Newspaper article St Louis Post-Dispatch (MO)

Condition Puzzles Experts Many in Police Custody Have Died of Agitated Delirium

Newspaper article St Louis Post-Dispatch (MO)

Condition Puzzles Experts Many in Police Custody Have Died of Agitated Delirium

Article excerpt

At least 11 people have died in police custody in the St. Louis area since 1990 while in the throes of a mysterious, often violent medical condition called agitated delirium, a review of death records shows.

In all, at least 20 people have died from the syndrome here over the last decade - 14 of those after police restrained them. Among them was Randolph Vance, 47, whose death on Oct. 20 sparked allegations of police brutality. Family members and friends also have alleged a police cover-up.

A grand jury will likely be asked to determine if police used excessive force in their struggle to restrain Vance, an official from the St. Louis Circuit Attorney's office said. The larger issue - how often such cases occur, how they're handled and whether changes in police procedures could help prevent future problems - has never been systematically addressed by city, county or East St. Louis police, officials said. San Diego, which has about the same population as St. Louis, created a task force to examine police custody deaths after seven people died between 1989 and 1992. Since then, only two agitated delirium deaths have occurred in police custody. The syndrome was first described in Miami in the mid-1980s. It often occurs in people who have used illegal drugs such as cocaine, amphetamines and the hallucinogen PCP. However, it is also seen in people with psychiatric problems who have not used illegal drugs. In some of those cases, medications used to treat those patients have been blamed. People with agitated delirium become irrational, exhibit bizarre behavior and extreme paranoia, then suddenly collapse and die. Often, they have greatly elevated body temperatures that can reach 110 degrees or more. They can demonstrate what is often described as "superhuman" strength before collapsing. Because of the way death records are compiled and stored, no one can say for certain how often such deaths occur in Missouri and Illinois or elsewhere around the country. The 1992 San Diego report documented at lea st 94 deaths nationwide, but experts say the true number is far greater. No one knows how often police are involved; or what other elements may come into play. Nor do they know how frequently police restraint is a factor in such deaths as St. Louis Medical Examiner Michael A. Graham said it was with Vance. No one knows how often such deaths go misdiagnosed or unreported - although experts say that is almost certainly the case, especially in rural areas or places where a coroner rather than a forensic pathologist investigates deaths. What is clear is the chilling similarity of many cases. Among the local examples: 1996: A St. Louis County man, celebrating his 40th birthday, suddenly begins complaining about being overheated. He has been drinking and injecting cocaine. He strips off his clothes and leaps through a plate glass window. After police arrest the man, he collapses. He is pronounced dead shortly afterward. 1996: A St. Louis county man, 29, locks himself in his bathroom and begins binging on cocaine. Police are called. They break into the room. He is restrained and arrested, then taken to a hospital. He dies shortly afterward. 1995: A psychiatric patient, 44, in St. Louis becomes agitated. Security guards restrain him. Shortly afterward, he dies. 1994: A city man, 30, is running wildly through his neighborhood. He has been using cocaine. Paramedics and police are called. Police restrain him, and he is put into an ambulance. When he arrives at a hospital, he is dead. 1993: A city woman, 41, with a history of psychiatric problems begins to act strangely. Again, police and paramedics are called. Police restrain her and put her in an ambulance. She dies on the way to the hospital. 1992: A man, 32, is visiting friends in East St. Louis when he suddenly becomes unruly and barricades himself in a room. Police break in the front door. The man leaps through a closed window and tries to flee. …

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