Symposium aims to define 'excited delirium'

November 30, 2007
OMAR EL AKKAD, The Globe and Mail

Critics say the medically unrecognized condition is a way to protect police officers from allegations of wrongdoing

LAS VEGAS -- In an aging ballroom at Las Vegas's Imperial Palace hotel usually reserved for a celebrity impersonators show, 360 cops, doctors, lawyers and others have gathered to talk about why people sometimes die in police custody.

The second annual Sudden Death, Excited Delirium and In-Custody Death Conference is under way in Las Vegas, bringing together dozens of experts on a controversial area of research. Most of the speakers - who range from emergency medicine doctors to researchers to current and former police officers - know each other on a first-name basis, having given talks at similar conferences for years. Most of the attendees have paid between $600 and $700 to be here.

While the three-day conference is specifically about in-custody death and excited delirium - an unrecognized medical condition - many of the nearly 20 talks inevitably touch on the role of tasers. As such, the conference has attracted greater Canadian attention since the death of Polish immigrant Robert Dziekanski at Vancouver International Airport last month.

In fact, Canadians play a major role in this conference, as well as excited-delirium research in general. Officers from Ottawa, Vancouver and Edmonton police forces are here, including members of the RCMP. Two of the conference's key scheduled speakers are Canadian, including James Cairns, Ontario's deputy chief coroner, who dropped out at the last minute.

"The goal is to educate as many people as we can about excited delirium," says John Peters, conference organizer and head of the Institute for the Prevention of In-Custody Deaths. "There's a wide array of issues."

However, the key issue is excited delirium, a collection of symptoms that is quickly becoming the leading explanation offered when a person dies in police custody or after a taser is used. According to the various speakers at the conference, signs of excited delirium can include erratic behaviour, profuse sweating and superhuman strength.

Critics, who include civil-liberties groups and plaintiffs in myriad lawsuits against both Taser International and police departments, say the condition is actually a vague collection of descriptors designed to protect police officers from allegations of wrongdoing. But there are virtually no such critics at this conference, only hundreds of researchers and front-line officers who'll readily stake their reputations on excited delirium being a very real medical emergency.

"I would have used agitated delirium," says Christine Hall, a Canadian emergency medicine doctor and leading expert on excited delirium. "When people hear the word excited, they think of birthday parties or going on a trip to Hawaii."

Dr. Hall, who is at this year's conference and has been asked to speak at next year's, says much in the same way that abdominal pain can be a symptom of a medical condition such as appendicitis, excited delirium is a collection of symptoms that could point to serious underlying medical problems. The end goal of such conferences, she says, is to allow police officers to spot the signs of what could be a medical emergency.

But as many people at the conference point out, the first step to getting medical help for someone showing signs of excited delirium is to get them restrained. "People say, 'You should just get him to a hospital,' " Dr. Hall says. "But how?"

There are, however, many problems with legitimizing excited delirium. For one thing, the myriad symptoms can blur the line between someone suffering from cocaine-induced excited delirium and someone with low blood sugar - especially for police officers, who generally aren't trained to make a medical diagnosis.

While excited delirium is not a recognized medical condition, it has been listed as a cause of death in several coroner jury inquests in Canada and the U.S. - Taser International has often said that excited delirium, not its devices, is the cause of death in many cases where people were hit with a stun gun and subsequently died.

The presenters at the conference are well aware of the possibility that they could be perceived in conflict of interest. Some of them disclose that their research is funded by Taser. Two such presenters conducted research on the negative effects of taser use on the human body; they found very few.