Death linked to 'excited delirium': coroner

November 20, 2009
CBC News

The death of a man who was stunned with a Taser several times during his arrest two year ago in Chilliwack was not the fault of police actions, a coroner's inquest has determined.

In his report, coroner Vincent Stancato concludes that Robert Knipstrom, 36, died from acute ecstasy intoxication and excited delirium.

A coroner's inquest into Knipstrom's death began Monday and the conclusions were released Thursday night.

The jury has recommended police and paramedics change how they handle cases where individuals show symptoms of excited delirium, which can include paranoia, agitation, aggression and extraordinary strength. It was also recommended that police request an advanced life support team when dealing with such patients.

RCMP spokesman Sgt. Peter Thiessen welcomed the jury's findings.

"It validates in the officers' minds — it certainly validates in my mind — what was it that they were dealing with in the first instance," Thiessen said.

Rental shop takedown
The incident that led to Knipstrom's arrest took place at a Chilliwack rental shop on Nov. 19, 2007, where he had gone to return a wood chipper. After clipping another car in the parking lot, Knipstrom entered the store and began acting strangely, the inquest heard.

Knipstrom aggressively confronted the police officers who were called in by staff at the shop, located east of Vancouver. The inquest was told that police used pepper spray, a metal baton and finally a Taser to subdue and restrain him.

The only contradictory evidence came from a former store employee who said Knipstrom was backing away from the first police officer at the time of his arrest, while other witnesses said it was the officer who was retreating.

The same witness said he thought the officer struck Knipstrom in the head deliberately with his baton, but the officer testified any blows that hit Knipstrom's head would have glanced off his body first.

Witnesses testified that after Knipstrom was taken down he continued to thrash around on the ground and resist officers. He was eventually loaded into an ambulance face down — a violation of policy — because he refused to turn over.

Knipstrom's heart stopped beating a short time later, and while doctors managed to resuscitate him, he never recovered and died five days later in Surrey Memorial Hospital.

Death blamed on drugs and delirium
It was later determined that Knipstrom had acute levels of the illegal drug ecstasy in his system.

Excited delirium has been blamed for a number of deaths in police custody and critics have dismissed the that conclusion as a way to excuse overly aggressive police actions.

But Dr. Christine Hall, an emergency medicine specialist, said Knipstrom was a textbook example of the condition: high, strong as an ox, and impervious to pain.

Hall said the condition is real and medical understanding of it is evolving.

"The controversy and the evolution has actually occurred in other illnesses — sudden infant death syndrome for example," said Hall.

"For years and years there was a huge debate about does this exist. Is it really a syndrome? What are the symptoms? Why is it only happening that children are dying? And now we know that medical textbooks and lists of diagnoses have evolved to include that," said Hall.

Drugs, not Tasers, main cause of Chilliwack man's death, inquest told

November 18, 2009
BCLocalNews

A lethal dose of the "feel good" drug Ecstasy - not repeated jolts of electricity from Tasers in the hands of Chilliwack RCMP officers - was the main cause of Robert Knipstrom's death, a forensic pathologist told a coroner's jury Wednesday.

But the decision to handcuff the 36-year-old Chilliwack man with his hands behind his back, and then transporting him to hospital lying on his belly in a prone position was "possibly" a contributing factor to his death, Dr. Dan Straathof said.

However, Chilliwack RCMP officers, fire department officials and BC ambulance paramedics testifying at the coroner's inquest have all insisted there was no other way to safely get Knipstrom to hospital after a violent confrontation with police on Nov. 19, 2007.

Knipstrom was returning a wood-chipper to the EZE-Rent-It Centre that day at about 3 p.m. when he started acting strangely, and refused to stay out of an area reserved for employees.

When police were called and two officers arrived from the RCMP detachment across the street, a fight erupted in which Knipstrom was tasered, pepper-sprayed and struck with a metal baton before he was finally subdued by several additional police officers who arrived on the scene.

But even after he was handcuffed, Knipstrom continued to struggle and kick, howling unintelligibly at anyone who approached him, including paramedics trying to treat his wounds.

Paramedic Rick Simon told the inquest Wednesday that he was aware of the ambulance service policy that no patients are to be transported in a prone position while their hands are secured behind their back.

But he said there was no other way to get Knipstrom to hospital, without causing him further injury.

"Every time we tried to move him, he was quite agitated," Simon said. "I was afraid we'd cause him further injury."

So Knipstrom made the 12-minute trip to Chilliwack General Hospital lying on his belly with his hands cuffed behind his back, in violation of the policy.

Shortly after his arrival at CGH at 4:01 p.m., still in a prone position, Knipstrom went into cardiac arrest and stopped breathing for about 28 minutes.

Straathof said "acute intoxication" with Ecstasy was the main cause of Knipstrom's death four days later on Nov. 24 at Surrey Memorial Hospital, where he had been transferred for treatment.

Straathof said the physical restraint that Knipstrom was held under at CGH was "a component" of the events which led up to his cardiac arrest, and to the resulting brain and organ damage due to the lack of oxygen.

But he could not say how much of a role the physical restraint played in Knipstrom's death, nor whether the prone position in particular added to the harm.

"There has been some suggestion that physical restraint, especially face-down restraint, can result in reduced lung function," he said.

However, he said it's also possible that Knipstrom could have gone into cardiac arrest from the effect of the Ecstasy alone, without any kind of physical restraints present.

The Tasers did not contribute to the cardiac arrest, Straathof suggested, because it occurred much later after the confrontation with the RCMP. He also found no evidence during an autopsy that the Taser probes actually made contact with Knipstrom's body.

Dr. Walter Martz, a toxicologist at the Provincial Toxicology Centre, said

6.1 mg of Ecstasy per litre of blood was found in a sample taken from Knipstrom when he was admitted to CGH on Nov. 19.

Martz said 150 mg of Ecstasy will produce about 0.5 mg/litre in the blood of a user. The 6 mg found in Knipstrom's blood sample is "within the range" of a lethal dose, he said.

But Martz warned that some people are more sensitive to the drug than others, and instead of the expected euphoria can experience a psychotic episode.

He said a recent animal study also suggests that pepper spray enhances the stimulant effect of Ecstasy, increasing the need for oxygen as the heart rate increases, while at the same time making breathing more difficult.

"The outcome might be fatal," he said.

The inquest is scheduled to end Friday after experts in police use of force and a condition known as "Excited Delirium" are heard.

Inquest begins into 2007 Taser death of Robert Knipstrom

November 16, 2009
CTV News BC

A coroner's inquest began Monday into the November 2007 death of Robert Knipstrom, who was Tasered during a struggle with a rookie RCMP officer.

Knipstrom, a 36-year-old arbourist, was taken to hospital but died four days later.

Knipstrom had gone to EZ Rental in Chilliwack to return a wood chipper. The store's owner, Russ Walsh, told the inquest that Knipstrom was twitchy and erratic.

When Knipstrom refused to leave the store, police were called.

The officer who tried to arrest Knipstrom testified that Knipstrom lunged at him.

He said that he used his pepper spray, his baton and his Taser to get him under control.

"I was trying to get away from him ... he was chasing me around the store ... I was getting tired," the officer testified.

"This guy seemed bound and determined to hurt me ...I was running out of options."

The officer cannot be identified because he now works undercover.

Mike Berube, a former worker at the store, said Knipstrom did not appear aggressive to him.

"From what I saw he just wanted to get away. And the two officers just wanted to hold him down," Berube told reporters outside the hearing. "It didn't look like they were rushing him. It didn't look like he was rushing them. They were just trying to corral him."

Knipstrom was Tasered twice. Police pulled the Taser probes from his back after taking him down.

Knipstrom's father later arrived to calm his son down.

An autopsy showed the cause of death to be lack of oxygen and the drug Ecstasy.

The role the Taser played will be examined later in the inquest.