The death of a 74-year-old man who struggled with security guards at MedStar Washington Hospital Center last fall has been ruled a homicide, authorities said on Jan. 4. (WUSA 9)

The death of a 74-year-old man who suffered neck injuries during a struggle with security guards last fall at MedStar Washington Hospital Center has been ruled a homicide, authorities said Monday.

James E. McBride, who had been a patient, was restrained by guards who were trying to bring him back to the hospital after he left Sept. 29 without signing out. He died two days later.

The D.C. medical examiner’s office said Monday that McBride’s cause of death was “blunt force injuries” of the neck. It also said the injuries involved “cervical spinal cord transection” and “vertebral artery compression.” They did not offer a further explanation.

D.C. police officials said they continue to investigate the death, but they declined to comment further. Bill Miller, a spokesman for the U.S. attorney’s office in the District, said Monday that there is an ongoing investigation into the case. He said no charges have been filed.

Family members had issued a statement saying McBride, who lived in Northwest Washington, was a “loving husband to his wife of 40 years, and a wonderful father to his son and daughter.” Relatives could not be reached Monday.

In a statement released Monday, the hospital said the incident “was devastating to all of us at MedStar Washington Hospital Center, and our hearts continue to go out to the patient’s family.” The statement said the hospital is cooperating with authorities.

Hospital officials also said in the statement that reviews conducted after the incident have led to changes, including enhancing training of care teams and security officers. They also created a team to respond to “high-risk” situations.

The hospital said the reviews “were focused on ensuring that nothing like this ever happens again.”

The incident began about 5 p.m. Sept. 29 when McBride left the hospital, officials from the hospital said. They would not say why McBride was at the hospital.

The patient’s nurse and a security guard found him across the street, near MedStar National Rehabilitation Hospital, according to the officials. The nurse and guard walked the man back to the hospital grounds and turned him over to two other security guards.

A police report said the patient and guards were outside the hospital when McBride “became non-compliant and resisted and a struggle ensued.” The report said McBride was “taken to the ground” by two of the people, and a third “utilized hand controls to restrain” him.

At the time, Arthur St. André, a surgical care specialist at the hospital, told reporters that the patient died after an “interaction that was physical between the patient and the officers.”

The security guards involved are special police officers, meaning they are qualified to carry firearms and have arrest powers limited to the area of their jurisdiction, in this case the hospital campus on Irving Street NW. They are licensed through the D.C. police.

Two guards involved in the incident no longer work for the hospital, a spokeswoman said.

A prior headline on this article incorrectly said James McBride had been put in restraints.

Peter Hermann contributed to this report.