Excited Delirium and Police Use of Force

*Haas Distinguished Chair and Professor of Law, University of California, Berkeley School of Law (joint appointment with the Joint Medical Program and School of Public Health). B.A., Yale University; J.D., Columbia Law School; Ph.D., University of California, Berkeley. Many thanks to Amelia Dmowska, Hayley MacMillen, and Anna Zaret for their excellent research assistance.Show More

­­­­

Excited delirium is often described as a psychiatric illness characterized by a sudden onset of extreme agitation, confusion, and aggression that can make people irrationally combative and dangerous. Since its inception in the 1980s, this medical condition has been used to justify deadly uses of force by police officers who detain individuals whose seemingly bizarre and uncontrollable behavior is believed to be a threat. Excited delirium is also commonly used by medical examiners and law enforcement to explain why the extreme toll taken on the bodies of people who experience these psychiatric episodes might lead to spontaneous death when they are in police custody. While this diagnosis is increasingly relied upon to explain police use of force and in-custody deaths, a curious matter remains unresolved: excited delirium, as an actual medical condition, does not seem to exist. It is not recognized as a valid medical diagnosis in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (“DSM-5”) nor in the World Health Organization’s International Classification of Diseases (“ICD-10”), which are the most authoritative classifications of mental health conditions. Moreover, excited delirium has an ignoble history linked to racism and fraudulent forensic science. Nevertheless, excited delirium continues to play a prominent role in policing, prosecutions, and § 1983 constitutional tort claims adjudicated by federal courts when victims of police violence seek damages for violations of their constitutional rights.

This Article provides the first comprehensive assessment of excited delirium in law and legal scholarship. Drawing upon an original dataset that collects information on in-custody deaths over the past decade tied to excited delirium, this Article documents the extent to which this condition has been articulated by legal and medical actors as a cause of death in situations where police have used force. The data show, among other findings, that at least 56% of deaths that occur in police custody that are attributed to excited delirium involve Black and Latinx victims. By putting these findings in conversation with an examination of the scientific literature and § 1983 police excessive force cases that discuss excited delirium, this Article draws attention to how excited delirium has become a misplaced medical diagnosis that obscures and therefore excuses questionable uses of police force that produce harm and death—especially in communities of color. By relying on pseudoscience with little evidence, medical examiners and coroners have given life to a false medical condition that is often used to shield police officers from accountability when they use unacceptably harsh and unlawful force. Excited delirium shifts the blame for these deaths to what is often wrongly presumed to be an individual’s tragic medical condition, which obfuscates the structural conditions that predictably lead to unlawful uses of police force that are the more proximate cause of harm. By offering this examination of excited delirium, its role in policing, and how it impacts the adjudication of excessive force claims, this Article suggests that policymakers and legal actors should be more attentive to how science and medicine can be used inappropriately to impede police accountability and justice for victims of police violence.

Introduction

Tommie McGlothen Jr. left his sister’s house in the Lakeside area of Shreveport, Louisiana, while experiencing a mental health crisis in April 2020.¹ 1.Gerry May, Attorney Disputes Coroner’s Finding in Death of Tommie McGlothen, Jr. After Police Confrontation, KTBS (June 10, 2020), https://www.ktbs.com/news/‌3investigates/attorney-disputes-coroners-finding-in-death-of-tommie-mcglothen-jr-after-police-confrontation/article_f100f4a6-ab7b-11ea-9d9b-1b7fb00daba3.html [https://perma.cc/8SEX-6Y42].Show More As he walked down the street, his erratic behavior gave a passerby the impression that McGlothen was attempting to break into a car. The police were summoned. When officers approached McGlothen, a dispute erupted and McGlothen was handcuffed. Witnesses noted that although McGlothen was not resisting at this point, the officers struck him several times and slammed him into a patrol car.² 2.Gerry May, Shreveport Man Dies in Police Custody; Family Fears “Cover-Up,” KTBS (May 31, 2020), https://www.ktbs.com/news/shreveport-man-dies-in-police-custody-family-fears-cover-up/article_ef947450-a20a-11ea-ac9e-87e6f58f8b87.html [https://perma.cc/6ADP-6EFT].Show More The officers then put McGlothen into the back of the car and left him there alone for nearly an hour. When they returned to check on him, McGlothen was unresponsive.³ 3.Gerald Herbert & Rebecca Santana, ‘Denied the Truth’ Says Son of Black Man Who Died in Custody, ABC News (June 12, 2020, 5:19 PM), https://abcnews.go.com/US/wireStory/‌denied-truth-son-black-man-died-custody-71222156 [https://perma.cc/G9ES-NMPP].Show More Paramedics arrived at the scene, and witnesses said that the “ambulance drove off slowly with no lights or siren,”⁴ 4.KSLA Investigates Reveals Video of Tommie McGlothen’s Last Encounter with Police, KSLA (June 8, 2020, 4:58 PM), https://www.ksla.com/2020/06/08/ksla-investigates-reveals-video-tommie-mcglothens-last-encounter-with-police/ [https://perma.cc/J2WM-NPJZ].Show More suggesting to some onlookers that he was already dead.

The local coroner, Dr. Todd Thoma, released a report on the cause of McGlothen’s death two months later. Curiously, he concluded that it was “natural”—the result of a psychiatric condition known as excited delirium. As Thoma explained:

These people get into a situation where they become confused, disoriented, violent, aggressive. They can’t listen to reason. There is no reason. This is a medical problem. This is not somebody’s behavioral problem . . . . When police try to restrain [people suffering from excited delirium] to try to take them into custody, it takes a lot of force sometimes to do that. . . . [They are also] impervious to pain.⁵ 5.May, supra note 1.Show More

Thoma recites what has become an increasingly familiar narrative embraced by coroners, law enforcement, and other legal and medical actors when people seem to suddenly and inexplicably die after being involved with the police. The death is seen as an unfortunate, yet natural, byproduct of a psychiatric condition that causes people to get so overworked and agitated that they spontaneously die, through no fault of anyone or anything except for their own defective bodies.

But what is curious about the coroner’s initial determination of McGlothen’s death is that all available evidence suggests that he died from injuries other than some mysterious psychiatric disorder. Video evidence shows four police officers pummeling a handcuffed McGlothen for several minutes with repeated punches and kicks. They hit him with night sticks, tased him, and used mace.⁶ 6.Herbert & Santana, supra note 3; May, supra note 2.Show More The coroner concluded that “[a]lthough [an] autopsy showed that Mr. McGlothen suffered multiple blunt force injuries from both his confrontation with police and the citizens earlier in the day and that evening, no injuries were life-threatening or could be considered serious.”⁷ 7.Caddo Coroner: McGlothen’s Death Natural, Possibly Preventable, KSLA (June 9, 2020, 9:41 AM), https://www.ksla.com/2020/06/09/caddo-coroner-mcglothens-death-natural-possibly-preventable/ [https://perma.cc/QU2Q-25ZP]. In September 2020, four officers were charged with negligent homicide and malfeasance after Thoma “determined that Mr. McGlothen’s death ‘was preventable’ because the officers should have known he needed medical treatment.” Michael Levenson, Four Louisiana Officers Charged in Death of Black Man with Mental Illness, N.Y. Times, (Sept. 18, 2020), https://www.nytimes.com/2020/‌09/18/us/shreveport-police-officers-charged-death.html [https://perma.cc/X9D2-3FQ3].Show More However, when McGlothen’s family saw his corpse, they were shocked by its condition. His sister, Macronia McGlothen, said: “When we got to the funeral it looked like he had been beaten. His nose was broken. His jaw was broken. And his eye was swollen. It looked like he had a fractured skull. . . . So something’s not adding up.”⁸ 8.May, supra note 2.Show More

* * *

Science and medicine have longstanding relationships with law and, in particular, law enforcement. Forensic scientists have worked with police investigators for many years to help understand crime scene evidence, and medical examiners have lent their knowledge of human anatomy and pathology to help investigators understand how mysterious deaths might have occurred. This intimate relationship between medical knowledge and legal procedures has been well documented.⁹ 9.See, e.g., Radley Balko & Tucker Carrington, The Cadaver King and the Country Dentist, at xiv, xxii (2018) (noting that a single medical examiner testified in approximately 80% of Mississippi’s homicide cases over almost twenty years); Nigel McCrery, Silent Witnesses: The Often Gruesome but Always Fascinating History of Forensic Science, at xxiii (2014) (describing the impact of DNA testing on criminal adjudication around the world); Douglas Starr, The Killer of Little Shepherds: A True Crime Story and the Birth of Forensic Science 11–12 (2010) (explaining the origin of modern forensic science at the turn of the twentieth century).Show More However, less attention has been paid to how medical professionals might use their knowledge of science and medicine to participate in—and, at times, even conceal—unlawful uses of force by law enforcement that lead to community members’ harm and death. For example, in a recent article in the California Law Review, my co-author and I examined how paramedics have partnered with police to administer harsh drugs that have a sedative effect, also known as chemical restraints, on people who have been detained or arrested—many of whom are thought to be experiencing excited delirium.¹⁰ 10.Osagie K. Obasogie & Anna Zaret, Medical Professionals, Excessive Force, and the Fourth Amendment, 109 Calif. L. Rev. 1 (2021).Show More These drugs are often used not for the health and well-being of the person under arrest, but to assist law enforcement by easing their efforts at managing what are often thought to be unmanageable bodies. Chemical restraints, such as ketamine, have been increasingly employed by police and EMS responders in recent years and have led to unnecessary hospitalizations and deaths of detained people.¹¹ 11.Patty Nieberg, Elijah McClain Case Leads to Scrutiny of Ketamine’s Use During Arrests, Denv. Post (Aug. 22, 2020, 2:31 PM), https://www.denverpost.com/2020/08/22/elijah-mcclain-ketamine-police-arrests/ [https://perma.cc/34SE-PB9R]; see also Gregory Yee, Mount Pleasant Man’s Ketamine-Related Death in Police Custody Under Investigation, Post & Courier (Feb. 28, 2020), https://www.postandcourier.com/news/mount-pleasant-mans-ketamine-related-death-in-police-custody-under-investigation/article_8b07f4de-59ae-11ea-adad-2f0e6f56d779.html [https://perma.cc/3M86-SJSP]; John Croman, Man Files Lawsuit Over Ketamine Injection, KARE (July 14, 2018, 1:35 PM), https://www.kare11.com/article/news/man-files-lawsuit-over-ketamine-injection/89-573408858 [https://perma.cc/G3D4-86QS].Show More

The questionable relationship between medical professionals and law enforcement is not limited to chemical restraints. Medical examiners and coroners play a critical role in the legal system in providing the official cause of death when someone dies in police custody. Forensic pathologists are often relied upon by police and investigators to explain how an unusual or unexpected death might have occurred. Excited delirium, as a psychiatric disorder that is thought to place significant physical stress on people, appears to offer medical insight into what seems like an epidemic of people suffering from drug dependency or mental health crises dying without explanation.

There are at least three aspects of excited delirium that are unusual and worthy of exploration. First, excited delirium appears to be more common among Black people. Although studies on excited delirium are scant, data suggest that Black people are diagnosed as suffering from it at much higher rates than White people.¹² 12.See infra Subsection III.C.2.Show More Second, the disease strangely seems to happen when police are around. For example, a recent review in Florida Today showed that nearly two-thirds of the deaths in Florida officially listed as being caused by excited delirium over the past decade occurred while the decedent was in police custody or had some other interaction with law enforcement.¹³ 13.Alessandro Marazzi Sassoon, Excited Delirium: Rare and Deadly Syndrome or a Condition to Excuse Deaths by Police?, Fla. Today (Jan. 30, 2020, 2:52 PM), https://www.floridatoday.com/in-depth/news/2019/10/24/excited-delirium-custody-deaths-gregory-edwards-melbourne-taser/2374304001/ [https://perma.cc/4M2A-5GE3].Show More Yet, this may be an undercount as other deaths that implicate police officers in Florida and across the country might be presumed to involve excited delirium without official designation or further investigation.¹⁴ 14.One example where this occurred is the police killing of George Floyd. One officer at the scene, Thomas Lane, described his concern that Floyd might have experienced excited delirium while being restrained (and ultimately strangled to death) by Officer Derek Chauvin. See Steve Eckert & Jeremy Jojola, KARE 11 Investigates: Did Officers Fear George Floyd Had ‘Excited Delirium’?, KARE 11 (Apr. 13, 2021), https://www.kare11.com/article/‌news/investigations/kare-11-investigates-did-officers-fear-george-floyd-had-excited-delirium/89-f7cc01f2-427c-48ab-a4fe-3f414c3c2236. Given the troubling and inaccurate manner that Minneapolis police initially reported the confrontation between police and George Floyd—the headline of the police press release read “Man Dies After Medical Incident During Police Interaction”—excited delirium could have easily become part of the way that Floyd’s death was described, but for video of the incident and public outcry. See Eric Levenson, How Minneapolis Police First Described the Murder of George Floyd, and What We Know Now, CNN (Apr. 21, 2021), https://www.cnn.com/2021/04/21/us/minneapolis-police-george-floyd-death/index.html [https://perma.cc/6TQN-ZTGA]. Indeed, even after the video of Floyd’s murder and social unrest, excited delirium still emerged as a possible explanation of his death during Derek Chauvin’s trial. See Steve Karnowski, Explainer: Why ‘Excited Delirium’ Came Up at Chauvin Trial?, AP News (Apr. 19, 2021), https://apnews.com/article/health-death-of-george-floyd-trials-george-floyd-3b60b3930023a2668e7fc63f903fc3aa.Show More And lastly, and perhaps most strangely, excited delirium is not a psychiatric disorder that is recognized by most medical professionals. Professional organizations such as the American Psychiatric Association¹⁵ 15.Press Release, Am. Psychiatric Ass’n, Position Statement on Concerns About Use of the Term ‘Excited Delirium’ and Appropriate Medical Management in Out-of-Hospital Contexts (Dec. 2020), https://www.psychiatry.org/File%20Library/About-APA/Organization‌-Documents-Policies/Policies/Position-Use-of-Term-Excited-Delirium.pdf [https://perma.cc/2HVX-2X3N].Show More and the American Medical Association¹⁶ 16.Press Release, Am. Med. Ass’n, New AMA Policy Opposes ‘Excited Delirium’ Diagnosis (June 14, 2021), https://www.ama-assn.org/press-center/press-releases/new-ama-policy-opposes-excited-delirium-diagnosis [https://perma.cc/T9DP-6XPT].Show More have been extremely critical of the term and oppose its use. Medical guidebooks used to identify psychiatric conditions, such as the Diagnostic and Statistical Manual of Mental Disorders (“DSM-5”) and the International Classification of Diseases (“ICD-10”), do not acknowledge it as a valid psychiatric disorder. Moreover, the peer-reviewed literature on excited delirium is rather thin; there is no clear articulation of causal mechanisms or pathways to support the notion that excited delirium has a distinct pathology that leads to death.

Nevertheless, excited delirium as a psychiatric diagnosis allows law enforcement to pathologize people’s behavior, justify the use of chemical or physical restraints (and even deadly force), or explain how someone might unexpectedly die while in custody. As one example, a recent investigation uncovered that paramedics in Colorado used a chemical restraint called ketamine to sedate 902 people who were thought to be experiencing excited delirium in pre-hospital (i.e., public) settings over a two-and-a-half year period.¹⁷ 17.Michael de Yoanna & Rae Solomon, Medics in Colorado Dosed 902 People with Ketamine for ‘Excited Delirium’ in 2.5 Years, KUNC (July 21, 2020, 5:35 PM), https://www.kunc.org/news/2020-07-21/medics-in-colorado-dosed-902-people-with-ketamine-for-excited-delirium-in-2-5-years [https://perma.cc/5RUA-ZEJA].Show More This includes the death of Elijah McClain, a twenty-three-year-old Black man who was approached by police while walking down a street after a 911 caller said he “looked sketchy.”¹⁸ 18.Lucy Tompkins, Here’s What You Need to Know About Elijah McClain’s Death, N.Y. Times (last updated Oct. 19, 2021), https://www.nytimes.com/article/who-was-elijah-mcclain.html [https://perma.cc/6CTY-S438].Show More Multiple officers tackled him and placed him in a chokehold. Paramedics injected him with ketamine when they arrived at the scene after the officers reported that McClain had “incredible, crazy strength” and was “definitely on something,”¹⁹ 19.Id.Show More which were “signs they took not as a struggle to survive, but as symptoms of excited delirium.”²⁰ 20.John Dickerson, Excited Delirium: The Controversial Syndrome That Can Be Used to Protect Police from Misconduct Charges, 60 Minutes (Dec. 13, 2020), https://www.cbsnews.com/news/excited-delirium-police-custody-george-floyd-60-minutes-2020-12-13/ [https://perma.cc/98HM-799S].Show More The amount of ketamine injected into McClain was grossly inappropriate for his size,²¹ 21.Brian Maass, Ketamine Dose for Elijah McClain ‘Too Much,’ Says Anesthesiologist, CBS4 Denv. (July 7, 2020, 11:59 PM), https://denver.cbslocal.com/2020/07/07/elijah-mcclain-ketamine-aurora-police-anesthesiologist/ [https://perma.cc/5DR6-TNML] (“Multiple anesthesiologists are questioning the amount of Ketamine, a widely employed sedative, used on Elijah McClain just before he stopped breathing last August, with one doctor saying it was, ‘Too much, twice too much.’”).Show More and McClain went into cardiac arrest in the ambulance on the way to the hospital. He died several days later.

The numbers from Colorado regarding the widespread use of ketamine in response to perceived episodes of excited delirium, along with evidence from other states, demonstrate that this unfounded medical diagnosis is having an increasing influence on: (1) how law enforcement assess and respond to people that they engage and their decision to use force; (2) how medical examiners and coroners classify the cause of death when police interactions have deadly endings; and (3) how courts review the appropriateness of police use of force when these matters are litigated as possible instances of excessive force that might violate the Fourth Amendment. This Article examines how excited delirium is being used in law, places these developments in a social and historical context, and provides an evidence-based set of recommendations on how law and policy should move forward.

This examination of excited delirium is closely connected to doctrinal issues regarding police use of force. Part II reviews the social context and community impact of police violence while also being attentive to the doctrinal evolutions that constitute modern use of force jurisprudence to show how law makes it difficult to hold police accountable when excessive force is used. Understanding the role of law in undermining accountability provides an important context for appreciating how excited delirium, as an ostensible medical diagnosis, became enmeshed in the legal system as an additional way to exculpate police officers of wrongdoing. Part III offers a close examination of the history of excited delirium and reviews the scientific evidence used to support it as a diagnosis. This Part ends with a discussion of an original empirical dataset that I collected on how excited delirium has been used to describe the cause of deaths that occur in police custody as reported in local newspapers over the past decade. Part IV continues this assessment by examining how excited delirium has been discussed in federal courts, mostly in constitutional tort cases pursuant to 42 U.S.C. § 1983. An examination of these cases demonstrates that federal courts often give weight and meaning to excited delirium that is not supported by the existing scientific evidence. Part V provides a series of recommendations on how federal courts, local police departments, and medical professionals (including coroners and medical examiners) should approach excited delirium. I then briefly conclude in Part VI.

1. * Haas Distinguished Chair and Professor of Law, University of California, Berkeley School of Law (joint appointment with the Joint Medical Program and School of Public Health). B.A., Yale University; J.D., Columbia Law School; Ph.D., University of California, Berkeley. Many thanks to Amelia Dmowska, Hayley MacMillen, and Anna Zaret for their excellent research assistance. ↑

2. Gerry May, Attorney Disputes Coroner’s Finding in Death of Tommie McGlothen, Jr. After Police Confrontation, KTBS (June 10, 2020), https://www.ktbs.com/news/‌3investigates/attorney-disputes-coroners-finding-in-death-of-tommie-mcglothen-jr-after-police-confrontation/article_f100f4a6-ab7b-11ea-9d9b-1b7fb00daba3.html [https://perma.cc/8SEX-6Y42]. ↑

3. Gerry May, Shreveport Man Dies in Police Custody; Family Fears “Cover-Up,” KTBS (May 31, 2020), https://www.ktbs.com/news/shreveport-man-dies-in-police-custody-family-fears-cover-up/article_ef947450-a20a-11ea-ac9e-87e6f58f8b87.html [https://perma.cc/6ADP-6EFT]. ↑

4. Gerald Herbert & Rebecca Santana, ‘Denied the Truth’ Says Son of Black Man Who Died in Custody, ABC News (June 12, 2020, 5:19 PM), https://abcnews.go.com/US/wireStory/‌denied-truth-son-black-man-died-custody-71222156 [https://perma.cc/G9ES-NMPP]. ↑

5. KSLA Investigates Reveals Video of Tommie McGlothen’s Last Encounter with Police, KSLA (June 8, 2020, 4:58 PM), https://www.ksla.com/2020/06/08/ksla-investigates-reveals-video-tommie-mcglothens-last-encounter-with-police/ [https://perma.cc/J2WM-NPJZ]. ↑

6. May, supra note 1. ↑

7. Herbert & Santana, supra note 3; May, supra note 2. ↑

8. Caddo Coroner: McGlothen’s Death Natural, Possibly Preventable, KSLA (June 9, 2020, 9:41 AM), https://www.ksla.com/2020/06/09/caddo-coroner-mcglothens-death-natural-possibly-preventable/ [https://perma.cc/QU2Q-25ZP]. In September 2020, four officers were charged with negligent homicide and malfeasance after Thoma “determined that Mr. McGlothen’s death ‘was preventable’ because the officers should have known he needed medical treatment.” Michael Levenson, Four Louisiana Officers Charged in Death of Black Man with Mental Illness, N.Y. Times, (Sept. 18, 2020), https://www.nytimes.com/2020/‌09/18/us/shreveport-police-officers-charged-death.html [https://perma.cc/X9D2-3FQ3]. ↑

9. May, supra note 2. ↑

10. See, e.g., Radley Balko & Tucker Carrington, The Cadaver King and the Country Dentist, at xiv, xxii (2018) (noting that a single medical examiner testified in approximately 80% of Mississippi’s homicide cases over almost twenty years); Nigel McCrery, Silent Witnesses: The Often Gruesome but Always Fascinating History of Forensic Science, at xxiii (2014) (describing the impact of DNA testing on criminal adjudication around the world); Douglas Starr, The Killer of Little Shepherds: A True Crime Story and the Birth of Forensic Science 11–12 (2010) (explaining the origin of modern forensic science at the turn of the twentieth century). ↑

11. Osagie K. Obasogie & Anna Zaret, Medical Professionals, Excessive Force, and the Fourth Amendment, 109 Calif. L. Rev. 1 (2021). ↑

12. Patty Nieberg, Elijah McClain Case Leads to Scrutiny of Ketamine’s Use During Arrests, Denv. Post (Aug. 22, 2020, 2:31 PM), https://www.denverpost.com/2020/08/22/elijah-mcclain-ketamine-police-arrests/ [https://perma.cc/34SE-PB9R]; see also Gregory Yee, Mount Pleasant Man’s Ketamine-Related Death in Police Custody Under Investigation, Post & Courier (Feb. 28, 2020), https://www.postandcourier.com/news/mount-pleasant-mans-ketamine-related-death-in-police-custody-under-investigation/article_8b07f4de-59ae-11ea-adad-2f0e6f56d779.html [https://perma.cc/3M86-SJSP]; John Croman, Man Files Lawsuit Over Ketamine Injection, KARE (July 14, 2018, 1:35 PM), https://www.kare11.com/article/news/man-files-lawsuit-over-ketamine-injection/89-573408858 [https://perma.cc/G3D4-86QS]. ↑

13. See infra Subsection III.C.2. ↑

14. Alessandro Marazzi Sassoon, Excited Delirium: Rare and Deadly Syndrome or a Condition to Excuse Deaths by Police?, Fla. Today (Jan. 30, 2020, 2:52 PM), https://www.floridatoday.com/in-depth/news/2019/10/24/excited-delirium-custody-deaths-gregory-edwards-melbourne-taser/2374304001/ [https://perma.cc/4M2A-5GE3]. ↑

15. One example where this occurred is the police killing of George Floyd. One officer at the scene, Thomas Lane, described his concern that Floyd might have experienced excited delirium while being restrained (and ultimately strangled to death) by Officer Derek Chauvin. See Steve Eckert & Jeremy Jojola, KARE 11 Investigates: Did Officers Fear George Floyd Had ‘Excited Delirium’?, KARE 11 (Apr. 13, 2021), https://www.kare11.com/article/‌news/investigations/kare-11-investigates-did-officers-fear-george-floyd-had-excited-delirium/89-f7cc01f2-427c-48ab-a4fe-3f414c3c2236. Given the troubling and inaccurate manner that Minneapolis police initially reported the confrontation between police and George Floyd—the headline of the police press release read “Man Dies After Medical Incident During Police Interaction”—excited delirium could have easily become part of the way that Floyd’s death was described, but for video of the incident and public outcry. See Eric Levenson, How Minneapolis Police First Described the Murder of George Floyd, and What We Know Now, CNN (Apr. 21, 2021), https://www.cnn.com/2021/04/21/us/minneapolis-police-george-floyd-death/index.html [https://perma.cc/6TQN-ZTGA]. Indeed, even after the video of Floyd’s murder and social unrest, excited delirium still emerged as a possible explanation of his death during Derek Chauvin’s trial. See Steve Karnowski, Explainer: Why ‘Excited Delirium’ Came Up at Chauvin Trial?, AP News (Apr. 19, 2021), https://apnews.com/article/health-death-of-george-floyd-trials-george-floyd-3b60b3930023a2668e7fc63f903fc3aa. ↑

16. Press Release, Am. Psychiatric Ass’n, Position Statement on Concerns About Use of the Term ‘Excited Delirium’ and Appropriate Medical Management in Out-of-Hospital Contexts (Dec. 2020), https://www.psychiatry.org/File%20Library/About-APA/Organization‌-Documents-Policies/Policies/Position-Use-of-Term-Excited-Delirium.pdf [https://perma.cc/2HVX-2X3N]. ↑

17. Press Release, Am. Med. Ass’n, New AMA Policy Opposes ‘Excited Delirium’ Diagnosis (June 14, 2021), https://www.ama-assn.org/press-center/press-releases/new-ama-policy-opposes-excited-delirium-diagnosis [https://perma.cc/T9DP-6XPT]. ↑

18. Michael de Yoanna & Rae Solomon, Medics in Colorado Dosed 902 People with Ketamine for ‘Excited Delirium’ in 2.5 Years, KUNC (July 21, 2020, 5:35 PM), https://www.kunc.org/news/2020-07-21/medics-in-colorado-dosed-902-people-with-ketamine-for-excited-delirium-in-2-5-years [https://perma.cc/5RUA-ZEJA]. ↑

19. Lucy Tompkins, Here’s What You Need to Know About Elijah McClain’s Death, N.Y. Times (last updated Oct. 19, 2021), https://www.nytimes.com/article/who-was-elijah-mcclain.html [https://perma.cc/6CTY-S438]. ↑

20. Id. ↑

21. John Dickerson, Excited Delirium: The Controversial Syndrome That Can Be Used to Protect Police from Misconduct Charges, 60 Minutes (Dec. 13, 2020), https://www.cbsnews.com/news/excited-delirium-police-custody-george-floyd-60-minutes-2020-12-13/ [https://perma.cc/98HM-799S]. ↑

22. Brian Maass, Ketamine Dose for Elijah McClain ‘Too Much,’ Says Anesthesiologist, CBS4 Denv. (July 7, 2020, 11:59 PM), https://denver.cbslocal.com/2020/07/07/elijah-mcclain-ketamine-aurora-police-anesthesiologist/ [https://perma.cc/5DR6-TNML] (“Multiple anesthesiologists are questioning the amount of Ketamine, a widely employed sedative, used on Elijah McClain just before he stopped breathing last August, with one doctor saying it was, ‘Too much, twice too much.’”). ↑