Excited Delirium: Police Brutality vs. Sheer Insanity

March 2, 2007 — -- Police and defense attorneys are squaring off over a medical condition so rare and controversial it can't be found in any medical dictionary — excited delirium. Victims share a host of symptoms and similarities. They tend to be overweight males, high on drugs, and display extremely erratic and violent behavior. But victims also share something else in common. The disorder seems to manifest itself when people are under stress, particularly when in police custody, and is often diagnosed only after the victims die.

Is excited delirium a real medical condition brought on by mental illness, drugs and the stress of being arrested? Or is it a convenient excuse to let cops off the hook for using brutal and deadly force?

Everyone in the court of inquiry that convened in New Brunswick, Canada, this week could agree on these facts: Kevin Geldart was a big man. So big that he couldn't even fit into the police cruiser on the night in 2005 when Royal Canadian Mounted Police found him in a bar talking to himself in a mirror and threatening people. Everyone also agreed that Geldart, 34, was mentally ill and that police, in an effort to restrain him, shot him multiple times with a Taser gun and sprayed him with pepper spray.

But just what caused Geldart's death — excited delirium or police brutality — has been left to the court to determine. Wednesday, forensic pathologist Dr. Ken Obenson told the inquiry that "on the balance of probabilities and considering the circumstances, I believe his death was caused by excited delirium."

The term "excited delirium" began showing up in coroners' reports and in the charts of emergency room doctors in the 1980s, on the coattails of the cocaine epidemic. Dr. Corey Slovis, a professor of emergency medicine and chairman of medicine at Vanderbilt University Medical Center, said patients become "wild and bizarre" and "are often found running down streets, screaming, and sweating until dehydration."

Slovis and others are convinced excited delirium is a "real clinical disorder." But the fact that the disorder seems to manifest most often when people are in police custody, and is often diagnosed only after the victims die, gives civil libertarians cause for concern.

Eric Balaban, a lawyer for the American Civil Liberties Union National Prison Project, says the cause for these arrestees' deaths is police brutality, not excited delirium.

"There remain many questions. Excited delirium still doesn't exist as a recognized diagnosis. It can't be found in any medical textbooks, and the AMA still doesn't recognize it as a diagnosis. Medical examiners only picked up the term to explain and whitewash excessive use of force by the police," he said.

The American Medical Association has "no official policy" on the disorder, AMA spokesperson Melissa Smith said.

Excited delirium can't be found in medical textbooks, dictionaries or on lists of standard diagnoses. There are also no official national statistics as to how often in-custody deaths are attributed to it. Three deaths last year in Dallas resulted in the state providing police with mental health training.

The International Association of Police Chiefs is also waiting for more evidence before weighing in formally. Wendy Balazik, the association's spokeswoman, said the organization has not yet taken a position on excited delirium as "it's not officially recognized in the medical literature. It's definitely on our radar," she said, adding, "It's an important issue and we're paying a lot of attention to it."