Eric Garner, 43, a black man whose confrontation with a white police officer has prompted calls by the Rev. Al Sharpton for federal prosecution, was killed by neck compressions from the chokehold as well as "the compression of his chest and prone positioning during physical restraint by police," said medical examiner spokeswoman Julie Bolcer.
Asthma, heart disease and obesity were contributing factors in the death of Garner, a 6-foot-3, 350-pound father of six, she said.
The finding increases the likelihood that the case will be presented to a grand jury to determine whether Daniel Pantaleo, the officer who placed Garner in the chokehold, or any other officers involved in the confrontation will face criminal charges. Pantaleo's attorney, Stuart London, declined to comment Friday.
Garner's wife, Esaw, told the Daily News, "Thank God the truth is finally out."
Mayor Bill de Blasio extended his sympathies to Garner's family in a statement and pledged to continue repairing the relationship between minority communities and the NYPD.
"I've said that we would make change, and we will," he said.
Partial video of the July 17 confrontation shows an officer placing a chokehold on Garner, who was being arrested for selling untaxed, loose cigarettes. He then apparently loses consciousness.
Chokeholds are prohibited by the New York Police Department.
Prosecutors on Staten Island, the borough where the confrontation occurred, are investigating. A spokesman for Daniel Donovan, the Staten Island district attorney, said prosecutors were still investigating the death and awaited a full autopsy report and death certificate from the medical examiner. Donovan will have to determine whether to empanel a grand jury and charge officers in the death of Garner.
Federal officials are monitoring the progress of the New York investigation, Justice Department spokeswoman Dena Iverson said, adding that the department has not begun its own inquiry into the death.
In a statement, police Commissioner Bill Bratton said officials were aware of the medical examiner's findings and said the department is cooperating with prosecutors. He has said the NYPD's use-of-force training is lacking, pledged to retrain all 35,000 officers and dispatched a team to Los Angeles to develop a state-of-the-art program.
Pantaleo was stripped of his gun and badge pending the investigation, and another was placed on desk duty. Two paramedics and two EMTs were suspended without pay.
Patrick Lynch, president of the powerful Patrolmen's Benevolent Association, expressed his sympathies to Garner's family in a statement but noted that Garner "was a man with serious health problems."
"We believe, however, that if he had not resisted the lawful order of the police officers placing him under arrest, this tragedy would not have occurred," he said.
Garner's family will join Sharpton on Saturday to address the medical examiner's ruling, a spokeswoman said.
Ramsey Orta, 22, a friend of Garner's who videotaped his struggle with police, said in an interview that the medical examiner's ruling wasn't surprising.
"I knew that was the cause because I saw it," he said. "Now somebody should get charged."
Associated Press writers Eric Tucker in Washington and Jonathan Lemire contributed.