A video posted online on Friday shows California sheriff's deputies watching as an inmate with schizophrenia, who had been restrained in a chair for 46 hours, writhes on the floor of a jail cell and eventually dies.

The video, obtained by The Tribune of San Luis Obispo, Calif., shows deputies at times laughing as the prisoner, Andrew Holland, 36, lost consciousness and eventually died on Jan. 22, 2017.

His death was ruled as "natural" due to a pulmonary embolism resulting from a blot clot that traveled from his leg to one of his lungs, according to The Tribune.

"What happened to Andrew Holland was a tragedy that impacts our entire community," San Luis Obispo County Administrative Officer Wade Horton said in an email to The Tribune.

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"Although we can't bring Andrew back, our county has made and continues to make changes in response to this terrible event."

The county official called the video "extremely painful to watch."

Holland had struggled with schizophrenia since he was in his early 20s, and done multiple stints in county jail, according to The Tribune. He was restrained in the chair after he repeatedly hit himself.

The video shows deputies entering the cell periodically to rotate Holland's limbs and offer him food and water. County policy requires officials to rotate restrained inmates' extremities to prevent blood clots.

After being released from the chair, Holland is taken into another cell, where he's left naked on the floor, the video shows. He can be seen writhing and struggling to breath.

Deputies then enter the cell, call for help and begin performing CPR. Eventually a fire crew arrives and takes over for the deputies.

Holland's family was awarded a $5 million settlement for his death last year, according to The Tribune.