A jury on Thursday acquitted the first defendant to stand trial in the death of Irvo Otieno, a who died in custody at a Virginia mental hospital last year. The verdict raises questions about the fate of others still facing charges in a case that sparked nationwide outrage over mental health care and law enforcement practices.

Jurors found former Central State Hospital worker Wavie Jones not guilty of involuntary manslaughter Thursday afternoon, after about 20 minutes of discussion. The verdict followed a four-day trial in Dinwiddie County that saw prosecutors argue that Jones’ actions caused Otieno’s death and violated hospital policy.

“My son was in the depths of a mental health crisis,” Otieno’s mother Caroline Ouko said in a statement to the press outside the courthouse. “The verdict here today shows us very clearly that those persons that find themselves in a crisis like my son did have no protection under the law.”

Jones was among the hospital staff who helped Henrico County sheriff's deputies try to restrain Otieno for about 11 minutes when he arrived at the facility last year. Otieno had spent days in police custody after a neighbor reported his mental health crisis.

Otieno died in custody due to what Medical Examiner Jennifer Bowers diagnosed as “positional and mechanical asphyxia with restraints.” Security camera footage of his final moments, lying on the floor of the admission suite, sparked nationwide outrage. The incident also led to new legislation on mental health crisis response and an $8.5 million settlement for his family.

Defense lawyers argued Otieno died from pre-existing health problems that led to sudden cardiac arrest, citing his enlarged heart, hypertension and obesity.

These factors, alongside a lack of sleep, medication and food they argued, made Otieno’s heart a “time bomb” that ran out as Jones and others tried to restrain him.

“We can wish that Irvo Otieno had not died that day, as we can hope that Wavie Jones is not wrongly convicted for his death,” defense attorney Doug Ramseur said as part of his closing argument. “Do not respond to one tragedy by creating another.”

The verdict sparked emotional reactions in the courtroom. Ouko shouted "miscarriage of justice" at jurors and was removed, while Jones' family members wept.

Defense attorneys acknowledged the tragedy of Otieno's death while arguing Jones' innocence. They highlighted Jones' record as a hospital employee and emphasized Otieno's aggression and mental illness in custody, using witness testimony, documents and video evidence.

Jones echoed the defense’s argument when he testified during the hearing Wednesday, saying that he attempted to keep Otieno secured but safe when trying to restrain him. Jones and his family have not provided a response to the verdict, though Ramseur described him as “very thankful” for the result after what the attorney called “18 months of hell.”

“Unfortunately, for the past 18 months, we’ve had to suffer the slings and arrows of distortions,” Ramseur said. “Intentional misrepresentations to the press from people who had eight and a half million reasons to sell a different version of this than what the truth was.”

Allan-Charles Chipman, a lead organizer for Otieno's family, was less convinced, describing the trial as one where Otieno was “questioned and prosecuted more heavily than the defendant was.”

Witnesses in the trial included special agents for the Virginia State Police, CSH staff and some of the deputies and another hospital worker originally charged for Otieno’s death.

Bowers also took the stand multiple times during the trial, with the defense challenging her assessment of Otieno’s death across nearly two hours on Tuesday. Medical professionals called up by the defense also disagreed with her conclusion.

Chipman questioned the choice by Dinwiddie Circuit Judge Joseph M. Teefey to not admit evidence of a separate incident with Jones and another patient that occurred the day after Otieno died. He further worried about the potential impact of the verdict for others who experience mental health crises and their loved ones.

“It should be alarming for anyone who believes that mental health should get you help instead of a death sentence,” Chipman said.

The verdict's impact on pending trials remains unclear. Jones was the first of three defendants to face court in Otieno's death, with sheriff's deputies Brandon Rodgers and Kaiyell Sanders still awaiting trial.

Seven deputies and three CSH workers were originally indicted with charges of second-degree murder. Over the months that followed, however, most of the defendant’s charges were dropped and the original charges downgraded to involuntary manslaughter.

The charges have also gone through three different Dinwiddie County Commonwealth’s Attorneys, each one changing them and the trials in some way. Commonwealth’s Attorney Amanda N.Mann had previously rearranged the order of trials in what she said was an attempt to have a more favorable order for her office’s arguments.

“This is not the outcome we sought and while we are disappointed, we respect the jury's decision,” Mann wrote in a statement. “Given there are additional cases stemming from Mr. Otieno's death pending, it's not appropriate for me to comment further. It's important right now for information in these cases to be addressed in court, not the media and beyond.”

Rodgers’ trial is currently set for Nov. 19, following a motion that canceled hearings originally slated for next week, while Sanders’ trial hearings will be held from Dec. 2 to Dec. 6.