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Authorities have ruled that the death of Nurul Amin Shah, a 56-year-old Rohingya refugee from Myanmar who was left by immigration agents at a restaurant in Buffalo, was a homicide.

Shah, who was visually impaired, died on 24 February, five days after US Border Patrol agents dropped him off in the parking lot of a Tim Hortons on a cold winter night without notifying his family or attorney.

In a statement, the Erie county medical examiner’s office said the cause of death was “complications of a perforated duodenal ulcer precipitated by hypothermia and dehydration”, and ruled the manner of death a homicide. The office said the final determination was made on 31 March.

The examiner added that, for death certification purposes, “homicide” refers to a death resulting from the actions of another person, including negligent acts or omissions, and does not imply intent to cause harm or establish criminal liability.

“When I got the call from the medical examiner, my body went into shock,” said Mohamad Faisal Nurul Amin, Shah’s son. “I felt like I was going to throw up. I couldn’t move. Someone told my mother, and she was devastated. I am still depressed.”

The ruling adds new weight to an investigation into the circumstances of Shah’s death.

In a statement, New York attorney general Letitia James, who opened a formal investigation earlier in March, said: “Mr Shah Alam fled genocide to build a life in this country. Instead, he was abandoned and left to suffer alone in his final hours.

“No New Yorker should be treated this way. My office is continuing our review of the circumstances and treatment that led to Mr Shah Alam’s death.”

In a statement to the Guardian, the Erie county district attorney’s office said it had requested the autopsy report and would review the findings alongside other evidence.

“We are committed to seeking the truth and upholding justice,” the office said in a statement. “While we recognize the demand for answers, it would be inappropriate to comment on the specifics of the autopsy report or the status of any investigation at this time.”

Following the breaking news, New York congressman Tim Kennedy said: “Mr Shah Alam would be alive today with his family if he had access to medical care. Instead, he was callously abandoned on a cold winter night by the Department of Homeland Security.

“In light of this determination, DHS must fully cooperate with the attorney general’s investigation and ensure a transparent review of what happened.”

Shah had resettled in Buffalo in December 2024 with his wife and two sons after fleeing decades of persecution in Myanmar. Three of his sons and their families remain in Malaysia, waiting to be resettled.

Less than two months later, on 15 February 2025, Shah was arrested.

According to his family, he had gone to a nearby Burmese grocery store and bought a few items, including a curtain rod he later used as a walking stick. Nearly blind and unable to speak English, he became disoriented on his way home and wandered into the Black Rock neighborhood of north-west Buffalo.

He entered the backyard of Tracy Chicon, a white resident, as she was letting her dog out.

According to reporting by Investigative Post, Chicon called police and described Shah as “an unidentified Black man” in her driveway. Chicon told authorities Shah had opened a gate, let the dog out, and damaged a shed door with the curtain rod.

On 19 February, Erie county authorities transferred Shah to Border Patrol custody. Shah was held for several hours before agents dropped him at a Tim Hortons parking lot at about 8.18pm without informing his family or lawyer. Five days later, he was found dead about four miles from where he had been left.

The Guardian has contacted the Erie county sheriff’s office for comment on the homicide ruling.

The Department of Homeland Security said in a statement to the Guardian that Shah’s death “had nothing to do with Border Patrol” and described the findings as “another hoax being peddled by the media and sanctuary politicians to demonize our law enforcement”.