A Radio 4 documentary has highlighted the need for further research into the condition ‘Excited Delirium’ following concerns that it is increasingly been identified as a cause of death in cases of death in police custody.  The file on 4 documentary examines the controversy surrounding the use of the disorder as a cause of death in Coroners Courts.

Despite the condition not being recognised as an official disorder by the World Health Organisation (WHO), Excited Delirium is becoming more widely used and recognised in certain parts of the US, and more recently in the UK; where the disorder has been cited in 17 cases in Coroner’s Courts.

One of the cases that is highlighted in the documentary is the death of Nadeem (Dean) Khan. Nadeem Khan died in 2007 after being restrained and arrested by police, and further restrained whilst in police custody. The initial post mortem report identified that Dean had died from Excited Delirium as a consequence of taking cocaine, ruling out restraint as being a contributory factor to his death, despite there being an excessive amount of  bruises, cuts and wounds on Dean’s body.

During Mr Khan’s inquest, a further expert was instructed to prepare an opinion on Dean’s death and the circumstances that surrounded it.  His opinion was that the use of restraint in this case could not be ignored and had to be a contributory factor to his death. The verdict in the inquest concluded that Mr Khan’s death was the result of the combination of excited delirium and the ‘necessary’ restraint that was used.

As the inquest solicitor who represented Mr Khan’s family during inquest proceedings, I was asked to participate in the documentary.

Mr Khan’s death was the first case in which we had come across Excited Delirium. Clearly, if it is a condition that people are starting to recognise, the Police Forces in England and Wales need to be adequately trained to recognise the symptoms people display whilst in this state in order for it to be treated as a medical emergency.

Dr Richard Shepherd, a leading pathologist and a member of the independent advisory panel on deaths in custody, commented in the documentary that he did not feel there was enough research into excited delirium as a specific condition, and as such, the term should be used with ‘great care’ and never to explain a death as a standalone factor.

As identified in the narrative verdict in the inquest of Dean Khan, the Police officers involved failed to identify the symptoms of Excited Delirium, and as such, medical attention was not sought. Whether or not the condition is recognised by the WHO, there does seem to be call for more research into Excited Delirium, and furthermore, the need for police forces to train their officers in the recognition of the disorder so that necessary medical intervention can be made, and fewer deaths caused.

Listen to the documentary here.