NEW YORK (AP) – An airplane passenger who died after a struggle with several fellow travelers on a New York-bound flight in March suffered a fatal drug and alcohol overdose, authorities said Monday.

William Lee, 48, died from accute cocaine and alcohol intoxication, which was aggravated by heart trouble, said Ellen Borakove, a spokeswoman for the medical examiner’s office. The office ruled the death an accident.

Witnesses said Lee grew belligerent after flight attendants refused to serve him beer on an American Airlines flight on March 18 from Los Angeles to John F. Kennedy International Airport.

After Lee stood up and pushed aside an attendant, seven other male passengers restrained him. The flight crew then put flexible handcuffs on him and put him back in his seat, an airline spokesman said at the time.

Lee got out of his seat again, and the seven passengers held him on his back on the galley floor until the plane landed, the spokesman said. By the time the plane landed, Lee needed CPR; he was pronounced dead at a hospital.