PHILADELPHIA -- A troubled teen who was sent to a Tennessee youth center for treatment died of strangulation after a confrontation with staff members, a coroner found.

Video: Over 200 911 Calls To Chad Center In Past 6 Years

The death of Omega Leach, 17, of Philadelphia, was ruled a homicide, according to the autopsy report by the Tennessee medical examiner.

Coroner Bruce P. Levy found that Leach had multiple hemorrhages of his neck muscles after a struggle with two staff members at the Chad Youth Enhancement Center in Clarksville, Tenn.

A grand jury in Montgomery County, Tenn., will have to decide if charges are warranted, said Ted Denny, a spokesman for the county sheriff's office.

The Philadelphia Department of Human Services has sent scores of emotionally troubled youngsters to Chad since 2001, saying no Pennsylvania facility would take them.

Leach's death on June 3 prompted city officials to begin removing children from Chad, but eight still remain there, a city official told The Philadelphia Inquirer on Tuesday.

Arthur Evans Jr., acting commissioner of the Department of Human Services, said the agency was "deeply troubled by the homicide ruling."

The autopsy found other scrapes and bruises on Leach's body, but also noted the teen's enlarged heart contributed to his death.

Tennessee child-welfare officials have already cited Chad in the Leach case, saying staff members needlessly provoked him. Officials said staff should have given Leach space to calm down June 2 when he retreated to a dorm after a fight with another resident.

Instead, Leach was ordered to leave the dorm, sparking the confrontation in which police said he was pushed face-down to the floor with his arms behind his back. Leach died the next day.

Chad spokesman Nick Ragone had no comment on the autopsy. Previously, Ragone has said that Chad works zealously to train its staff and that physical holds were used on youngsters only as a last resort to protect them or others.

Leach had been sent to Chad a month earlier after Philadelphia police said they found him racing a stolen car.

Chad is owned by Universal Health Services Inc., for-profit corporation based in King of Prussia.

A Montgomery County Emergency Services report shows various 911 calls dating from 2001 to the present in relation to the Chad Center.

Of the more than 200 responses to the facility, 36 required transport, a number of calls involved seizures, but there were also instances of a possible broken shoulder, a possible dislocated shoulder and a male with a hematoma the size of a baseball in back of his head.

The autopsy results are no surprise to the family of the dead boy. They spoke through their lawyer and said, "They knew him to be in excellent health. This solidifies what they knew to be true."

Channel 4 News called the youth center for a comment on Thursday, but a woman who answered the phone said "no comment."

The Tennessee Department of Children's Services is still investigating that death that occurred at Chad.