The death of a Kahului man who breached Honolulu International Airport security on Feb. 18 was caused by cardiac arrest, the Honolulu Medical Examiner’s Office said Monday.

A history of drug use and heart conditions had already put 48-year-old Charles Kosi Jr. at risk when he pushed through security and ran out onto the tarmac of the commuter terminal, deputy medical examiner Dr. Masahiko Kobayashi said.

Kosi died due to “complications of sudden cardiac arrest during a physical struggle” when authorities tried to restrain him, according to autopsy results. The death has been classified by the Medical Examiner’s Office as a homicide but not because of foul play, Kobayashi said.

“Homicide in this case merely indicates an act by others appeared to at least have contributed to his death,” Kobayashi explained. “The classification of homicide . . . does not indicate or imply criminality of the acts or intent to harm or intent to kill.”

At 5:48 a.m. Feb. 18, Kosi forced his way into a secured area at the commuter terminal of the airport, state Department of Transportation spokesman Timothy Sakahara said at the time.

Several law enforcement officers gave chase and tackled the 5-foot-9-inch, 236-pound man out on the tarmac, according to Kobayashi. He was facedown on the ground as officers restrained him with handcuffs and leg shackles. But when they sat him up, they found him unresponsive.

“They immediately removed all the restraints and started CPR,” Kobayashi said.

Kosi was taken to Kaiser Foundation Hospital, where he later died, according to a March 5 Maui News obituary.

Securitas law enforcement officers, state sheriffs and Transportation Security Administration officers responded to the incident, Sakahara said. One Securitas law enforcement officer was injured and was taken to the hospital for treatment.

There was no evidence of excessive force in the autopsy, nor any indication that Kosi’s death was caused by the weight of officers on top of him, Kobayashi said.

“In the autopsy, I didn’t find any significant traumatic injuries apparently due to the restraint,” he said. “Just some rib fractures. They were probably due to resuscitation efforts.”

Kosi was “not in good condition to begin with,” the deputy medical examiner added. He had a history of chronic methamphetamine use and high blood pressure, and the autopsy showed methamphetamine in his system. He also suffered from a number of heart conditions that included dilated cardiomyopathy and atherosclerotic coronary artery disease, as well as hypertension and obesity. All were listed as contributing factors in Kosi’s death.

The amount of meth in his system was “kind of high,” though many methamphetamine users can tolerate high levels of the drug in their system, Kobayashi said. “If I have the same level (in my system), I would die,” he said. “But it’s very hard to say for him how much this level means.”

The Honolulu Police Department opened an unattended death investigation into the incident back in February. HPD spokeswoman Michelle Yu said Monday that “the investigation is continuing,” but that police still classify the incident as an unattended death.

Kosi was born in Honolulu and had family on Maui. In February, Kosi’s brother Ryan Tuzon told KHON2 that Kosi loved his family and was just trying to come home. Kosi had been arrested on a number of drug charges in the past and was supposed to be in a drug rehabilitation facility on Oahu at the time of the incident. The Hawaii Criminal Justice Data Center shows Kosi had 35 state convictions between 1988 and 2003.

The family was not immediately available for comment Monday.

* Colleen Uechi can be reached at cuechi@mauinews.com.