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Monday, May 04, 2009

Psychiatrist tells Taser inquiry Dziekanski suffered delirium

May 4, 2009
The Canadian Press

VANCOUVER, B.C. — A psychiatrist who reviewed evidence of Robert Dziekanski's behaviour leading up to his death at Vancouver's airport concluded he was in a state of "agitated delirium" before he was shot several times with a Taser stun gun.

But Dr. Lu Shao-Hua on Monday told a public inquiry into Dziekanski's October 2007 death that exactly what caused that delirium remains a mystery.

The 40-year-old died on the floor of the airport after being shocked multiple times with an RCMP Taser. Mounties had been summoned to deal with Dziekanski after he started throwing furniture around the arrivals area of the airport.

Lu, an expert in delirium syndrome as well as addiction medicine, was hired by the Integrated Homicide Investigation Unit, which probed the death.

Lu testified Monday that his review took into account witness statements, Dziekanski's autopsy report and a 10-minute video of the incident shot by traveller Paul Pritchard.

"There is a high degree of certainty Mr. Dziekanski was in a state of agitated delirium prior to the police incident and his death," Lu concluded in his April 9, 2008, report.

RCMP investigators later went to Poland to interview Dziekanski's friends there, and Lu said their information only reinforced his opinion Dziekanski was in a state of delirium when he died.

Lu was careful not to say Dziekanski was suffering from "excited delirium," which turned up in the autopsy report and has been cited in other deaths where conducted energy weapons have been involved.

The term has been attacked by critics who say it's just a way to avoid connecting someone's death with use of the devices.

"Excited delirium is not a term that we use in a medical sense," said Lu, who also testified a year ago during the first phase of the inquiry, which looked into the use of Tasers by law enforcement generally.

"Delirium is a medical syndrome. It's not a disease in and of itself. Delirium is the symptom of some underlying condition."

Dziekanski received the first of as many as five Taser jolts within seconds of Mounties arriving on the scene, though the constable who used the stun gun has testified he's not sure if it connected every time.

In his report, Lu said based on the evidence he reviewed, Dziekanski had several risk factors for delirium.

Fearful of flying, he hadn't slept much, if at all, before and during the flight. He appeared dehydrated and could have been suffering from alcohol withdrawal.

The autopsy report found evidence of brain and liver damage suggesting alcoholism but Dziekanski's mother, Zofia Cisowski, and his friends in Poland deny he drank heavily.

Lu said that in the video Dziekanski displayed "classic features of delirium." He was disorganized, unsteady on his feet and exhibiting unfocused aggression.

But the inference of alcoholism aside, Lu said the evidence turned up no pre-existing psychiatric condition nor history of aggression.

"Based on available information and observations Mr. Dziekanski's delirium was likely precipitated by prolonged sleep deprivation, dehydration and electrolyte imbalance," Lu's report says.

Before his confrontation with police, Dziekanski managed with help to fill out his customs form and interacted with border services officers.

Lu, who often works with elderly patients suffering post-operative delirium, said someone in that state can be aware of their surroundings, recognize people and respond to instructions.

He agreed with Walter Kosteckyj, Cisowski's lawyer, that lack of sleep alone could trigger irritability and unreasonable behaviour without it being "agitated delirium." But it doesn't rule out delirium either, he said.

"Delirium is not an on and off," he said. "It's not you're pregnant, not pregnant. Delirium is a continuum of syndromes."

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