American student who died after release from North Korea mourned at funeral

Otto Warmbier, an American college student who died just days after North Korea released him from prison, was laid to rest in his hometown of Cincinnati on Thursday.

A funeral service was held Thursday morning at Wyoming High School in Wyoming, Ohio, a suburb of Cincinnati, where Warmbier was the salutatorian of his 2013 graduating class. The service was open to the public but closed to the press, according to a press release from the funeral home.

Hundreds of people were seen lined up outside the school's Pendery Center for the Arts, waiting to enter the auditorium for the service. Joseph Yun, the State Department's special representative for North Korea, and Deputy Secretary of State Joseph Sullivan were in attendance.

Warmbier's belongings from his time in North Korea, including the jacket he wore during his trial in Pyongyang, were displayed at the service.

Bagpipes blared after the service as his casket was carried out of the building toward a hearse, followed by a long line of mourners.

Nearby trees were adorned with blue and white ribbons, the high school's colors, in honor of Warmbier.

He was then buried at the Spring Grove Cemetery and Arboretum in Cincinnati.

Warmbier, a 22-year-old University of Virginia student, was detained by North Korea for nearly 17 months before he was medically evacuated and flown to Cincinnati on June 13. He was then rushed to the University of Cincinnati Medical Center. North Korea claimed that he slipped into a coma after contracting botulism and taking a sleeping pill shortly after his sentencing.

He was arrested in January 2016 at the airport in Pyongyang for allegedly trying to steal a propaganda poster while he was visiting North Korea on a sightseeing tour organized by a Chinese-based company. After a one-hour trial in March 2016, he was convicted and sentenced to 15 years of hard labor.

At a news conference that day, his father, Fred Warmbier, revealed that President Trump called him a day earlier to ask about his son and the rest of his family. Warmbier said Trump, who was "very candid" during the telephone call, told him Secretary of State Rex Tillerson and other U.S. officials worked hard to negotiate his son's release.

Fred Warmbier told reporters at a news conference that the North Korean regime deemed his son a "war criminal" and "brutalized and terrorized" him during his detainment.

At that news conference, doctors from the University of Cincinnati Medical Center said Otto Warmbier suffered from injuries related to cardiopulmonary arrest and was in a state of unresponsive wakefulness, characterized by a lack of awareness of one’s environment and self despite being awake. They said that scans showed extensive loss of tissue in all regions of his brain and that they found no evidence of botulism.

"This pattern of brain injury is usually seen as result of cardiopulmonary arrest, where blood supply to the brain is inadequate for a period of time, resulting in the death of brain tissue," Dr. Daniel Kanter told reporters at the news conference.

He said Warmbier was breathing on his own at the time and his vital signs were normal but he could not speak or move voluntarily.

"He shows no signs of understanding language ... He has not spoken. He has not engaged in any purposeful movements," Kanter said. "He has profound weakness of contraction in his arms and legs."

According to Dr. Jordan Bonomo, Warmbier had "no fractures to the bone and has minor blemishes on his skin. We see no evidence of an acute or healing fracture."

Warmbier died six days after he was returned home.

"It is our sad duty to report that our son, Otto Warmbier, has completed his journey home. Surrounded by his loving family, Otto died," his parents wrote in a statement Monday.

"Unfortunately, the awful torturous mistreatment our son received at the hands of the North Koreans ensured that no other outcome was possible," they said.

The Warmbiers added that they are "at peace" and "at home."

The Hamilton County Coroner's Office in Ohio examined Otto Warmbier after his death and announced that his family declined an autopsy, leaving his cause of death a medical mystery for now.

"The family's objection to an autopsy was honored, and only an external examination was performed," the coroner's office said in a statement Tuesday night.

In addition to the external exam, the coroner's office reviewed his medical records from the University of Cincinnati Medical Center and AeroMed Management Group, the air ambulance service that helped evacuate him from Pyongyang, where he had been detained. The coroner's office also had "extensive conversations" with Warmbier's treating physician at the University of Cincinnati Medical Center, according to the statement.

"No conclusions about the cause and manner of Mr. Warmbier's death have been drawn at this time, as there are additional medical records and imaging to review and people to interview," the coroner's office said in its statement. "Our deepest sympathies are with the family and friends of Mr. Warmbier at this time of their tragic loss."

ABC News' Conor Finnegan and Rachel Katz contributed to this report.