RALEIGH, N.C. (AP) — The death of a pilot who fell from a small airplane in flight in North Carolina in July has been ruled an accident, according to the Office of the Chief Medical Examiner.

The autopsy states that the death of Charles Hew Crooks, 23, was likely the result of falling from the back of the plane while vomiting, The News & Observer reported.

“Based on the autopsy findings and circumstances surrounding the death, as currently understood, the cause of death is listed as multiple blunt force injuries. The manner of death is classified as accident,” the report states. Crooks suffered extensive injuries, including several broken bones and fatal internal injuries.

Two pilots had been flying skydivers out of Raeford West Airport on July 29 and were descending toward the airport for a third run when a hard landing occurred, according to a preliminary report from the National Transportation Safety Board released in August. The other pilot assumed the flight controls and directed Crooks to declare an emergency and request a diversion to Raleigh-Durham International Airport for landing, the report stated.

The twin-engine plane reported having landing gear issues as it approached RDU about 2:40 p.m. and went off the runway and into the grass.

The other pilot told investigators that Crooks became upset about 20 minutes into the diversion, opening his side cockpit window and “may have gotten sick,” the report stated. Crooks then lowered the ramp in the back of the airplane, indicating that he felt he was going to be sick and needed air.

The report said the co-pilot “got up from his seat, removed his headset, apologized and departed the airplane via the aft ramp door.”

Early reports and 911 calls said Crooks “jumped” or “exited” the plane, but the autopsy found that the fall was accidental.

“Upon review, it was concluded that the decedent had gone aft, likely to vomit from the open ramp, and accidentally fallen from the aircraft,” the autopsy report said.