MILWAUKEE (AP) _ The Milwaukee County medical examiner's office has changed its ruling in the case of a man who died in police custody last year from natural death to homicide, the Milwaukee Journal Sentinel reported Sunday (


The decision came after the newspaper alerted Assistant Medical Examiner Christopher Poulos to newly released records, including a video of a suffocating Derek Williams pleading for help from the back of a Milwaukee Police Department squad car. The newspaper said it also made Poulos aware of a national expert who says the 22-year-old did not die naturally of sickle cell crisis.

For his initial determination, Poulos did not review all the police reports or the video obtained by the newspaper under an open records request, the Journal Sentinel reported.

Now, District Attorney John Chisholm is reopening his investigation into whether criminal charges are warranted against any officers. Chisholm and other authorities previously cleared the officers, largely based on the earlier ruling.

“The medical examiners are our experts in these cases,'' Chisholm told the Journal Sentinel. “Without any question, we place a tremendous amount of weight in their determination. Any time they revisit one of their determinations, we really take that seriously.''

The prosecutor emphasized, however, that the revised finding does not mean a crime was committed. Medical examiners define homicide as “death at the hands of another.'' In contrast, the crime of homicide requires prosecutors to prove intent to kill or reckless disregard for life.

Police Chief Edward Flynn said he did not expect any officers to be criminally charged as a result of the new ruling.

Williams died July 6, 2011, after being freed from jail and then sought for another crime he allegedly committed following his release. Police said he fled officers after trying to rob a couple later that day and was sweating profusely when police caught him.

According to a police report, a handcuffed Williams repeatedly told officers he couldn't breathe for at least 15 minutes between his arrest and his death. He first made the complaint as he lay face down on the ground with his hands cuffed behind him and an officer's knee pressed across his back, the report said.

The video shows Williams in the squad car struggling to breathe for seven minutes and 45 seconds. Then, he loses consciousness.

An officer then checks Williams' pulse, props him up and walks to a supervising officer's car nearby. Finding the supervisor's car empty, the officer returns to Williams and starts performing CPR. Another officer calls for medical assistance.

Police and paramedics continue CPR for more than 45 minutes before Williams is declared dead.

Chisholm and others determined the officers did nothing wrong, despite rules requiring police to call for help immediately “if medical treatment becomes necessary.''

Poulos re-examined Williams' case after the Journal Sentinel told him Werner U. Spitz, a forensic pathologist and one of the nation's leading experts on death investigations, reviewed the case at the newspaper's request.

“This is not a natural death,'' Spitz told the Journal Sentinel.

A sickle cell crisis results when red blood cells become misshapen, or sickle, blocking blood vessels.

Spitz said that while Williams likely suffered a sickle cell crisis, it was caused by an officer applying pressure to Williams' back _ and perhaps his neck _ while he was face down on the ground.

“This officer didn't have the intention of killing him, but that doesn't mean this kind of restraint should be performed,'' Spitz said.