officials claimed Warmbier contracted botulism after his trial and lapsed into a coma after taking a sleeping pill. Fred Warmbier, the student’s father, has said he disbelieves this account.

North Korea’s government said it released Warmbier last week on “humanitarian grounds”.

Donald Trump said on Tuesday he had spoken with Warmbier’s family and praised them as “incredible”.

“It’s a total disgrace what happened to Otto,” Trump told reporters in the White House, where he was meeting with the Ukrainian president, Petro Poroshenko. “And frankly, if he were brought home sooner, I think the results would have been a lot different”.

The White House press secretary, Sean Spicer, said the administration would “continue to apply economic and political pressure” on North Korea, in conjunction with US allies and China, “to change this behaviour and this regime”.

Trump said on Twitter on Tuesday he appreciated efforts by the Chinese president, Xi Jinping, to “help with North Korea”, adding: “It has not worked out. At least I know China tried!”

The government of China, North Korea’s main ally, said Warmbier’s death was a tragedy.