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Restraint asphyxiation in excited delirium
1Ventura County Medical Examiner's Office, California 93003.
The American Journal of Forensic Medicine and Pathology
|December 1, 1993
Summary
Sudden deaths occurred in men restrained in prone positions, often hogtied, while in excited delirious states from psychosis or drug intoxication. These restraint-related deaths highlight critical risks during police apprehension and medical interventions.
Area of Science:
- Forensic Pathology
- Toxicology
- Law Enforcement Medicine
Background:
- Prone restraint is a method used by law enforcement.
- Excited delirium is a state of severe agitation and psychosis.
- Sudden death associated with restraint has been documented.
Observation:
- Eleven cases of sudden death in men restrained in prone positions were analyzed.
- Nine men were hogtied, one was secured to a gurney, and one was manually held prone.
- All subjects exhibited an excited delirious state, including psychosis or drug intoxication (cocaine, methamphetamine, LSD).
Findings:
- Two individuals received stun gun shocks shortly before death.
- The combination of prone restraint and excited delirium appears to be a significant factor in these fatalities.
- Review of literature suggests potential mechanisms including positional asphyxia and cardiac events.
Implications:
- This study underscores the potential dangers of prone restraint, particularly in individuals experiencing excited delirium.
- Recommendations for law enforcement and medical personnel regarding safer restraint techniques and de-escalation are warranted.
- Further research into the physiological mechanisms underlying restraint-related sudden death is crucial.