Excited Delirium Syndrome: Cause of Death or Police Cover-Up?

     When people die suddenly and unexpectedly without a clear reason, forensic pathologists, rather than classify them as deaths of undetermined causes, often explain these fatalites as being caused by a syndrome. Attribu…

     When people die suddenly and unexpectedly without a clear reason, forensic pathologists, rather than classify them as deaths of undetermined causes, often explain these fatalites as being caused by a syndrome. Attributing a mysterious or suspicious death to a syndrome, while it sounds scientific, isn't always forensically enlightening. Some of the more common causes of death syndromes include the Sudden Infant Death Syndrome (SIDS), the Shaken Baby Syndrome (SBS), and the more recent, Excited Delirium Syndrome (EDS). As causes of death, syndromes are based less on forensic science than on human behavior and the circumstances surrounding these deaths. These postmortem determinations often leave a lot to interpretation and are therefore controversial and subject to intense debate.

Excited Delirium Syndrome (EDS)

     Forensic pathologists in the United States, Canada, England, and Wales, in situations involving agitated, violent, incoherent, and erratic male subjects who die suddenly while fighting with police officers or prison personnel trying to subdue them through physical force or taser jolts, often attribute these deaths to EDS. Most of these men are overweight, a high percentage are black, and they are all high on drugs and/or alcohol. Many are also seriously mentally ill. Under intense stress, the hearts of these men race wildly, their body temperatures soar to 103-5 degrees, and they either die of cardiac or respiratory arrest. Dr. Vincent Di Maio, the former medical examiner of Bexar County, Texas, a well known forensic pathologist and textbook author, believes EDS subjects die from overdoses of adrenaline.

Dr. Deborah Mash

     The term "excited delirium" was coined by Dr. Deborah Mash, the neurologist who founded the Excited Delirium Education, Research and Information Center at the University of Miami where she has studied the brain tissue of 120 men she believed died of EDS. Called a junk scientist and charlatan by her critics, Dr. Mash has appeared as an expert witness on behalf of Taser International, the stun gun company that was been sued by families of men who have died after being tasered. When asked about her relationship with the firm, Dr. Mash has reportedly said, "I don't care about the taser, and I'll tell you why. Excited delirium was happening before the taser....If it happened with pepper spray, you'd say, 'oh, it's the pepper spray that's killing them.'...We have some cases where there were no police involved, and they still died....Medical examiners have described cases where paramedics got to the scene and the room is trashed, there are ice cubes everywhere, and the subject is dead. That tells me that person was trying to cool down." (Miami-Dade County fire rescue paramedics carry excited delirium survival kits designed to cool overheated brains.)

     Critics of EDS as a cause of death determination include the ACLU and other civil libertarian organizations. Noting that EDS is not recognized by the American Medical Association, these critics believe the authorities use EDS to cover-up and white-wash the real causes of death--police brutality and excessive force. They see EDS as a forensic device used to excuse and exonerate heavy-handed law enforcement.

Cases

September 5, 2006
Louisville, Kentucky

     The police encountered 52-year-old Larry Noles, an ex-Marine, standing nude in the middle of the street. After failing to subdue Noles by force, officers shot him with a taser three times. The highly agitated subject suddenly stopped breathing and died. The Jefferson County Medical Examiner attributed the death to EDS.

October 29, 2006
Jerseyville, Illinois

     Roger Holyfield, 17, was walking in the middle of the street carrying a phone in one hand and a Bible in the other. He was screaming incoherently when approached by the police. After struggling with the out-of-control man, officers tasered him. Holyfield went into a coma and died the following day. The local medical examiner attributed the death to EDS.

December 17, 2006
Lafayette, Louisiana

     High on cocaine and delirious, 29-year-old Terill Enard, with a broken bone sticking out of his leg, was creating a disturbance at a Waffle House restaurant. The police came, tried to restrain him, then shocked him with a taser. Enard collapsed and died at the scene. The coroner's office listed the death as "cocaine-induced Excited Delirium."

January 2008
Coral Gables, Florida

     At two in the morning, Coral Gables police found ex-con Xavia Jones lying in the middle of a highway screaming "God is coming to take me!" When officers approached him, Jones yelled, "Kill me, shoot me." Instead of shooting him, an officer tasered him four times. When that had no effect, another officer gave Jones five more jolts. The subject sort of locked-up, then died with a white liquid trickling from his mouth. The Miami-Dade County Associate Medical Examiner cited "excited delirium syndrome, associated with cocaine use" as the cause of death.

July 2008
Hanover Township, New Jersey

     A New Jersey State Trooper pulled up to 25-year-old Kenwin Garcia as he walked along Interstate 287. After frisking the unarmed man, the officer put him in the back of his patrol car where the mentally ill subject became agitated and kicked out a window. Zip-tied around his wrists and ankles, the trooper and another officer placed Garcia into a second patrol car where the subject kicked out another window. A third trooper arrived at the scene to help restrain the agitated man. One of the troopers turned off the dashboard camera before they pulled Garcia out of the car and piled on top of him. Garcia kicked and struggled, said he couldn't breathe, then went limp. He died a week later at a nearby hospital after they took him off life support.

     Although the medical examiner found that Garcia had a broken breastbone, fractured ribs, a torn kidney and internal bleeding, and had not been under the influence of alcohol or drugs, he ruled the cause of death excited delirium syndrome. As a result, none of the troopers in the case were charged with a crime or even disciplined.

      Pursuant to an independent investigation of Garcia's death, four forensic pathologists reviewed the autopsy and found that Garcia had died from suffocation while being restrained. Three law enforcement experts opined that the troopers in this case had used excessive force. The dead man's family, based on these findings, filed a wrongful death suit against the township.

     In 2013, attorneys for Hanover Township agreed to pay the Garcia estate $700,000 in an out of court settlement. No criminal charges were filed in this case.

July 22, 2011
Bangor, Maine

     The Bangor police were called at 6:45 P.M. to deal with 32-year-old Ralph E. Willis, a man addicted to a hallucinogenic stimulant called MDPV, the key ingrediant in bath salts. Officers found him running wildly around yelling at people on the street. When Willis resisted being taken into custody, several officers had to subdue him. In so doing, they used their nightsticks.

    At the Penobscot County Jail, Willis continued to be agitated and uncooperative. He fought with jail personnel who put him into a holding cell. Thirty minutes later, when they checked on him, Willis appeared unresponsive. When deputy sheriffs entered the cell, Willis began to yell. He then grabbed his testicles, banged his head against the wall, and rolled onto his stomach flailed his arms and legs At that point the inmate stopped breathing. A short time later doctors pronounced Willis dead at a local emergency room. He had died of cardiac arrest and at the time of his death had a body temperature of 103 degrees.

     The state's medical examiner ruled the manner of Willis' death accidental. The cause: MDPV toxicity. In her report, the forensic pathologist described Willis as having been in a state of excited delirium. As a result of the Willis case, the Penobscot County Jail no longer accepted prisoners who were under the influence of bath salts.

EDS in England and Wales

     Research by the Bureau of Investigative Journalism, a not for profit organization based at City University in London, disclosed that excited delirium was first used in a British case in 1996. Since then, the condition has been used by coroners in England and Wales to explain 10 police restraint related deaths. In researching EDS, bureau journalists interviewed several forensic pathologists including Dr. Deborah Mash who told an interviewer that,"Just because you die in police custody doesn't mean that what the police were doing at the time you died led to your death. The symptoms of EDS are why the police are called to the scene to begin with."

     In Great Britian, Dr. Mash has drawn the wrath of several prominent critics in the field of forensic pathology. Dr. Derrick Pounder, a forensic pathology expert at the University of Dundee said, "Excited delirium is a theory....It has come from the United States, where the science is very politicized, without a robust enough analysis. If you write off a death as excited delirium, then you close the door to guilt being attributed, and more importantly, lessons being learned from the types of [police] restraint used."

     Dr. Richard Shepherd, another English forensic pathologist who spoke to journalists with the Bureau of Investigative Journalism, said this: "We know there are a group of people who exhibit this very bizarre behavoir. Whether they strictly fall into this group called 'excited delirium' or not, I think will become clearer as more research is done....I think it is a term that should be used with great care...."

     Like its cause of death counterparts, SIDS and SBS, EDS will attract supporters and critics and remain controversial until it is either totally rejected in the medical community or accepted as valid forensic science.

    

from http://jimfishertruecrime.blogspot.com/