ENCINITAS, Calif. (AP) — A 23-year-old man jumped out of the back of a moving ambulance and was struck by a car and killed on an interstate near San Diego, authorities said.

The man, who may have been suffering from mental health issues, slipped out of restraints Saturday and pushed past the attendant to open the ambulance’s rear door, California Highway Patrol Officer Mark Latulippe said.

The patient landed in southbound lanes of Interstate 5 in Encinitas and managed to jump the center divider. As the man sprinted across northbound lanes he was struck by a BMW, Latulippe said. He died at the scene.

The BMW driver, a 40-year-old Carlsbad woman, called 911 to report hitting a pedestrian. She was taken to a hospital in unknown condition and her car was towed, the newspaper said.

The patient was being transferred by private ambulance from Tri-City Medical Center in Oceanside to the Veterans Administration hospital in La Jolla, the Union-Tribune reported.