James Brady, who was shot during a 1981 attempted assassination of U.S. President Ronald Reagan, lived with complications from a bullet wound for nearly three decades, until he died at 73 this week. On Friday, the former White House press secretary’s death was ruled a homicide, as it stemmed from the same shooting that had left him paralyzed, Washington police said.

“His remains were transported to the Office of the Chief Medical Examiner for the Northern District of Virginia,” the police department said in a statement. “An autopsy was conducted and revealed the cause of death to be a gunshot wound and consequences thereof, and the manner of death was ruled a homicide.”

The medical examiner’s ruling prompted questions as to whether prosecutors will pursue murder charges against shooter John W. Hinckley Jr., who was found not guilty by reason of insanity in 1982 and continues to reside in St. Elizabeths Hospital in Washington, as the Washington Post reported. The U.S. attorney’s office would only comment to say it was “reviewing the ruling on the death of Mr. Brady,” the New York Times said.

Brady and his wife Sarah became leading advocates for gun control and fought for the background-check requirements contained in the Brady Handgun Violence Prevention Act of 1993, as USA Today reported. On Friday evening, a Brady family representative told NBC News the medical examiner’s ruling “isn’t a surprise to anybody or to [Sarah], given that his health was impacted and he suffered such consequences over the years. If that is the case, it is in the prosecutors’ hands, and it is up to them.”