Pubdate: Fri, 5 Jun 2009 Source: Prince George Citizen (CN BC) Copyright: 2009 Prince George Citizen Contact: http://www.princegeorgecitizen.com/ Details: http://www.mapinc.org/media/350 Author: Frank Peebles Bookmark: http://www.mapinc.org/prison.htm (Incarceration) Bookmark: http://www.mapinc.org/coke.htm (Cocaine) Bookmark: http://www.mapinc.org/topic/taser MEDICAL EXPERT DELVES INTO HOW AGITATED DELIRIUM CONTRIBUTED TO IN-CUSTODY DEATHS People have been going berserk in the streets then mysteriously die soon after, usually in the hands of police. That is not to say, said a medical doctor and leading scientific researcher, that it was because of the police. Dr. Christine Hall is an emergency room doctor in Victoria at Royal Jubilee and Victoria General hospitals. She is also a researcher funded by the Canadian Police Research Centre (a division of the Department of National Defense) and the National Institute of Justice in the U.S. She is delving into the history of what has lately been termed agitated delirium or excited delirium. Specifically, she is looking at what happened when people died while exhibiting the traits of the condition. She was in Prince George recently to teach police about these aggressive forms of delirium because it is often the officers on the street who wind up facing these wild individuals. All too often, including the 2003 high profile Prince George case of Clay Willey, someone in the throes of agitated delirium are so aggressive that it attracts the attention of the police who sometimes have to do extreme things to take the subject into custody. In Wiley's case it took multiple officers to wrestle him to the ground, he was tasered, he was hog-tied and he was taken to RCMP cells. He was soon transported to hospital and died there the next day. A pathologist testified at the coroner's inquest that all physical factors in subduing Willey were irrelevant; what killed him was an extreme reaction to a dose of cocaine. Hall's research so far indicates strongly, she told The Citizen, that the pathologist in the Willey case was correct and similar cases are common, dating back decades. "We in the medical community are now trying to teach police officers that there are things they need to watch for," she said. "We want them to recognize that when they are in that state, don't assume the person is just high on cocaine. They have to bring them to the hospital for care, not a jail cell." Her research shows that 80 per cent of agitated delirium fatalities occur at the scene of police intervention, or in a close time frame, meaning emergency medical intervention is critical. However, "these are not people just having a hissy fit," Hall said, which poses all sorts of associated problems. These subjects may even have moments of clarity, but generally their behaviour is extreme, violent, irrational and many exhibit (as did Willey) superhuman strength. "Just bring them to the hospital, right? Simple," said Hall. "How do you get a person behaving like that to the hospital doors in the first place? And then, we (medical staff) do not really like it when someone in that state is dropped off in our front room. If your grandma is sitting in the waiting room, you probably wouldn't want this kind of person dropped in her lap. There have to be pre-established systems for handling these situations." There is nothing that can be done that makes such scenarios neat and tasteful for the public, however, she stressed. The subjects are likely going to be shocking to anyone who sees them in action, the process of restraining them will likely be violent since Hollywood solutions like tranquilizers cannot be used in such situations for a number of reasons. "Police restrain people. That is their job," she said. "Paramedics are not trained to wrestle these people to the ground." In decades of these incidents occurring and being documented, there is no evidence to suggest any of these deaths were caused or hastened by any restraint methods used by either police or civilians. Through the years pepper spray was introduced, tasers were introduced, different restraint methods used, but so far no correlation has been established to any of these. What does seem to correlate is the use of drugs, especially cocaine. The condition was first studied in deliberate fashion by two pathologists in the United States in the early 1980s and the triggering circumstance was a concerning number of these fatalities in the Miami area. At that time, not coincidentally according to Hall, Miami was the North American headquarters for the cocaine importation industry. Hall found it concerning that some in society, even in the medical field, still don't recognize agitated delirium as a factual condition. It is not a title that stands by itself, she said, but fits under other proper diagnoses. "Stomach ache" is also not a billable diagnosis a doctor can make, she said, but it is still a recognized condition that leads the doctor to the ultimate cause of pain or death. So to is agitated or excited delirium, and that, she said, has been well established by the global medical community for many years. "OK. So if you're so sure it doesn't exist, you're OK with police just grabbing someone thrashing about and throw them into a cell, not taking them to medical attention. Is that really what you want?," she asked. It is time the rest of society understood this behaviour as a medical situation, she said, especially those who encounter the worst case scenarios: the police. Likewise, she said, the police were often the first to bring this condition to the attention of doctors, and the medical community in general has to respond to what the police are experiencing in the field. "It is just easier for a lot of people to blame the police," she said, referring to the times people die in their care. "We have to examine the facts behind every death and certainly there should not be an assumption by anyone that the last person to touch this individual caused this individual to die." - --- MAP posted-by: Richard Lake