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Diagnosis used in high-profile police deaths has no medical basis, say group of doctors

A group of doctors released a report on Wednesday saying an increasingly common diagnosis at the center of some high-profile police deaths has no medical or psychiatric basis.

The 95-page report, released by the nonprofit group Physicians for Human Rights, calls on Congress to investigate the diagnosis of “excited delirium” and urges professional organizations that have accepted the term to clarify that it is not is not ‘a valid medical diagnosis and cannot be a cause of death.

The report’s authors add that the term – which authorities say manifests itself in increased forcefulness, inconsistency and other behaviors – “cannot be divorced from its racist and unscientific origins”.

According to the report’s authors, who said they conducted a review of literature and court depositions, as well as two dozen interviews with medical, legal, law enforcement and mental health experts.

Among those whose autopsies included the diagnosis are Elijah McClain, 23, a Colorado man who died in 2019 after officers strangled him and injected him with ketamine, and Daniel Prude, who died after Rochester police , New York, retained him.

The report also highlighted the role of “excited delirium” in the murder of George Floyd. According to the Associated Press, an attorney for former Minneapolis police officer Derek Chauvin brought it up in closing arguments to claim that Chauvin used objectively reasonable force when he knelt on the neck of Floyd for more than 9 minutes.

Attorney Eric Nelson said Chauvin was watching for signs of “excited delirium,” the AP reported.

The term appears to have been first used in the early 1980s to describe fatal cocaine poisoning among a small group of black women believed to be sex workers, the report said, adding that it later relied on “racist tropes of black men”. and other people of color as having “superhuman strength” and “insensitivity to pain”, while pathologizing resistance to law enforcement.”

A University of California, Berkeley researcher found that blacks and Latinos accounted for 56% of the 166 in-custody deaths involving the disease from 2010 to 2020, according to the report.

The report’s authors partly attributed the term’s growing popularity among law enforcement officials, medical examiners and others in recent years to experts and researchers associated with Axon, the maker of Taser stun guns.

According to the report, a company attorney and an expert who had worked with Axon hosted a conference in 2007 where attendees were told they would help make “law enforcement history, medical and legal” by creating a “consensus” on the condition.

What the report describes as the “results” of the conference were published in a 2009 white paper published by the American College of Emergency Physicians, or ACEP, a professional organization for emergency physicians.

The article described the condition as a syndrome and said it was “particularly likely” in someone who had six or more characteristics, including “pain tolerance, superhuman strength, sweating, rapid breathing, tactile hyperthermia and inability to respond to police presence”. .”

A CAPE spokesperson did not immediately respond to requests for comment on the 2007 conference and its connection to the report two years later.

In a statement to NBC News, Axon said the company was not involved in publicity for the conference and was unaware of how those materials were put together. The press release adds that of the 19 expert authors of the CAPE white paper, none was an employee of Axon and three had been retained by the company for specific cases.

A CAPE official said earlier Wednesday that the 2009 document acknowledged the condition was real, but the official added that it was not “officially endorsed” by the group. In an article published last year, the organization changed the name of the disease to “hyperactive delirium”.

In a statement Wednesday, the group attributed the change in language to an effort to “better form consensus around a more medically accurate description of this condition.”

“We recognize that the term ‘excited delirium’ is increasingly used in discussions of non-clinical medicine and the term can produce a visceral and negative response, particularly among those from communities with complicated relationships with the forces of law. ‘Order or Medicine,’ the statement read.

In a statement, Axon said the disease has been recognized by various names – “Bell’s Mania” and “Profound Agitation” among them – and “has been the subject of hundreds, if not thousands of studies and publications in the medical literature” over more than 150 years.

“There is no debate among knowledgeable medical professionals that some people, after being in an unusual state of agitation, will collapse and suddenly die,” the society said.

In Wednesday’s report, the doctors’ group also called on the National Association of Medical Examiners to clarify its position on “excited delirium.” The band did not immediately respond to a request for comment.

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