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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.

The California Highway Patrol says the man may have been suffering from mental health issues.

He slipped out of restraints and pushed past the attendant to open the ambulance’s rear door.

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.

He died at the scene.