SOUTH LAKE TAHOE, Calif. — A California man died following a struggle with sheriff’s deputies who were called because he refused to be taken to a hospital, authorities said.

The El Dorado County Sheriff’s Office says 49-year-old Odie Prettyman died at Marshall Medical Center Saturday, The Sacramento Bee reports.

Deputies were called around 9 p.m. to a home in Placerville, about 44 miles east of Sacramento, by El Dorado County Fire District medical personnel attempting to assist Prettyman.

Prettyman was “a combative patient” who was in “obvious medical and mental distress,” the sheriff’s office said.

Deputies told Prettyman he needed to go to a hospital before he slashed at them with a metal pen and the deputies grabbed his hand and disarmed him.

Prettyman then “began to show signs of medical distress” and deputies performed CPR. Prettyman was then transported to a hospital, where he was pronounced dead, the sheriff’s office said.

The cause of his death is under investigation by the sheriff’s coroner unit.

A multi-agency team including the sheriff’s office, El Dorado County District Attorney’s Office, California Highway Patrol, Placerville Police Department and South Lake Tahoe Police Department are expected to investigate.