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‘Excited delirium’ finding in custody death angers parents- Guardian 1 Feb 2012

Pathologist concludes Jacob Michael died of ‘excited delirium’, a term not recognised by Department of Health.

The parents of a 25-year-old man who died in police custody have been angered by a Home Office pathologist’s finding that their son died of “excited delirium”, a medical term that is not recognised by the Department of Health.

The family of Jacob Michael, who died last summer after calling police saying he feared for his life, say the pathology report ignored how their son was heavily restrained by 11 officers on the street outside their home, as well as evidence of broken ribs and a torn liver.

According to witnesses, Michael was repeatedly hit with police batons after fleeing his home when two officers from Cheshire constabulary entered his bedroom and released pepper spray into his face.

The IPCC has told the Guardian that 58 witness statements have been taken and 98 exhibits logged in the investigation. Two pieces of relevant CCTV footage have been secured, including film from the police custody suite where Michael was held down on the floor by officers.

Michael’s father said: “As far as I’m concerned, if the police didn’t treat my lad the way they did, he would be here today. He did nothing wrong, he hadn’t committed any crime, he rang the police for help.

“We’re still waking up crying every day. The pain is there 24 hours,” he said.

Despite not being listed by either the Department of Health or the World Health Organisation as a recognised cause of death, excited delirium has been cited in a number of death in custody cases.

A joint investigation by File on Four and the Bureau of Investigative Journalism broadcast on BBC Radio 4 on Tuesday cast doubt on the medical basis for the term, which has been cited in 17 suspicious death cases in the UK.

Richard Shepherd, one of the UK’s leading pathologists and a member of the independent advisory panel on deaths in custody, who recently reviewed the scientific evidence on excited delirium, told File on Four that pathologists should be wary of the term.

“I’m clear in my own mind that there is no strict definition [of excited delirium]. It’s a term that should be used with great care … because I don’t think it is yet established that closely and it should never explain a death [by itself]”

There have been dozens of excited delirium cases in the US, most notably where police have used Tasers or pepper spray. A two-year official inquiry by a retired Canadian judge, Thomas Braidwood, in 2009 concluded that the term was uniformly rejected by medical professionals and was being used to cover up actual causes of deaths in custody, especially those involving excessive restraint and Taser use.

In a 1,000-page report, Braidwood concluded it was “not helpful to characterise people displaying these behaviours as suffering from excited delirium. Doing so implies that excited delirium is a medical condition or diagnosis, when mental health professionals uniformly reject that suggestion.

“Assigning responsibility to such symptoms (in the guise of a diagnosis) conveniently avoids having to examine the underlying medical condition or conditions that actually caused death, let alone examining whether use of the conducted energy weapon and/or subsequent measures to physically restrain the subject contributed to those causes of death.”

Helen Shaw, co-director of the charity Inquest, which campaigns for justice in death in custody cases, said: “Where the use of force may be a contributing factor in the death, there is frequently an attempt to obscure that contribution, often by relying upon completely unfounded or disputed physiological theories like excited delirium.

“We have seen evidence presented at inquests which appears to be designed to shift the focus on to anything but the use of force, to deflect attention away from the acts or omissions of those involved and to attempt to blame the victim for their own death as a result of their supposed pathological condition.”

The IPCC said there was nothing in the pathology report to suggest Michael’s injuries were linked to his cause of death.

“The Independent Police Complaints Commission has been involved in a small number of cases where pathologists have cited a condition called excited delirium as a factor in the death or behaviour of an individual,” it said. “We are aware there is an ongoing debate within medical circles about the condition, but the IPCC does not have the medical expertise to comment on such a matter.

“We are reliant on the opinions of the medical professionals in determining what we investigate and the recommendations we make.”

It said four police officers and one civilian member of staff were under notice of investigation over their actions during Michael’s arrest. It is looking into whether officers involved in the incident had received training in identifying and dealing with excited delirium. The investigation is expected to reach a conclusion in April.