Hamilton County Coroner's Office examined Warmbier's family at their request, but it was limited to external examination and did not conduct a comprehensive autopsy. Autopsy report shows that Warmbier suffered unknown injuries more than one year before his death, but the specific situation is unknown at present.
Sammarco said that they conducted various examinations on Warmbier, including medical imaging and CT scanning, and found that Warmbier's lower teeth and mandible showed no signs of trauma. Hamilton County Coroner Sammarco: He (Warmbier) suffers from hypoxic encephalopathy, or brain damage, which is caused by brain hypoxia. But what is the root cause? We don't know. There are many possibilities, such as the interruption of blood supply to the brain and the cessation of breathing, but what causes these situations is unknown. We don't know whether we are likely to be tortured. We don't have enough information to prove what happened, and we can't draw concrete conclusions about it.
North Korea responded that Warmbier was treated humanely when his health deteriorated.