A 20-year-old Louisana woman was charged with second-degree murder for a brawl on a St. Tammany Parish sandbar Saturday that left a man dead.

NOLA.com reported that Blaine Manalle is the third person to be charged in connection with the death of Jeffery Howell, 46. Manalle was booked on second-degree murder charges Monday after an autopsy determined Howell determined died from blunt force trauma to the head and his death was deemed a homicide.

Howell had recently undergone brain surgery to remove a tumor and had staples in his head at the time of the deadly incident, according to WVUE. Officials said the fatal blow he sustained was near his surgery scar.

“If you cup your hand behind your left ear, that’s where the incision was, and that’s where the bone had been removed,” St. Tammany Coroner Dr. Charles Preston said, describing the construction worker’s recent surgery.

The St. Tammany Parish Sheriff’s Office said Howell died following a “disturbance” between two groups of people which escalated into a physical altercation. Investigators conducted more than 40 interviews to establish probable cause to arrest Manalle Monday night, the police department said in a statement obtained by NOLA.com.

A neighbor of the victim, Kathy Maillet, told WVUE that Manalle’s group was throwing bottles in the river and someone asked them to stop, leading to the brawl. Police have yet to confirm this account.

In addition to Manalle, 21-year-old Cameron Alphonso’s manslaughter charge was upgraded to second-degree murder. Alden Kindergran, 22, was charged with disturbing the peace and released Sunday after posting $750 bond.

[Featured image: Blaine Manalle/St. Tammany Parish Sheriff’s Office; Jeffery Howell/Facebook]