Get the Facts about the Theory of Excited Delirium

Excited delirium is a controversial theory based in pseudoscience or junk science, which claims that a person, usually on drugs or in a mental health crisis, becomes so agitated and delirious that they suddenly die. Despite not being recognized by the mainstream medical community, the excited delirium theory is perpetuated by law enforcement and the manufacturers of Tasers, and it continues to be used as a defense in civil rights cases involving restraint asphyxia-related deaths and police brutality.

When Was the Term Excited Delirium First Used?

In the 1980s, Miami-Dade County Deputy Medical Examiner Charles Wetli, MD, determined that nineteen Black women who were suspected prostitutes all died of “excited delirium” from “sexual excitement” (servicing their clients) while on cocaine. Chief Medical Examiner Joseph Davis reexamined all of Wetli’s excited delirium autopsies and found evidence that all the women actually died of asphyxiation. He reclassified the cause of death as homicide and the murders were eventually tied to a serial killer.

Despite the autopsy scandal, Dr. Wetli continued to promote excited delirium as a cause of death in cases where people had stimulants in their systems. In 1990, he said that 70 percent of people who die from excited delirium are Black men and that “it may be genetic.” However, since Wetli’s report, there has been scant support for his concept of excited delirium.

How Has Excited Delirium Theory Evolved Since Then?

California now bans the use of excited delirium as a diagnosis or cause of death. Excited delirium unfortunately is still used by some pathologists and coroners in other places as a cause of death in cases where individuals die in law enforcement custody. An Austin-American Statesman Investigation into non-shooting deaths of individuals in police custody in Texas from 2005 to 2017 found more than one in six deaths were “linked to excited delirium.” A January 2020  Florida Today report concluded that of 85 deaths attributed to excited delirium by Florida medical examiners since 2010, at least 62 percent involved the use of force by law enforcement.

What are the Dangers of Excited Delirium Theory?

In short, the theory of excited delirium exists to provide police with an excuse for when they cause the wrongful death of a person in their custody. By pinning death in police custody on a claimed naturally occurring phenomenon, blame falls to the victim and not the officer in charge of their restraint. This means that police officers are not held responsible for their wrongdoing and can continue to mistreat people in their custody. This can lead to further cases of police excessive force and restraint asphyxia.

How are Haddad & Sherwin Addressing Excited Delirium?

Haddad & Sherwin LLP partner Julia Sherwin has worked for many years to debunk the junk science theory of excited delirium. In 2022, she co-authored a report with Physicians for Human Rights debunking the theory. In 2023, she provided amendments to California’s Assembly Bill 360, banning the use of excited delirium as a diagnosis or cause of death in the State of California. AB 360 passed the California legislature overwhelmingly, and is now the law in California. The law prohibits the use of excited delirium as a cause of death or a diagnosis in medical records or death certificates. The law also prohibits defense expert witnesses from testifying about excited delirium as a diagnosis or a cause of death in any state or federal court, and specifically prohibits government employees or contractors, like the prominent members of the American College of Emergency Physicians (ACEP) who were paid to promote excited delirium theory, from testifying that excited delirium caused or contributed to any person’s death or injury.

Because it’s still widely used by forensic pathologists, coroners, and law enforcement outside California, there are a lot of questions about excited delirium and how it impacts victims of police brutality. Our excited delirium FAQ provides a good overview of the topic and highlights how excited delirium theory continues to plague the justice system.

Haddad & Sherwin LLP have a long track record of winning civil rights cases with results that include large settlements and verdicts for their clients, groundbreaking legal rulings, and important reforms to prevent future harms.  Haddad & Sherwin LLP handle only a unique subset of Section 1983 cases: cases where a person was killed or permanently, catastrophically injured in California by law enforcement or county jail misconduct.  If you would like to consult with experienced civil rights lawyers because your loved one was killed by police or died in a California county jail, then contact the attorneys at Haddad & Sherwin LLP.  If your civil rights were seriously violated, but without death and without permanent, catastrophic injury, you could try the list of civil rights attorneys here.