US has warned its patience with 'rogue nation' is spent
Some observers saw Otto Warmbier's arrest and detention last year as an attempt by North Korea to force concessions from the United States as it sought harsher sanctions against the rogue nation.
But his tragic death will almost certainly harden American resolve at a precarious time for Kim Jong-un's regime.
US citizens held in North Korea had previously been used by Pyongyang as leverage; human bargaining chips for behind-the-scenes deal-making needed to prolong the life of the regime.
Indeed, previous prisoners had been directly threatened by North Korea as it sought to get its own way.
In 2010, officials threatened to impose "wartime law", or a military execution, with regards to US teacher Aijalon Gomes as the regime faced diplomatic pressure for sinking a South Korean warship.
Such concessions for North Korea often depend on promises of the safe return of captives.
And Mr Gomes was reunited with his family later in 2010 after former president Jimmy Carter apologised for the prisoner's actions.
But with Mr Warmbier, North Korea not only has nothing left to bargain with, it is also facing accusations of murder from senior US politicians, such as John McCain.
North Korean officials claim that Mr Warmbier had become unresponsive almost immediately after he was sentenced to 15 years' hard labour in March 2016.
He suffered from botulism and never woke up from a sleeping pill, Pyongyang said.
Examinations of Mr Warmbier since he arrived back in the US have not revealed what caused his severe brain damage.
But there are few in Washington who believe North Korea's official account.
While the reasons behind Mr Warmbier falling into a coma will probably never be known, what is certain is that the young student's death has come at another moment of escalating tensions between the US and North Korea.
Donald Trump's administration has taken a firm line against Pyongyang, vowing that the period of "strategic patience" against the regime is now over.
Mr Trump is concerned that the nuclear-armed state could reach the United States with a missile during his term.
While many Americans agree that the threat of a military attack by the rogue nation is something that should be confronted, the concept of an economically backward country inflicting serious destruction on the US is a distant one for many.
But the images of Mr Warmbier being carried back onto American soil with tubes coming out of his nose after months of unresponsiveness brings the North Korean issue closer to home.
Mr Trump has talked tough on Pyongyang, sending an aircraft carrier group into the region earlier this year.
But despite his strong words, he has played a waiting game by attempting to use China as a means of reigning in North Korea.
Beijing, however, has reiterated that it has little leverage over its neighbour, and that it cannot force Kim to give up his nuclear weapons on its own.
Mr Trump has thus far remained patient in his approach.
But with American public opinion being transformed by Mr Warmbier's ordeal, the temptation for him to act alone can only increase.