The Hard Work
Dedicated to the hard work that needs to be done at the intersection of society and emergency medicine.
Resources
Relevant videos and literature about death in custody can be found below.
Videos
Note: These videos contain sensitive material involving tragic deaths.
Minute-To-Minute Breakdown Leading Up To Elijah McClain's Deadly Stop | NBC News NOW
​James Britt 2019 (excerpts)
​Charleston County EMTs inject Britt with ketamine during arrest
​Testimony of Dr. Martin Tobin, Pulmonologist re Death of George Floyd
​News Report ABC Dallas, TX 2020 re Prone Restraint Deaths
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Most of the video links here are to publicly accessible videos on Youtube, Vimeo or elsewhere. Some are not publicly available. The Hard Work does not have ownership or license to use any of the videos and no representation is made regarding the ability to use them to provide EM or EMS training.
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Bibliography
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Excited Delirium:
Revisiting “Excited Delirium”: Does the Diagnosis Reflect and Promote Racial Bias?, Walsh et al., 2023
“Excited Delirium” and Deaths in Police Custody, PHP, 2022
Fatal Excited Delirium Following Cocaine Use: Epidemiologic Findings Provide New Evidence for Mechanisms of Cocaine Toxicity, Ruttenber et al. 1997
Brain Biomarkers for Identifying Excited Delirium as a Cause of Sudden Death, Mash et al. 2009
Factors Associated with Sudden Death of Individuals Requiring Restraint for Excited Delirium, Stratton et al. 2001
Excited Delirium Deaths in Custody: Past and Present, Grant et al. 2009
Excited Delirium: A Systematic Review, Gonin et al. 2018
Medical Conditions and Restraint in Patients Experiencing Excited Delirium, Strote et al. 2014
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2009 ACEP Paper Endorsing "Excited Delirium"
ACEP (American College of Emergency Physicians) Statement 2009
Recent National Medical Organizations Rejecting "Excited Delirium":
APA 2020 Position Statement Regarding “Excited Delirium”
Re ACEP see also A doctors group calls its ‘excited delirium’ paper outdated and withdraws its approval
NAME 2023 Position re "Excited Delirium"
See also Medical examiners group steps away from ‘excited delirium’
CAP Position re Excited Delirium 2023
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Philosophy of Excited Delirium:
Making up Monsters, Redirecting Blame: An Examination of Excited Delirium, Byju at al. 2023
This is one of the best papers I have read on the "philosophy" of excited delirium. I highly recommend it.
Excerpts:
“As such, we ask here, what work is excited delirium doing in these spaces, such that it persists so doggedly, despite a remarkable lack of scientific or medical support for its existence? In response, we explore two levels at which excited delirium achieves its aims: 1) justifying force, and 2) redirecting responsibility.”
“Indeed, the analysis of excited delirium’s logic and construction reveals that there may be good reasons to doubt the innateness, validity, or natural kind status of the diagnosis, but also that the reality it is given by police, EMTs, physicians, and others for whom it circulates is a significant one. Much like race, this allows excited delirium to be both constructed and causal, both real and imagined, both fact and fiction”
Making Up Excited Delirium, Anaïs et al. 2014
Excited Delirium’, Acute Behavioural Disturbance, Death and Diagnosis, McGuinness et al. 2022
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Older Excited Delirium Literature:
This literature contains the origins of "excited delirium."
Cocaine Intoxication, Delirium, and Death in a Body Packer, Fishbain et al., 1981
Cocaine-induced psychosis and sudden death in recreational cocaine users, Wetli et al., 1985
>> One of the original papers promoting "excited delirium"
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Ketamine:
Inadvertent ketamine overdose in children: Clinical manifestations and outcome, Green et al., AEM, 1999
Massive Iatrogenic Pediatric Ketamine Overdose With Serial Levels and Minimal Morbidity, Bowman et al. PEC, 2021
Special K with No License to Kill: Accidental Ketamine Overdose on Induction of General Anesthesia, Warner et al., AJCR, 2018
Rapid Agitation Control With Ketamine in the Emergency Department: A Blinded, Randomized Controlled Trial, Barbic et al., AEM, 2021
Clinical Uses of Ketamine in Children: A Narrative Review, Cureus, 2022
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Death in Custody & Behavioral / Mental Health Facilities:
THE LETHAL HAZARD OF PRONE RESTRAINT: POSITIONAL ASPHYXIATION 2002
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Independent Reports:
Maryland AG Death in Custody: Audit of the Maryland Office of Chief Medical Examiner Oct. 2022
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Legal EMS Reporting / Commentary:
Patients in custody and in need of treatment: 8 recommendations for EMS | Page, Wolfberg & Wirth | EMS1 | Sept 2021
Legal analysis: What the paramedic criminal charges in the Elijah McClain case mean for EMS | Page, Wolfberg & Wirth | EMS1 | Sept 2021
News Reporting / Commentary:
A doctors group calls its ‘excited delirium’ paper outdated and withdraws its approval
Subduing Suspects Face Down Isn’t Fatal, Research Has Said. Now the Research Is on Trial., NYTimes, Oct. 2, 2021
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More Than Half of Police Killings Are Mislabeled, New Study Says, NYTimes, Sept. 30, 2021
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They Investigate Police Killings. Their Record Is Wanting, NYTimes, Sept. 25, 2021
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'Using medication as a weapon': What's the consequence when a paramedic is involved in a deadly police encounter?, USA Today, Sept. 22, 2021
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Jurors in Daniel Prude Case Voted Overwhelmingly in Favor of Police, NYTimes, April 16, 2021
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Expert Witness Pinpoints Floyd’s Final Breath and Dismisses Talk of Overdose, NYTimes, April 8, 2021
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PRONE: Facedown and handcuffed is no way to die, yet it keeps happening over and over again, KARE 11, Nov. 9, 2020
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George Floyd is not alone. 'I can’t breathe' uttered by dozens in fatal police holds across U.S., USA Today, June 13, 2020
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Excited Delirium dilemma: Explanation or excuse for in-custody deaths?
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Handcuffed and facedown: People continue to die like this in police custody
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Snopes: What Is ‘Excited Delirium’ and Why Is It Controversial?
Research Studies:
Prone restraint cardiac arrest: A comprehensive review of the scientific literature and an explanation of the physiology, Med Sci Law, Feb. 25, 2021
Other Publications:
Positional Asphyxia—Sudden Death, US DOJ, June 1995
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Individuals Who Have Died in Custody:
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David Cutler (2017):
Lawsuit: Southern Arizona authorities used excessive force, failed to render aid to man in distress
Settlement in Arizona's ketamine case
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Jerica LaCour (2018):
Mom of 5 died after ketamine injection by a paramedic, family alleges in wrongful death suit
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Elijah McClain:
Report of the Independent Review Panel that looked into Elijah McClain’s death on behalf of the City of Aurora Colorado.
Linked below is an excerpt from the report containing the conclusions of the ED physician asked to review the actions of EMS
Minute-To-Minute Breakdown Leading Up To Elijah McClain's Deadly Stop | NBC News NOW
James Britt (2019):
Charleston County EMTs inject Britt with ketamine during arrest
‘I can’t breathe,’ police video of James Britt arrest in Mount Pleasant
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Nekeya Moody (2020):
Note: This case does not involve the administration of a sedative.
'I think she's playing possum': Woman's death one year later draws comparisons to George Floyd's
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Hunter Barr (2020):
Springs man dies after double dose of controversial drug ketamine
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George Floyd (2020):
Testimony of Dr. Martin Tobin, Pulmonologist
Expert Witness Pinpoints Floyd’s Final Breath and Dismisses Talk of Overdose, NYTimes, April 8, 2021
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Mario Gonzales (2021):
Note: This case does not involve the administration of a sedative.
Mario Gonzalez died after police pinned him down for 5 minutes. Now his autopsy is in
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Demetrio Jackson (2021):
Man dies 2 weeks after incident with law enforcement officers in Altoona
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Daniel Taylor (2021):
It's been a year since Daniel Taylor died in JSO custody, and the investigation goes on
The In-Custody Death Investigation Regarding Daniel Christian Taylor