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Excited Delirium FAQs

Our civil rights attorneys provide answers to commonly asked questions about “Excited Delirium Syndrome,” and its use as a defense in police misconduct cases.

What is Excited Delirium?

Excited delirium is a controversial diagnosis rejected by mainstream medical organizations and is pseudoscience, or junk science. Proponents of excited delirium syndrome characterize it as an abrupt onset of extreme aggression, physical strength and distress or psychotic behavior, typically accompanying drug abuse, which results in sudden death. The condition is primarily alleged to be found in people who have been Tased, and/or subject to prone and weighted restraint by police.

How is Excited Delirium used in Police Misconduct Cases?

Excited delirium is often used by police who kill people to defend themselves against allegations of excessive force or police brutality. After a person dies in police custody following a violent confrontation, the syndrome is diagnosed postmortem to justify police aggression, and shield officers from accountability for causing or contributing to a person’s death. The defense claims that the Taser or restraint was not the cause of death, but rather the victim suffered from excited delirium.

In addition, the syndrome is disproportionately diagnosed among young black men, highlighting racist undertones.

Where did the term Excited Delirium originate?

The phrase “excited delirium” was first used in Florida in the 1980s by forensic psychologist and Miami-Dade County Deputy Medical Examiner Charles V. Wetli. He first claimed a person who had “bodypacked” cocaine by inserting it into the rectum died of delirium, even though it is well known in medicine that a person who “bodypacks” a drug can continue to absorb the drug, in potentially deadly amounts, if it is not removed from the rectum. Wetli next claimed that seven people died of excited delirium even though all seven of them had been restrained, and four of them were even hogtied, which is well known to impair breathing. Wetli next claimed that 17 Black women who were known or suspected prostitutes who died with small amounts of cocaine in their systems died of “excited delirium” from sexual excitement while servicing their clients. He claimed that, even though it looked like the women had been raped and murdered, he had conclusively shown the women died of excited delirium. However, after a 14-year-old girl was found dead in similar circumstances, with no cocaine in her system, and Wetli still claimed her death was from excited delirium, Wetli’s boss, Chief Medical Examiner Joseph Davis, re-examined all of the autopsies and found that all of the women had died of strangulation or asphyxia. Dr. Davis said in some cases the evidence of murder was so obvious you could see it from 10 feet away. Eventually all of the deaths were attributed to serial killer Charles Henry Williams, but not before he murdered as many as 32 women.

Even after being debunked, Wetli continued promoting excited delirium as a cause of death. In 1990, he claimed that 70% of people who die of excited delirium are Black men, and “it may be genetic.”

Despite the scandal and excited delirium’s racist and sexist roots, the use of the junk science theory of excited delirium has persisted, perpetuated by law enforcement and the manufacturers of Tasers. TASER International defense expert, forensic pathologist Vincent Di Maio, and his wife wrote a book about “Excited Delirium Syndrome,” to try to legitimize the theory. In 2007, TASER International purchased 1,000 to 1,500 copies of Di Maio’s book, to hand out for free to forensic pathologists. The obvious intention was to get forensic pathologists who do autopsies on people who die after being Tased, or Tased and restrained, to say the cause of death was the junk science theory of excited delirium.

In 2008, TASER International’s in-house lawyer, Michael Brave, co-organized a conference in Las Vegas to legitimize excited delirium. As a result of that conference, in 2009, several TASER International defense experts participated in co-authoring a “white paper” by the American Academy of Emergency Physicians to promote excited delirium as legitimate. It does not appear that any of these TASER defense experts ever disclosed their clear conflict of interest.

How often is death attributed to Excited Delirium?

A 2017 Reuters report found that excited delirium has been listed as a factor in autopsy reports, court records or other sources in at least 276 deaths that followed Taser use since 2000. In fact, excited delirium has been asserted as a defense in nearly all of the restraint asphyxia death cases prosecuted by Haddad & Sherwin LLP.

Is Excited Delirium recognized by the Medical Community?

Responsible medical organizations have rejected the junk science theory of excited delirium. It is not recognized by the World Health Organization, the American Medical Association, American Psychological Association, or the American Psychiatric Association. Excited delirium has no International Classification of Diseases (ICD-9 or ICD-10) Code, which means it cannot be assigned as a diagnosis or as a cause of death for statistical purposes. It has never appeared in any edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the main mental health diagnostic tool, which is in its fifth edition. In 2020, the Royal College of Pathologists issued guidance for the United Kingdom advising against the use of excited delirium as a cause of death and against training law enforcement about the junk science theory. In 2021 the American Medical Association issued a strong opinion against the legitimacy of excited delirium, and noting its racist origins and use.

What should you do if your family member is the victim of restraint asphyxia and police misconduct?

Attorney Julia Sherwin is a nationally known expert on restraint death and excited delirium.  She has worked for many years to debunk the theory, and has consulted with lawyers around the country to help them win their cases where the junk science defense is raised.  She has taught forensic pathologists from around the world about the junk science nature, and racist and sexist roots, of excited delirium.  She is co-authoring the world’s first comprehensive paper on excited delirium, which will be published by Physicians for Human Rights in early 2022.  If you have a loved one who died during a police restraint in Northern or Central California, we encourage you to contact the law offices of Haddad & Sherwin for a free consultation. We know the excited delirium theory is junk science, and we had many years of experience in beating it. Our restraint asphyxia attorneys have successfully debunked excited delirium in our cases, preserved the civil rights of our clients by winning cases, and spearheaded settlements with reforms to improve policies and procedures and prevent future restraint-related deaths.