Otto Warmbier, an American college student who fell into a coma while detained by North Korea and was returned to the U.S. last week in a stunning display of diplomatic prowess, has died, his family said Monday — the latest twist in increasingly fraught ties between Washington and Pyongyang.

The 22-year-old Warmbier “has completed his journey home,” the family said in a statement.

“Unfortunately, the awful, torturous mistreatment our son received at the hands of the North Koreans ensured that no other outcome was possible beyond the sad one we experienced today,” the statement said.

Warmbier’s death, after he was treated at a Cincinnati hospital upon his arrival there June 13, is likely to increase already soaring tensions between Washington and Pyongyang over the North’s ramped-up nuclear weapons and missile development programs.

U.S. President Donald Trump slammed the regime of leader Kim Jong Un following news of Warmbier’s death.

“It’s a brutal regime,” he said at a White House event. “Bad things happened but at least we got him home to his parents.”

Later, Trump released a statement offering his condolences, saying that there “is nothing more tragic for a parent than to lose a child in the prime of life.”

Trump has made the North Korean issue a top priority of his administration.

“Otto’s fate deepens my administration’s determination to prevent such tragedies from befalling innocent people at the hands of regimes that do not respect the rule of law or basic human decency,” Trump said. “The United States once again condemns the brutality of the North Korean regime as we mourn its latest victim.”

Prior to his release, Warmbier had been serving a 15-year prison term with hard labor for alleged “anti-state” acts against the North since he was sentenced by the regime in March 2016.

Warmbier, a University of Virginia student, had been detained for trying to steal a propaganda poster from a hotel while on a trip to the country.

But the feel-good story of his release took a darker turn amid revelations that he had been in a coma for more than a year, and had been medically evacuated from the North after a rare visit there by a high-level U.S. official.

U.S. doctors had called Warmbier’s condition a state of “unresponsive wakefulness,” where he opened his eyes and blinked, but showed no signs of understanding language or of being aware of his surroundings. They said he had suffered a “severe neurological injury” of unknown cause.

Warmbier had been in a coma for more than a year, since shortly after a final public appearance at his show trial in Pyongyang, according to North Korean officials who claimed that he had contracted botulism and was given a sleeping pill, from which he never woke up.

The New York Times, quoting a senior U.S. official, reported last week that Washington had recently received intelligence reports that Warmbier had been repeatedly beaten while in custody.

But U.S. doctors who examined him said they had uncovered no traces of botulism or beatings, and Fred Warmbier said last week that his son had been “brutalized and terrorized” by Pyongyang, but that the family did not believe the North’s claim.

A flurry of U.S. diplomatic activity had secured Warmbier’s release, including the first confirmed dispatch of a high-ranking U.S. official to the North by Trump since he took office in January.

The North said Warmbier had been released “on humanitarian grounds.”

But analysts said concerns by the North about his deteriorating condition and fears of an American detainee dying in their custody was likely the driving factor behind his release.

“It’s a tragedy of North Korea’s making, and I think that’s how most Americans will see it,” James Schoff, an Asia expert with the Carnegie Endowment for International Peace in Washington, said of Warmbier’s death.

Three other Americans are still being held by the North: Kim Sang-duk, who also goes by the name Tony Kim, and Kim Hak-song — two academics who worked at Pyongyang University of Science and Technology — and businessman Kim Dong Chul.

U.S. Secretary of State Rex Tillerson said in a statement Monday that Washington “would hold North Korea accountable for Otto Warmbier’s unjust imprisonment, and demand the release of three other Americans who have been illegally detained.”

But the State Department was coy last week when asked if Warmbier’s release could spur a return to dialogue on North Korean nuclear and missile issues, and Schoff said he believed there was presently little appetite for such talks.

“Beyond the release of the detained, I don’t see any room for meaningful U.S.-North Korean dialogue on nuclear or missile issues in the short term,” Schoff said.

While Warmbier’s death would freeze any momentum toward dialogue, Euan Graham, a former British diplomat who served in Pyongyang and who is currently director of the International Security Program at the Lowy Institute in Australia, said that “contacts will remain open if only because of the other three Americans in North Korean custody.”

Beyond the three, Pyongyang has also tested Washington’s patience by unleashing a string of missile launches and tests of other advanced weaponry in recent weeks, as it seeks to highlight its progress toward mastering technology needed to mount a nuclear warhead on an long-range ballistic missile capable of hitting the continental U.S.

In written testimony to lawmakers ahead of a hearing on the Pentagon budget earlier this month, U.S. defense chief James Mattis called North Korea the United States’ “most urgent and dangerous threat to peace and security.”

While the North has tested missiles at a rapid clip this year, Andrew O’Neil, a professor at Griffith University in Australia, said the apparent murder of an American national could burn into the U.S. consciousness the savagery of the Kim regime.

“It’s one thing dealing with North Korean missile launches and nuclear tests, but the death of a U.S. citizen as a result of the brutality of a totalitarian regime has a visceral edge to it,” O’Neil said. “I would expect to see more commentary in the U.S. over just how appalling the human rights situation is in the DPRK, which will supplement and complement the narrative around North Korea as a threat to global security.”

The North has also threatened to strike U.S. bases and other sites in Japan, prompting Prime Minister Shinzo Abe to push for stricter sanctions on Pyongyang in hopes of reining in its missile and nuclear ambitions.

Calls from Washington and Tokyo for a tougher sanctions regime were expected to grow in the wake of Warmbier’s death, but it was unclear if this would include increased pressure from China, the North’s sole patron.

“I think we can expect to see tougher U.S. unilateral or autonomous sanctions, but Washington doesn’t have a whole lot of leverage over Pyongyang on much of value to the regime,” said O’Neil.

Because of this, experts say, the Trump administration has focused on convincing Beijing of helping to bring Pyongyang to heel.

O’Neil, however, doubted that the killing would be enough to persuade China.

“China will be unresponsive to U.S. pressure on this — after all, it’s a human rights related issue.”

The authoritarian government of China’s Communist Party has faced repeated criticism over its human rights record.

China, O’Neil added, “has only acted grudgingly in any case in the past when North Korea has flouted U.N. Security resolutions on nuclear and missile testing.”

In what could be a response to Warmbier’s death, the U.S. was also expected to send two long-range B-1B strategic bombers to train with South Korean fighter jets over the peninsula later Tuesday as part of a “regular combined exercise,” the South’s Yonhap news agency reported.

The Trump administration has dispatched a number of strategic assets to the region this year, including aircraft carriers and nuclear submarines. The U.S. military has also conducted a spate of joint exercises with the South Korean military and Self-Defense Forces.

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