|
|
|
| NEWS > 02 September 2007 |
Other related articles:
Police corruption claims refer
Western Australia's Police Commissioner, Karl O'Callaghan, has referred allegations of police misconduct to the Corruption and Crime Commission (CCC).
The allegations involve police failing to disclose evidence in a high profile murder trial.
The High Court last week ordered a retrial for Andrew Mallard who was sentenced to life imprisonment for the 1994 murder of Mosman Park jeweller, Pamela Lawrence.
In Parliament yesterday, the Member for Mindarie, John Quigley, alleged during Mr Mallard's trial police had attempted to pervert the course of justice by failin... Read more
|
 Article sourced from
|
|
Appleton Post Crescent - WI, U
02 September 2007
This article appeared in the above title/site.
To view it in its entirity click this link.
|
|
Doctors, police in conflict ov
High on cocaine, a 26-year-old man parked his car along the highway.
He climbed out of the car at 10:20 p.m. and onto State 441. Another driver, attempting to avoid the stopped car, ran into him.
Fernando Alonso Maldonado Sr. died less than two hours later on Aug. 1, 2006.
According to the Winnebago County coroner, the car crash did not kill Maldonado, who left behind a wife and three children. The Appleton man died of "excited delirium," the coroner ruled.
One year later, doctors, coroners and police are no closer to agreeing on what excited delirium is — or if it even exists.
Many doctors argue that excited delirium stops short of listing a medical diagnosis. Despite the protests of those doctors, Maldonado was not the last Fox Cities resident whose death was blamed on the poorly understood syndrome, which continues to pop up in police reports across the country, usually to explain deaths of people in police custody.
Excited delirium in Wisconsin
Though police and coroners who cite excited delirium do not agree on what exactly it is or what causes it, there are common threads.
"What excited delirium is, is a condition where a person gets a massive dose of adrenaline pumped into their body because their sympathetic nervous system is aroused," said Lt. Dave Nickels of the Appleton Police Department, who trains Fox Valley officers on how to recognize excited delirium.
Those affected quickly become extremely violent and paranoid and often act in bizarre ways, like attacking glass, Nickels said. The condition, which is usually spurred by chronic use of stimulant drugs or a mental illness, also brings "incredible strength and endurance."
"Their body does not seem to have the shut-off mechanism. That adrenaline dump and that superhuman strength just continue. It doesn't stop," Nickels said.
Without medical attention — and a sedative to calm them down — they usually die, Nickels said.
Though they consider themselves on the leading edge, Fox Cities police departments are not the only ones labeling such behavior as a medical condition.
The state Law Enforcement Standards Board in a June 2005 report called it "perhaps the most worrisome" of the "various medical and psychiatric conditions that officers may encounter."
Excited delirium is a medical condition that indicates "the person is in a downward cycle to serious medical complications if a police officer does not control them and get them medical help immediately," said Mark Kohl, a member of the Standards Board and criminal justice instructor at Fox Valley Technical College.
The state does not track the number of cases, but excited delirium has been cited as the cause of death for least two Fox Cities men. Winnebago County Coroner Barry Busby made the determination in those cases, including the highway death of Maldonado.
Attempts to reach the men's families were unsuccessful because their current contact information could not be found in phone listings, court records or online searches.
In both cases, the men had enlarged hearts and cocaine in their systems, according to autopsy and toxicology reports.
Busby could not pinpoint a medical reason for the deaths, but said the use of drugs played a significant role.
To conclude that excited delirium caused the deaths, Busby, a former police sergeant, said he relied on toxicology reports, emergency room records and reports from doctors, police and forensic pathologists because his own medical training is "limited."
"I don't consider myself an expert in (excited delirium) in any way, shape or means," Busby said, "except I've seen the results of this and it's not nice, obviously."
No medical diagnosis
While police are taught to treat excited delirium as a medical condition — and to control the person's aggressiveness by using a Taser — most of the medical community insists excited delirium is not, in fact, a medical diagnosis.
"Excited delirium is not a term that is recognized, so (in the case of) nonmedical people who use the term, it's very difficult to determine exactly what they mean," said Dr. William Narrow, associate director of the division of research at the American Psychiatric Association.
The American Medical Association, whose Web site returns no search results for the term excited delirium, defers to Narrow's opinion, said spokeswoman Lisa Bevilacqua.
Excited delirium may well exist but falls short of a medical explanation for a death, said Dr. Michael A. Williams, chairman of the ethics committee for the American Academy of Neurology and medical director of the LifeBridge Brain and Spine Institute in Baltimore.
What police officers and coroners are describing as excited delirium seems to be a syndrome, he said.
"A syndrome is just a collection of symptoms," he said. "A syndrome describes symptoms of behaviors or a typical series of events ... that seem to be consistent among a certain group of people.
"But the diagnosis is the next step. When doctors say diagnosis, they're thinking a particular cause, something I can see under a microscope or a blood test I can give."
A given syndrome can have several causes or diagnoses, Williams said.
"When the coroner says excited delirium, it's not clear to me what single pathological entity is supposed to be causing that," he said. "When somebody says excited delirium, the next thing they should say is, 'caused by diagnosis A, diagnosis B, diagnosis C.'
"Excited delirium doesn't cause itself. Something causes excited delirium."
No anatomical cause of death
Being more specific about excited delirium is not so easy, said Dr. Joe Prahlow, president of the National Medical Examiners Association.
"In cases of excited delirium, there is no anatomical cause of death," he said.
Instead, determining death by excited delirium is like putting together pieces of a puzzle, he said. Investigators look at a body and the scene of the death for clues, like clothes strewn about or furniture knocked over, indicating a person was overheating from the adrenaline rush or demonstrating unusual strength.
Such bizarre deaths have been studied since 1849 under names such as sudden exhaustive death and cocaine-induced psychosis, Prahlow said. The syndrome has gained increased attention since cocaine use grew in the 1970s.
Identifying a factor that makes a death clearly caused by excited delirium, though, is nearly impossible.
"That's the million-dollar question," he said.
To complicate matters, Williams said, some people could suffer from excited delirium without any police or medical intervention. That, he said, means doctors have incomplete information on the syndrome, specifically who might be at risk and whether cases are necessarily fatal.
That mystery has led civil rights groups like Amnesty International and the American Civil Liberties Union to accuse police of creating excited delirium as a cover-up for police abuse.
Nickels calls excited delirium "mysterious," but says the criticism is unfounded. In the case of excited delirium, a person is "out of control" so police are inevitably called but enter the scene well after the crisis began, Nickels said. Police often use a Taser because "we have to try to use the tools at our disposal to protect the community."
While he understands the scrutiny, he said critics should instead turn their attention toward how to most effectively respond to excited delirium.
"It is a medical emergency. It's been in existence long before law enforcement was dealing with these people," Nickels said.
"My feeling is this: We need to quit focusing on the tools and tactics and start focusing on the medical problem, what's happening to them medically and come up with very good response protocols."
The controversy over excited delirium makes even the Winnebago County coroner uncomfortable about citing it in a death. A year after Maldonado's death, Busby was hesitant to speak about the excited delirium cases and repeatedly said he is not an expert.
"The study is rather new in its entirety," Busby said. "It's a very complicated issue, and a lot of things could still be coming out about excited delirium."
|
| |
 EiP Comments:
|
|---|
|
| |
* We have no wish to infringe the copyright of any newspaper or periodical. If you feel that we have done so then please contact us with the details and we will remove the article. The articles republished on this site are provided for the purposes of research , private study, criticism , review, and the reporting of current events' We have no wish to infringe the copyright of any newspaper , periodical or other works. If you feel that we have done so then please contact us with the details and where necessary we will remove the work concerned.
|
|
| |
|
|
| |
| |
| |
| |
| |
 |
Ethics in Policing, based in the UK, provide information and advice about the following:
Policing Research | Police News articles | Police Corruption | International Policing | Police Web Sites | Police Forum | Policing Ethics | Police Journals | Police Publications |
|
| |
|
