Excited delirium is a real risk, Nova Scotia report into taser death warns

See also NOVA SCOTIA REPORT ON "EXCITED DELIRIUM" MISSES THE ENTIRE POINT

September 7, 2009
OLIVER MOORE, Globe and Mail

Excited delirium is real and anyone showing symptoms of it should be "considered at risk of sudden death," according to a report commissioned by the Nova Scotia government.

The chairman of a panel of medical and mental-health experts dismissed as pointless the continuing debate over whether excited delirium, often cited in the deaths of people who have been tasered, actually exists.

"Does it exist as a medical diagnosis? That's a useless discussion - the phenomenon exists," Stan Kutcher, an expert in adolescent mental health at Dalhousie University's department of psychiatry, said. "The point is, what is this phenomenon, how can we best identify it, how can we best intervene?"

The panel's report warns that efforts to restrain someone suffering from excited delirium, which the report calls an autonomic hyperarousal state, may be risky. Medical personnel should be summoned as soon as possible, the panel recommends. "The state itself is a medical emergency," Dr. Kutcher said. "People in this state have a higher risk of death."

According to the report, given to the government in June and released publicly Friday, first responders should try to de-escalate the situation and negotiate when dealing with such a person. But if physical restraint proves necessary, it must be done as rapidly and safely as possible because a long struggle may pose greater risk to the subject.

The authors do not specify what form that restraint should take. That raised concerns for a lawyer acting for the family of Howard Hyde, a paranoid schizophrenic Dartmouth man who died in custody 30 hours after being tasered by police.

"From what I can see, the police [handling Mr. Hyde] felt that they were doing just that by using the taser," Kevin MacDonald said. "That's seen as the quickest and safest way to restrain someone."

Justice Minister Ross Landry said that more research needs to be done to determine whether there should be greater restrictions on how the stun weapons are used.

"I was a police officer for 30 years and I don't think this report takes away the need for the taser at this time," he said. "We're still trying to determine the relevance of the taser and what impact it has with regards to excited delirium."

The panel, which was struck last fall, included Nova Scotia chief medical examiner Dr. Matthew Bowes, who found that Mr. Hyde's death was caused by excited delirium because of his mental illness. It was tasked with cutting through what the government viewed as public confusion surrounding the condition.