Excited Delirium Cause Of Death
Arrestee’s death natural but possibly preventable, coroner says
A man who died in Shreveport police custody in early April died of natural causes, but his death could possibly have been prevented, the Caddo Parish Coroner’s Office has determined.
Coroner Dr. Todd Thoma determined that Tommie Dale McGlothen Jr., 44, died early April 6 from excited delirium. According to the American Medical Association, this is the sudden death of individuals “who are combative and in a highly agitated state” and who have exhibited “agitation, excitability, paranoia, aggression and apparent immunity to pain, often associated with stimulant use and certain psychiatric disorders.”
Dr. Thoma’s decision was based on autopsy and toxicology results, McGlothen’s medical history and review of police and witness statements and videos.
“Although Mr. McGlothen’s death has been ruled from natural causes, excited delirium, it is my opinion that this is still a potentially preventable death,” Dr. Thoma said. “When confronted with Mr. McGlothen, it should have been obvious that he needed medical care. He was left in the back of the patrol vehicle for 48 minutes before he was found unresponsive and not breathing. He was predominantly unsupervised during this entire period. After a violent confrontation with psychotic behavior and being tased several times, a more thorough evaluation by either the fire department or preferably an emergency department would have been indicated. It is my opinion that if Mr. McGlothen had survived, he would have been transported to a medical facility for treatment rather than jail. Why there was a delay in achieving this is at issue.”
Police officers used Tasers, mace and nightsticks to control McGlothen, who was agitated and combative and had fought with a homeowner in the 3700 block of Eileen Lane late April 5. Police arrived after McGlothen blocked a driveway, followed the homeowner inside his house, mumbling incoherently and exhibiting signs of paranoia and emotional disturbance before the altercation with the homeowner, according to police.
After his arrest, McGlothen was placed in the back of a police cruiser and later was observed to be non-responsive. Police attempted CPR, but attempts at the scene and at the hospital to revive McGlothen were not successful. He was pronounced dead just after 2:30 a.m. at Willis-Knighton Medical Center on Greenwood Road.
“Although 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,” Dr. Thoma said. “Mr. McGlothen had underlying heart disease and clearly was suffering from excited delirium. The combination of these factors caused his death.”
Excited delirium is an emergent medical condition that is usually survivable with appropriate medical care, Dr. Thoma said. “Early treatment increases chances of survival.”
According to the AMA, triggering factors for Excited Delirium Syndrome, or ExDS, “include sudden and intense activation of the sympathetic nervous system, with hyperthermia, and/or acidosis, which could trigger life-threatening arrhythmias in susceptible individuals.”
ExDS was only officially recognized as a medical condition by the American College of Emergency Physicians in 2009. However, descriptions of similar cases date back 150 years, and the AMA has traced the syndrome back to what once was termed “Bell’s Mania.”
More information on Excited Delirium Syndrome is available at the website https://www.lexipol.com/resources/blog/understandingexcited-delirium-4-takeaways-for-lawenforcement-officers/
John Andrew Prime is the public information officer for the Caddo Parish Coroner’s Office.