Excited delirium

From Wikipedia, the free encyclopedia

Excited delirium is a controversial term used to explain deaths of individuals in police custody, in which the person being arrested or restrained shows some combination of agitation, violent or bizarre behavior, insensitivity to pain, elevated body temperature, or increased strength.^[1] It has been listed as a cause of death by some medical examiners.^[2][3]

It only appears as a cause of death where police are involved in restraining agitated individuals.^[4][5] The term has no formal medical recognition and is not recognized in the Diagnostic and Statistical Manual of Mental Disorders. There may also be a controversial link between "excited delirium" deaths and the use of Tasers to subdue agitated people.^[6]

Contents 1 Disputed validity 2 Supposed Symptoms 3 Alleged Cases 4 See also 5 References 6 External links

[edit] Disputed validity

The term "Excited Delirium" was first coined in 1985 by a doctor in Miami, Florida who noticed a sudden influx of cases involving bizarre psychotic behaviour. That date is also when crack cocaine started to be actively marketed in Miami.^[7]`

Some civil-rights groups^[who?] argue that the term is being used to absolve police of guilt while possibly overly restraining people during arrests. This does not account for the known historical record of such cases (under a variety of names) dating back at least to 1836^[8]` of people whose deaths involved chemical dependence treatment, EMS, hospital, or psychiatric care facilities who die while being restrained or while in seclusion, none of which involved police.^{[citation needed]}

Eric Balaban of the American Civil Liberties Union said: "I know of no reputable medical organization — certainly not the American Medical Association (AMA) or the American Psychological Association (APA) that recognizes excited delirium as a medical or mental-health condition."^[4] Melissa Smith of the American Medical Association said the organization has "no official policy" on the disorder.^[5]

Grame Norton, director of the public safety project of the Canadian Civil Liberties Association argues that "Anytime you see a specific condition being referenced in only one context it raises serious question." Other critics assert that the term is used to mask police brutality. Although the term "excited delirium" has been accepted by the National Association of Medical Examiners, the American Medical Association has no official policy on its use. The Canadian Medical Association Journal dismisses it as a "pop culture phenomenon".^[9] The condition is not recognized by the Diagnostic and Statistical Manual of Mental Disorders.

Police psychologist Mike Webster testified at a British Columbia inquiry into Taser deaths that police have been "brainwashed" by Taser International to justify "ridiculously inappropriate" use of the electronic weapon. He called "excited delirium" a "dubious disorder" used by Taser International in its training of police.^[10]

A description that appears to correspond to excited delerium was published in 1849 by the superintendent of Massachusett's McLean Asylum for the Insane, Luther V. Bell, M.D..^[11]` Since then, it has been variously known as Bell's Mania, agitated delirium, excited delirium and acute exhaustive mania. Most of the early papers describing the condition speak of a prolonged period of increasingly bizarre behaviour, usually over several days or weeks. In those who have consumed cocaine or amphetamines, the course is accelerated to several hours.^{[citation needed]}

Some cases have been attributed to police use of excessive force. In one case the victim, who was restrained and transported by friends, died when in the custody of medical personnel^[12]. Police and EMS are usually called due to the signs/symptoms manifested by the victim due to concerns of public safety or criminal acts.

In a recent report by Compliance Strategy Group ^[13] (Kiedrowski's Report) addressed the concerns of excited delirium as used in policing. In the report entitled An Independent Review of the Adoption and Use of Conducted Energy Weapons by the Royal Canadian Mounted Police, ^[14] the authors argued that the "concept of excited delirium" should be removed from the RCMP training manual, policies and procedures. They referred to excited delirium as "folk knowledge" which was only introduced to justify the use of tasers. Prior to the purchase and use of tasers by the RCMP, excited delirium was not part of RCMP training. The report also references material from London, England where the term excited delirium has been removed from the policing policies and training manual.

[edit] Supposed Symptoms

Those signs/symptoms typically associated with excited delirium are:^{[citation needed]}

• Paranoia^[15]
• Hallucination
• Incoherent speech or shouting^[15][16]
• Incredible strength or endurance (typically noticed during attempts to restrain victim)^[15][16]
• Hyperthermia (overheating)/profuse sweating (even in cold weather)^[16]

Other medical conditions that can resemble excited delirium are panic attack, hyperthermia, diabetes, head injury, delirium tremens, and hyperthyroidism.^[17]

[edit] Alleged Cases

A review of reported cases noted that most deaths attributed to excited delirium were young men from an ethnic minority who died while in police custody with no clear cause of death. Out of 62 deaths, 94% were male and 63% were African American, with 66% of deaths occurring in custody. Only 6% of cases were women.^[18]

• Toney Steele, one of the first high-profile cases involving the cause of death as "excited delirium", died in San Diego after being restrained in the back of a patrol car.^[16]
• Lawrence Rogers, died on August 31, 2002, after being transported to a hospital, following police attempts to restrain him. He died in the hospital and his survivors are suing the police and hospital.^[19]
• Nathaniel Jones, died in 2003 while in custody of Cincinnati police and his death was first attributed to "excited delirium".^[16][4] In a lawsuit over Jones' death, some facts related to excited delirium were disputed.^[20] The defendants in the trial court proceedings asserted that: 1) the decedent was resisting arrest; 2) reasonable force was used in an attempt to restrain him; and 3) excited delirium was the cause of death.^[20] The plaintiffs claimed that: 1) the officers used excessive force; 2) the decedent died from compressive asphyxia caused by police officers whose entire weight was on his body; and 3) the decedent was not resisting but rather attempting to reposition his body so he could breathe.^[20] The trial court found that the plaintiffs sufficiently stated a claim of excessive force.^[20]
• Roger Holyfield, 17-years-old died in 2006 on the day after Jerseyville, Illinois police shocked him repeatedly with a Taser gun. "Holyfield died of natural causes after being restrained by the police, which occurred as a result of an episode of excited delirium", according to Jerseyville, Illinois officials.^[21]
• Robert Dziekański, died on October 14, 2007 at the Vancouver International Airport after he was tasered by police. The RCMP and Taser International have ventured that the man died from "excited delirium"^[22]. It was shown on videotape recorded by bystanders that the distressed individual was acting in an erratic yet non-violent manner before four RCMP officers shocked him with a Taser five times. After being pinned to the floor by the police and tasered four out of the five times he became unresponsive. Police did nothing to assist the dying man and paramedics were unable to revive him when they arrived fifteen minutes after the incident. ^[23]
• Stefan D. McMinn, died on November 2, 2007, after being shocked about six times by two deputies at the Henderson County jail in Henderson County, NC. He went into cardiac arrest minutes after being shocked with the Taser and was taken to a hospital, where he was declared dead. McMinn was high on cocaine and drunk at the time. The pathologist who autopsied McMinn said that use of the Taser did not contribute to McMinn's death, but that cocaine, alcohol, and physical restraint likely did.^[24] McMinn's sickle cell anemia may have also played a role.
• Howard Hyde, died on November 22, 2007, about 30 hours after he was Tasered by Halifax police. He had been involved in a scuffle with jail guards at the Central Nova Scotia Correctional Facility in Dartmouth.^[1]
• Austin Aylward Jr., died on March 22, 2008 of excited delirium while in custody in Her Majesty's Penitentiary at St John's, Newfoundland.^[25]
• Trevor Grimolfson, died on October 29, 2008, after he was shocked twice with a Taser by members of the Edmonton Police Service. He lost consciousness while be arrested and was subsequently declared dead upon his arrival at hospital. On March 26, 2009, the provincial medical examiner's report stated that Grimolfson died from "excited delirium brought on by multiple drug toxicity".^[26]
• Frederick Williams, died hours after police shocked him repeatedly with a Taser while in custody. After Williams' family announced they were suing, Taser International asserted that they would argue he died from excited delirium.^[6]
• Kevin Geldart, died after police, in an effort to restrain him, shocked him multiple times with a Taser gun and sprayed him with pepper spray.^[5]
• Gordon Walker Bowe, 30, was arrested after police were called to a vacant duplex in Calgary, Alberta on November 1st 2008, following reports of a suspicious man in the neighbourhood and a break-in. The medical examiner concluded the individual died as a result of excited delirium syndrome due to, or as a consequence of, cocaine toxicity.^{[citation needed]}
• Matthew Bolick, 30, died on November 17, 2009 in East Grand Rapids, Michigan after being hit with a taser multiple times by officers who were trying to subdue him. In the pathologist's report, Acute psychosis, not the shock of the taser, was reported to lead to a heart attack that caused death. His toxicology results indicated he was not the influence of any substances. ^[27]

[edit] See also

• Electroshock weapon controversy
• Sluggishly progressing schizophrenia
• Delirium tremens
• List of fictional diseases

[edit] References

[edit] External links

• Truscott A (March 2008). "A knee in the neck of excited delirium". CMAJ 178 (6): 669–70. doi:10.1503/cmaj.080210. PMID 18332375. 
• [3] Video of an 'excited delirium' incident- police contact, suspect/patient restraint, CPR, and paramedic arrival at incident
• Is 'excited delirium' at the root of many Taser deaths? CBC News report by Armina Ligaya (2007).
• Taser firms picked up coroner's lecture tab The Globe & Mail (2007).
• Symposium aims to define 'excited delirium' The Globe & Mail (2007).
• Filings with S.E.C. & class actions for allegedly failing to disclose and misrepresention on safety.
• Taser manufacturer's view
• Excited Delirium Medical research review at the Canadian Police Research Centre
• Excited Delirium": A Two-Fold Problem S. Marshall Isaacs, M.D., San Francisco Department of Health, Paramedic Division, San Francisco, California