Perris: She disputes deputies’ claims that the autistic man died of “excited delirium.”
By Sarah Burge
The Press Enterprise
Copyright 2007 The Press Enterprise, Inc.
All Rights Reserved
RIVERSIDE, Calif. — The mother of a 21-year-old autistic man who died last year after a struggle with sheriff’s deputies in Perris has filed a federal wrongful death lawsuit against Riverside County, accusing the deputies who subdued her son of negligence and brutality.
Sheriff’s officials, however, contend Raymond Lee Mitchell died from autism-induced “excited delirium syndrome,” a condition that leads to sudden cardiac arrest.
In the past few years, excited delirium has been appearing in coroner’s reports across the country with increasing frequency and has become a topic of hot debate.
The victims are usually high on drugs or mentally ill and display paranoid and erratic behavior.
What has given civil libertarians pause is that the deaths almost always involve police.
“That’s a clear cause for alarm,” said Peter Bibring, a staff attorney with the ACLU of Southern California. Excited delirium is controversial even among doctors, Bibring said. Also, he said, it shifts the blame away from police.
Dr. Vincent Di Maio, a former chief medical examiner in Texas who wrote a book on excited delirium, said it’s no surprise that police are usually involved.
“When somebody is acting crazy, running down the street, banging on cars and stripping off his clothes” - all signs of excited delirium - “you don’t call the ACLU. You call the police,” Di Maio said.
Di Maio estimated there are 600 to 800 excited delirium deaths in the United States each year.
The Riverside County coroner’s office reported one other case in 2006. Scott Anthony Wilke, 34, of Cherry Valley, died in September of excited delirium due to methamphetamine intoxication, coroner’s officials said.
The San Bernardino County coroner’s office has attributed three deaths to excited delirium in recent years, said coroner’s spokeswoman Sandy Fatland. Details about those deaths were not readily available.
Dr. Joseph Cohen, chief forensic pathologist with the Riverside County coroner’s office, said he could not discuss the specifics of particular cases. But, speaking generally, he defined “excited delirium” as an overdose of adrenaline that leads to sudden cardiac arrest. Cohen said most people who die of excited delirium are high on cocaine or methamphetamine. About 10percent suffer from mental illness. The combination of stressors releases so much adrenaline that it has a toxic effect on the heart, Cohen said.
`Defense du Jour’
Mitchell’s mother, Wanda, declined to comment for this story. But her attorney, Carl Douglas, disputed the claim that Raymond Mitchell died of excited delirium.
“That’s what they always say,” Douglas said, saying that excited delirium is the defense du jour for law enforcement agencies facing lawsuits over in-custody deaths.
Based on Wanda Mitchell’s claim that several officers piled on top of her son, Douglas said he thinks Raymond Mitchell died of positional asphyxiation.
At the time, Mitchell said her son was throwing a tantrum and she threatened to call the police. She had been taught that, when dealing with her autistic son, she needed to follow through, Mitchell said.
Autism is a developmental disability that affects a person’s communication and social skills.
Mitchell’s family said he was never able to carry on a conversation, but could communicate when he wanted things.
When deputies had been called to the house previously, they calmed him down and escorted him to an ambulance. But last July, the deputies got into a struggle with Raymond Mitchell, who was 5 feet 10 inches tall and weighed 240 pounds. Sheriff’s officials said Mitchell provoked the fight, but his relatives blamed the deputies.
Douglas said the sheriff’s office has placed a hold on the coroner’s and toxicology reports.
After Mitchell’s death, Sheriff Bob Doyle said Mitchell might have taken methamphetamine before his encounter with the deputies. But Wanda Mitchell said her son didn’t take drugs, drink or smoke.
“I think (officers) need to tell the truth,” Wanda Mitchell said at the time. “They were not equipped to handle Raymond.” Training for Special Needs
Dennis Debbaudt, who provides autism-related training to law enforcement agencies, said officers need to realize that a person with autism may not understand verbal commands and body language. In fact, the person may simply imitate the officers, which can spell trouble if officers are loud and aggressive.
Sheriff’s spokesman Jerry Franchville said deputies are trained to handle encounters with people who have special needs, such as autism and mental illness. Aside from Mitchell’s cause of death, Franchville said he could not release the results of the investigation.
New Term
Although “excited delirium” sudden deaths are not a new phenomenon, the term is.
Studies of cases resembling excited delirium exist back to the 19th century, Cohen said, but doctors really began to take note of it in the 1980s when cocaine use skyrocketed. Cohen said the phrase “excited delirium syndrome” evolved in recent years to describe deaths during or after struggles with police in which there is no evidence of significant physical injury. Before, he said, these deaths had been inaccurately attributed to positional or restraint asphyxia.
Dr. Gary Vilke, a professor of clinical medicine at UC San Diego, said both excited delirium and so-called positional or restraint asphyxia are real, but no definitive test exists for either.
“It’s not very satisfying,” Vilke said, but medical examiners have to judge each case based on limited information about the overall circumstances.
“Some people like to say, `They’re all this.’ Others like to say, `It’s excited delirium,’” Vilke said. “The truth is somewhere in the middle.”
`Caused by Police’
Dr. Werner Spitz, a well-known forensic pathologist and former chief medical examiner in Michigan, said it makes no sense that police are a necessary part of the excited delirium equation.
Spitz said the kind of adrenaline-induced cardiac arrest described by proponents of excited delirium exists, but is exceedingly rare. Most of the so-called excited delirium cases with which he is familiar involve someone high on drugs whose breathing was compromised by a police restraint.
“Some people have made a condition out of this,” he said, adding that it seems far more likely they were asphyxiated.
“Strep throat is caused by streptococcus,” Spitz said. “Excited delirium is caused by police.”