California Bans Doctors From Using ‘Excited Delirium’ as Cause of Death

A man is arrested by a Los Angeles police officer in Venice Beach, Calif., on June 2, 2020. John Fredricks/The Epoch Times

Doctors and government officials can no longer use the term “excited delirium” as a valid medical diagnosis or cause of death for those who die while in police custody in California.

California Gov. Gavin Newsom on Oct. 8 signed Assembly Bill 360, authored by Assemblyman Mike Gipson, a Democrat, making California the first state to ban the use of the term. The law will take effect Jan. 1.

“Excited delirium is not a reliable, independent medical or psychiatric diagnosis,” Mr. Gipson said in a statement after the legislation passed the Assembly in April. “From the beginning, this terminology has been disproportionately applied to communities of color and has only been used in specific contexts pertaining to encounters with law enforcement.”

Excited delirium syndrome includes bizarre and aggressive behavior, shouting, paranoia, panic, violence toward others, unusual physical strength, and hyperthermia, according to the National Library of Medicine.

Mr. Gipson said he wrote the measure after the death of U.S. Navy veteran Angelo Quinto, 30, who died after being restrained by Antioch, California, police in December 2020.

Mr. Quinto died three days after police restrained him with a knee on the back of his neck, according to reports. The coroner’s office testified that the death was caused by “excited delirium syndrome due to acute drug toxicity with disturbances,” according to his attorney.

Beyond banning the term from official use, the bill will prohibit state and local government agencies, employees, and contractors from testifying in court or documenting that “excited delirium” is a recognized medical diagnosis or cause of death.

Coroners, medical examiners, physicians, and physician assistants also won’t be allowed to use the term as an underlying cause of death on a death certificate or any report, and law enforcement will be prohibited from using the term to describe anyone in a police report.

The law now also prohibits the term from being used as evidence in any civil court action.

According to a state Senate Appropriations Committee hearing on the bill in September, the state expects to spend $50,000 from its general fund for the Department of Public Health to develop a system to identify the prohibited term and notify medical examiners, coroners, physicians, or others who submit a death certificate using the term that it can’t be completed until the cause of death has been changed.

The California Public Defenders Association supported the legislation.

“Excited Delirium is not a medical diagnosis and the use of certain pharmacological interventions solely for a law enforcement purpose without a medical diagnosis or reason is opposed by major medical and psychiatric associations,” the association said in a statement, according to a legislative analysis of the bill.

The bill passed the Assembly in May with a 75–0 vote, with five assembly members abstaining. It passed the Senate 31–1, with state Sen. Kelly Seyarto, a Republican, voting against it.

Mr. Seyarto’s office didn’t respond by press time to a request by The Epoch Times for comment about his opposition to the bill.

The Los Angeles Police Department declined to comment on the new law on Oct. 17. A spokesperson told The Epoch Times that the department needed more time to review the measure.

George Floyd Death Shines National Spotlight on Term

The use of the term “excited delirium” has undergone a complete reversal in policy over the past few years, prompted by the high-profile death of George Floyd in 2020.

In 2009, the American College of Emergency Physicians studied the use of the term and determined that the condition was a unique syndrome that can be identified by a group of characteristics.

However, it received national attention after Floyd died during an encounter with police on May 25, 2020, in Minneapolis. During court trials for the police officers involved, defense attorneys argued that Floyd’s “excited delirium” justified the use of force, but the judge in the case was skeptical of the explanation.

Then, in December 2020, the American Psychiatric Association raised concerns about the use of the term, saying law enforcement excessively applied it to “black men in police custody” and to explain or justify injury or death for suspects in police custody.

“Although the American College of Emergency Physicians has explicitly recognized excited delirium as a medical condition, the criteria are unclear and to date there have been no rigorous studies validating excited delirium as a medical diagnosis,” the psychiatric association said in a December 2020 policy announcement.

The association noted that ketamine, an FDA-approved medication for anesthesia, is frequently used to treat the condition, and emergency medical technicians often use the drug to treat people suspected of having the condition when detained by police.

A year after the psychiatric association raised concerns, the American Medical Association (AMA) adopted a policy opposing the use of “excited delirium” as a medical diagnosis and warned against the use of certain drugs—including ketamine—as an intervention for law enforcement.

The medical association also denounced the term as a sole justification for law enforcement’s use of excessive force and affirmed its stance that police brutality was a product of structural racism and that racially marginalized and minority communities were disproportionately subject to police force and racial profiling.

“As physicians and leaders in medicine, it is our duty to define the medical terms that are being used to justify inappropriate and discriminatory actions by non-health care professionals,” AMA President-elect Dr. Gerald E. Harmon said in a June 2021 statement.