Excited delirium

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Excited delirium is a controversial term used to explain deaths of individuals in police custody, in which the person being arrested, detained, or restrained is highly agitated and may be under the influence of stimulants.^[1] It has been listed as a cause of death by some government medical examiners.^{[citation needed]} The cause of death only appears where police are involved in restraining individuals.^[2]^[3] 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.^[4] In August 2007, three months before Robert Dziekański died shortly after being tasered at Vancouver International Airport, Royal Canadian Mounted Police changed its protocol on Taser use, from discouraging multiple Taser shocks to suggesting that multiple shocks may bring a subject under control more quickly, under certain circumstances. It was suggested that multiple taser jolts may lessen the risks of prolonged and dangerous struggle.^[5]

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

[edit] Disputed validity

Some civil-rights groups argue that the term is being used to absolve police of guilt while possibly overly restraining people during arrests. This does not include those deaths in chemical dependence treatment, EMS, hospital, or psychiatric care facilities who die while being restrained or while in seclusion.

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."^[2] Melissa Smith of the American Medical Association said the organization has "no official policy" on the disorder.^[3]

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 in the United States it has been rejected by the American Medical Association while the Canadian Medical Association Journal dismisses it as a "pop culture phenomenon".^[6] The condition is not recognized by the Diagnostic and Statistical Manual of Mental Disorders.^[7]

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. Webster criticized Taser International applying the notion of “excited delirium” and referring to it in its training of police “as if it's an actual existing disorder.”^[7]

However the first description of this syndrome was published in 1849 by the superintendent of Massachusett's McLean Asylum for the Insane, Luther V. Bell, M.D..^[8]` 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.

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^[9]. Police and EMS are usually called due to the signs/symptoms manifested by the victim due to concerns of public safety or criminal acts.

[edit] Symptoms

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

Bizarre and violent behavior, most commonly violence towards glass
Removal of clothing, public nudity (even in cold weather)
Aggression
Hyperactivity
Paranoia^[10]
Hallucination
Incoherent speech or shouting^[10]^[11]
Grunting or animal-like sounds
Incredible strength or endurance (typically noticed during attempts to restrain victim)^[10]^[11]
Imperviousness to pain (observed during violent acts or restraint)
Hyperthermia (overheating)/profuse sweating (even in cold weather)^[11]

Other medical conditions that can resemble excited delirium are panic attack, hyperthermia, diabetes, head injury, delirium tremens, and hyperthyroidism.^[12]

[edit] Cases

Nathaniel Jones: his death while in custody of Cincinnati police was first attributed to excited delirium.^[11]^[2] In a lawsuit over the death of Mr. Jones, some facts related to excited delirium were disputed.^[13] 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.^[13] 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.^[13] The trial court found that the plaintiffs sufficiently stated a claim of excessive force.^[13] No taser involvement.

Toney Steele: One of the first high-profile cases involving question of excited delirium, this drug addict died in San Diego after being restrained in the back of a patrol car.^[11] No taser involvement.

Kevin Geldart: died after police, in an effort to restrain him, shot him multiple times with a Taser gun and sprayed him with pepper spray.^[3]

Roger Holyfield: the 17-year-old died October 29, 2006, 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 officials.^[14]

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.^[15]

Robert Dziekański: died at the Vancouver International Airport on October 14, 2007 after he was tasered by police. The RCMP and Taser International have ventured that the man died from "excited delirium"^[16]. It was reported that the distressed individual was acting in an erratic yet non-violent manner before four RCMP officers shocked him with a taser at least twice. After being pinned to the floor by the police he quickly became unresponsive and paramedics were unable to revive him when they arrived fifteen minutes after the incident. The officers did not attempt to perform CPR despite knowing he had no pulse. (see: link to followup article reported by CKNW, link to video)

Austin Aylward Jr. died of Excited Delerium while in custody in Her Majesty's Penitentiary at St. John's, Newfoundland on March 22, 2008.^[17]

Lawrence Rogers died on August 31, 2002, after being transported to a hospital, following police attempts to restrain him without using a stun gun. He died in the hospital and his survivors are suing the police and hospital. Melissa Waters v. City of Rochester, et al., No. 03-CV-6505-CJS (W.D.N.Y.).^[18]