A child pulled from Pearl Harbor April 7 after wandering off at a church outing died last night at The Queen's Medical Center.

The Honolulu medical examiner's office today identified the victim as Rechie Shirai, 4.

An autopsy listed cause of death as "encephalopathy due to near drowning" and manner as accidental.

The National Institute of Neurological Disorder and Stroke defines encephalopathy as a term for any diffuse disease of the brain that alters brain function or structure. Encephalopathy may be caused by infectious agent (bacteria, virus, or prion), metabolic or mitochondrial dysfunction, brain tumor or increased pressure in the skull, prolonged exposure to toxic elements (including solvents, drugs, radiation, paints, industrial chemicals, and certain metals), chronic progressive trauma, poor nutrition, or lack of oxygen or blood flow to the brain.