EXCITED DELIRIUM SYNDROME New study on ExDS shows police can train for this March 2012 Volume 24 Number 3 Cover & Lead Story Photos Courtesy of Odd Squad Productions - Toby Hinton Features 6 Stop the Madness Excited Delirium Syndrome does exist 12 Building social capital After 50 years of policing, Clif Chapman is still looking for what’s next 6 14 Manhattan, the day before 16 Everyone deserves to be identified 18 Simulation training 24 An opportunity to serve Ottawa police chief moves to Senate 28 Secret Compartments Beat vehicle “trappers” at their own game Departments 38 Advertisers Index 30 Deep Blue – Mentoring the middle is critical 12 32 Dispatches 36, 37 Market Place 35 Product News 5 Publisher’s Commentary – A wise wielder of the judicial sword 35 Representative Profiles 22 Technology 24 – Computer hard-drives stop spinning Case Law 31 All known information used to assess reasonable grounds 33 Handcuffing and confinement not an arrest BLUE LINE MAGAZINE 3 MARCH 2012 STOP THE MADNESS Excited Delirium Syndrome does exist by Joel A. Johnston effort to help the reader navigate these muddy the observable behaviours, whatever the waters so as to do your own fact-checking and underlying cause. In 2011, I was involved with an Internation- perhaps better discern between reality and the • It is not helpful to blame resulting deaths on al Special Panel Review of Excited Delirium “mud” of conspiracy theories and media bias. “Excited Delirium Syndrome,” since this Syndrome (ExDS) for the US-based National Braidwood found: conveniently avoids having to examine the Institute of Justice (NIJ). The panel included a Based on the presentations of psychiatrists, underlying medical condition or conditions diverse group of law enforcement personnel, other mental health professionals and emer- that actually caused death, let alone exam- medical practioners, and researchers participat- gency medicine physicians, I concluded that: ining whether use of the conducted energy ing as panel members to examine ExDS. What • Police officers are called upon, with increas- weapon and/or subsequent measures to physi- has become clear is that there are tangible steps ing regularity, to deal with emotionally cally restrain the subject contributed to those we can take and protocols we can implement as disturbed people who display extreme behav- causes of death. an emergency response community to reduce iours, including violence, imperviousness to • The unanimous view of mental health present- the risk of unintended outcomes when these rare pain, superhuman strength and endurance, ers was that the best practice is to de-escalate circumstances present themselves. hyperthermia, sweating and perceptual dis- the agitation, which can best be achieved Ever since the Braidwood Commission of turbances. through the application of recognized crisis Inquiry on Conducted Energy Weapon Use, • Such emotionally disturbed people are often at intervention techniques. Conversely, the worst many politicians, their ministries and law an impaired level of consciousness; may not possible response is to aggravate or escalate enforcement governing bodies have taken the know who they are or where they are; may be the crisis, such as by deploying a conducted official position that ‘Excited Delirium Syn- delusional, anxious, or frightened; and may be energy weapon and/or using force to physical- drome’ does not exist. As a result, it is not (and unable to process or comply with an officer’s ly restrain the subject. It is accepted that there in some cases cannot) be addressed in training commands. may be some extreme circumstances, however – nor is it captured in standardized use of force • This cluster of behaviours is not a medical rare, when crisis intervention techniques will response reporting. condition or a diagnosis. They are symp- not be effective in de-escalating the crisis, but Some of the Braidwood findings were toms of underlying medical conditions that, even then there are steps that officers can take constructive but others contradicted the body of in extreme cases, may constitute a medical to mitigate the risk of deployment. knowledge on this subject at that time and have emergency. Although Braidwood influenced a sig- been the catalyst for emotionally charged debate • The officer’s challenge is not to make a medi- nificant number of inquiries, it wasn’t the final across Canada and beyond. This article is an cal diagnosis but to decide how to deal with word on this critical medical issue – nor was MARCH 2012 6 BLUE LINE MAGAZINE as those in The Globe & Mail (Jan. 4 2012) medical condition or conditions that actually and the Calgary Herald (Jan. 6 2012), have caused death, let alone examining whether the capacity to do even more damage in plac- use of the conducted energy weapon and/or ing already at-risk subjects at even greater risk. subsequent measures to physically restrain the They do so by advocating a position of denial, subject contributed to those causes of death.” based on ignorance and/or motivated by po- Mr. Bowe was on cocaine and acting litical expedience. This position – that Excited wildly in a dark house. The Tasering and heavy- Delirium Syndrome is a term made up by law handed restraint by Calgary police may or enforcement to “distract from the true cause may not have been justified – though the judge of death and to justify police use of force,” is should have questioned “kicks to the side of neither credible nor defensible. Unfortunately, Mr. Bowe’s body.” it continues to be perpetuated by those with a Any policy built around “excited delirium” variety of other agendas. would be an irrational response to such a death. The situation would be laughable if there Judges and policy-makers should read Mr. wasn’t so much at stake. Why, in the interest of Braidwood’s reports. enabling a safer and more effective approach to dealing with these difficult situations, is it so Editorial: Delirious fatality report difficult to consider the notion that this may, in (Copyright Calgary Herald) fact, be a “dynamic” in certain law enforcement The fatality report into the death of Gordon encounters with the public? Instead the Globe Bowe adds ammunition to the argument that and Herald criticize Alberta Provincial Court public inquiries too often become a waste of Judge Heather Lamoureux for recommending time and money. that emergency responders be trained to more Provincial Court Judge Heather Lam- capably recognize and readily implement a col- oureux’s recommendations are curious, in that laborative response in an effort to promote the they are almost entirely built around the theory best possible outcome: saving lives. that excited delirium is a legitimate medical condition, an assertion that’s controversial Editorial: Delirious over delirium and widely disputed. She concluded Bowe, 40, (Copyright The Globe & Mail) died as a result of excited delirium syndrome, Canada does not need a national delirium which she says was brought on by cocaine use over “excited delirium.” This supposed cause and not from the deployment of a Taser gun, of many deaths in police custody, including used by Calgary police trying to subdue him. those involving the use of Tasers, was laid to Her nine recommendations in the seven- rest after the exhaustive Braidwood inquiry fol- page report almost all deal with developing lowing the 2007 death of the Polish immigrant protocols around excited delirium, treating Robert Dziekanski. it as a legitimate condition without reference it intended to be. In fact, the commissioner Why then has an Alberta judge ruled to the controversy or debate in the medical affirmed that further research was required to that Gordon Bowe, tasered and restrained by community. She calls for mandatory training shed light on many unclear issues – including several officers, died from “excited delirium of emergency response workers, police and Excited Delirium Syndrome. Nonetheless, the syndrome”? Why is Judge Heather Lamoureux dispatchers in identifying excited delirium and inquiry report has profoundly affected public of Alberta Provincial Court proposing every- wants a national database established, where policy and public opinion. While it is clearly a thing from the training of police dispatchers in police chiefs across Canada would “record and misunderstood issue, dismissing its existence diagnosing “excited delirium” to the creation share information relating to death associated is not only problematic but both dangerous and of a countrywide “excited delirium” database? with excited delirium.” negligent. It is particularly troublesome because “Excited delirium” (overheating and wild There’s another school of thought that of the immense influence that the media appears behaviour) is a blind alley, not a recognized warns the controversial diagnosis of excited to have had on public perception. medical condition. It is a convenient way to delirium is a distraction from the true cause of Folks who rely on the news media for avoid tough scrutiny of police practices that the medical condition that caused the death and information seem to robotically align with the may contribute to death. is used to justify use of force by police. misinformed or inclined media position on the Mr. Braidwood, a retired appeal court The exhaustive Braidwood inquiry into subject. The failure of the public, politicians judge, spent two years and oversaw two inquir- the Taser death of Polish immigrant Robert and law enforcement governance bodies to ies, one on the overall safety concerns around Dziekanski heard overwhelming evidence recognize Excited Delirium Syndrome as a real the Taser and one on Mr. Dziekanski’s brutal that, while delirium is real, excited delirium syndrome puts people at risk every day – and death after being Tasered five times by the is “NOT a valid medical or psychiatric diag- relegates these situations to criminal or public RCMP at the Vancouver International Airport. nosis.” Moreover, it “provides a convenient safety issues to be dealt with by police, rather He spoke to experts in emergency medicine, post-mortem explanation for in-custody deaths than as the medical crises which they are.