The Bexar County Medical Examiner's Office ruled Friday that the cause of death was the combined effects of a physical altercation and severe myocarditis, the San Antonio Express-News reported on its Web site. The manner of death was a homicide.
Myocarditis is inflammation of the heart muscle, often caused by an infection.
Esquedo, a convicted sex offender diagnosed with mental retardation at a young age, has not been charged in Lara's death. Esquedo's father said it was an accident.
Lara's mother, Maria Salazar, said she did not know her son had a heart condition.
The San Antonio newspaper reported May 25 that Elijio Esquedo was in violation of the sex offender registry at the time of Lara's death because he had not updated his address with the Texas Department of Public Safety. On Friday, a month later, police still had not arrested him for that violation, a felony.
Esquedo told police he was roughhousing with Lara when the child stopped breathing after the older teen body-slammed him in a bedroom.
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