‘Excited delirium’ cited in Floyd case, and in other deaths involving law enforcement

In early February, Ramsey County sheriff's deputies were called to a house in Little Canada because a woman was having a seizure and a panic attack.

Nekeya Moody became unresponsive after the deputies restrained her and put her in handcuffs, according to the report from the sheriff’s office. Moody was taken to Regions Hospital, where she died. She was 37 years old.

The Ramsey County Medical Examiner ruled the cause of death as “probable complications of excited delirium with recent cocaine use.”

The diagnosis of excited delirium may come up in a far more high profile case: the killing of George Floyd by Minneapolis police officer Derek Chauvin. According to a transcript, another former officer charged with aiding and abetting in Floyd’s death, Thomas Lane, told Chauvin, “I’m worried about excited delirium or whatever,” and asked whether they should turn Floyd on his side.

Chauvin’s attorneys may argue that excited delirium contributed to Floyd’s death.

Law enforcement officials and others say excited delirium usually happens to people who have been using drugs or who have a serious mental illness. It may be seen when a person is held in a chokehold, hog-tied, or Tasered.

People with excited delirium are said to be very agitated, show extraordinary strength, and have an elevated body temperature, among other symptoms.

The associations representing emergency doctors and medical examiners say excited delirium is real, but the American Medical Association and the American Psychological Association do not recognize it.

“I do think that excited delirium has been used in so many defense cases often ends up as a wastebasket term, very ill-defined,” said Douglas Zipes, a professor of cardiology at the medical school at Indiana University who’s been an expert witness for the plaintiffs in a number of lawsuits involving the condition. He has not examined the documents in Nekeya Moody’s death.

Moody’s sister Patriece Standberry is skeptical of the diagnosis of excited delirium, and law enforcement’s conduct at the scene.

“To begin with, she was having a medical emergency,” Standberry said. “What is the point of restraining her? I don’t really feel like she was a danger to anyone or to herself at that moment. She was just, she was needing medical help.”

The sheriff’s department has not yet responded to questions about the incident.

Excited delirium has long been a part of law enforcement training in Minnesota and elsewhere.

Erik Misselt, interim executive director of the state’s Board of Peace Officer Standards and Training, remembers being told during his own training to be on alert when somebody showed signs of the condition.

“This person’s probably, their vital signs and everything are going to tank potentially,” he said. “And you need to get medical attention going immediately after, once the situation’s under control, anticipating that they’re going to go downhill quickly.”

Excited delirium is among the topics the POST board requires for law enforcement training in Minnesota.

MPR News has not seen the body cam footage from the day Nekeya Moody died. But her sister has, and believes the officers were too aggressive.

“There were two officers that restrained her. I think that kind of propelled whatever state that she was in that caused her to go into that cardiac arrest,” Standberry said.

This story is part of Call to Mind, MPR's initiative to foster new conversations about mental health.

If you know someone who has died of excited delirium, we’d like to hear from you: email aroth@mpr.org or on Twitter @alisa_roth

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