Deaths During Police Intervention
By RICHARD PARENT, Ph.D.
© Mark C. Ide

A

35-year-old male with
a history of bipolar disorder fatally stabbed his
9-year-old son on the front lawn
of the family residence. After
shouting that he had “killed
Satan,” he began removing most
of his clothing. Summoned
to the scene, six officers approached the irrational subject.
They employed pepper spray to
gain control of the combative
male, handcuffed him, and
“hog-tied” his legs to restrain
him while they placed him in

the rear of a police vehicle. As
this occurred, the man suffered
a massive heart attack and died.
A subsequent coroner’s inquest
determined that his death
resulted from excited delirium.
Two police officers responded to a report of a “male
acting crazy and taking his
clothes off.” When they arrived
at the scene, they saw the man,
wearing only his underwear,
standing in the street. When the
two officers tried to reason with
him, a fight ensued. Several

people in the area came to the
aid of the officers in their
attempt to arrest the violent,
combative individual. Upon
achieving control of him, the
officers handcuffed the man
who suddenly went into coronary arrest. The officers administered CPR but to no avail. A
subsequent coroner’s investigation determined the cause of
death as a cocaine overdose.
The author presents these
two cases as examples of the
more than 800 he examined in

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his recent study of police shootings in the United States and
Canada.1 During this research,
he found that on several occasions, official government data
and coroner inquest reports
erroneously included deaths that
occurred during police intervention with fatalities pertaining to
police firearm discharges. Examples of the causes of deaths
occurring during police intervention included excited delirium, positional asphyxia,
and cardiac arrest.
Unfortunately, the nature of
police work limits the options
and time available to officers to
effect successful intervention
strategies when dealing with
violent and combative individuals. Sometimes, deaths result
regardless of the good intentions and sound techniques used
by officers on the scene. The
author shares his research
findings to aid the law enforcement profession in determining
ways to reduce such tragedies.
Excited Delirium
Excited delirium refers to
individuals in a state of temporary mental confusion and
clouded consciousness who
display unusual, bizarre behavior and may be emotionally
charged, under the influence of
a drug, mentally ill, or affected
by a combination of these factors. In many instances, such
people come to the attention

of police personnel as a consequence of extreme behavior,
including violence, recklessness, and inappropriate removal
of their clothing.
Upon intervention, officers
typically deploy less lethal force
techniques in an attempt to control and restrain these individuals. Once they subdue them,
police personnel handcuff and
may need to restrain them
further by hog-tying their legs
together or by strapping them
to a stretcher or board. This
additional restraint depends
upon an individual’s continued
violent and combative behavior,
as well as issues surrounding
transportation to either a police
lockup or a medical facility.
For example, handcuffed
subjects attempting to kick out
the rear window of police

vehicles during transport to jail
generally will have the additional restraint of having their
legs hog-tied. The rationales for
this procedure include protecting officers from assaultive
behavior, reducing or eliminating prisoners’ self-inflicted
injuries, decreasing damage to
police transport vehicles, and
minimizing the potential for
escape.
In some instances, a violent
and combative individual must
be transported to a medical
facility for treatment. In these
cases, the person usually is
strapped to a stretcher and
transported in an ambulance to
the appropriate facility. Unfortunately, it is during the restraining and transporting
process that some subjects
suddenly experience respiratory

“

Examples of the
causes of deaths
occurring during police
intervention included
excited delirium,
positional asphyxia,
and cardiac arrest.

”

Dr. Parent, a sergeant with the Delta Police Department, is
the manager of Research and Academic Development at the
Justice Institute of British Columbia, Canada, Police Academy.

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Symptoms of Excited Delirium
• Overt demonstration of violent, agitated, and combative behavior
• Exhibiting psychosis, such as hallucinations and delusions of grandeur or persecution
• Possibly under the influence of stimulant drugs that include cocaine
• Hyperthermia (extremely high temperature)
• Great strength and nonpain compliance
• Talking incoherently and failing to respond to simple commands
• Sudden collapse and death, which may result during the application of physical restraint

arrest resulting in death. In
other instances, people may
suddenly lapse into respiratory
arrest and linger in a comatose
state for a prolonged period of
time causing medical complications, which ultimately lead to
death. In all of these situations,
the resulting death or extensive
hospitalization is attributed to
the police intervention by way
of the application of less lethal
force techniques, including
methods of physical restraint.
Positional Asphyxia
and Cardiac Arrest
In addition to excited delirium deaths occurring during
police intervention, frontline
police personnel face the additional challenge of preventing
deaths resulting from positional
asphyxia and cardiac arrest. In
these instances, death results
when the positioning of an
individual’s body interferes

with the ability to breathe or
when someone suddenly suffers
cardiac arrest due to the exertion associated with a foot chase
or physical confrontation.
In the case of positional
asphyxia, the arrest or restraint
of a violent and combative

“

In some instances,
a violent and
combative individual
must be transported
to a medical facility
for treatment.

”

individual may inadvertently
result in the compression of the
trunk area of the person’s body.
This will serve to limit chest
movement and may restrict the

diaphragm area, preventing
effective breathing. In some
instances, subjects being arrested may die of asphyxiation.
As for cardiac arrest, an
offender avoiding apprehension
or struggling with officers may
unexpectedly suffer a heart
attack. The high level of exertion associated with a foot chase
and subsequent struggle may
cause respiratory strain and a
dangerous heart-rhythm disturbance, ultimately resulting in
cardiac arrest. This situation
occurs more often when individuals have preexisting heart
or respiratory disease or are
under the influence of illicit
drugs.
An additional factor that
may compound this “flight and
fight” situation involves the
application of less lethal weaponry by police, such as Tasers,
chemical agents, or empty-hand
compliance techniques. The use

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of less lethal weapons upon
noncompliant fleeing felons
may have a precarious impact
upon vital organs, including the
heart and lungs.
Intervention Techniques
to Minimize Risk
Police personnel intervening
during an incident of excited
delirium should follow certain
precautionary measures during
the arrest and restraining process. In this regard, officers
should remain cognizant of such
issues as—
• the amount of time during
which the restraint is applied;
• the method of restraint; and
• the body position of the
restrained individual during
transport.
Continued struggling, as
well as prolonged restraint,
likely will cause a violent
individual to suffer severe
exhaustion that may result in
sudden death. To reduce such
an outcome, officers should
employ the following intervention techniques when confronting individuals displaying
characteristics associated with
excited delirium:
• Officers should summon
an ambulance to the scene
of all incidents involving
individuals displaying signs
of excited delirium in the
event that they lapse into
sudden cardiac arrest.

• If the situation permits,
responding law enforcement
personnel should contain the
irrational individual until
additional officers and
emergency medical workers
arrive.
• The deployment of pepper
spray often has little effect
on such people and may
only aggravate the situation
facing the officers.
• Officers should consider
restraining methods, such as
hog-tying, as a last resort.
• Officers should avoid
placing subjects in the prone
position if at all possible. If
they must use it as a means

of taking down an armed
individual, they should
minimize its duration.
Importantly, the prone
position may aggravate a
person’s anxiety level, as
well as prevent the observation and monitoring of vital
signs that include the level
of consciousness.
• Upon achieving control and
restraint, officers should
transport the subject in an
ambulance directly to a
medical facility for diagnosis and treatment.
• Officers should use police
vehicles to transport such
people only after they have

Case Study
An individual attempted to cash an obviously stolen check at a local bar. When staff at the bar refused to
cash the check, the subject pushed an employee,
grabbed her purse, and fled on foot. Three off-duty
officers, as well as other bar patrons, witnessed the
event and gave chase. Upon being confronted, the offender reached into his jacket as if he had a weapon,
advising the individuals to back off. Eventually, they
cornered the subject, and a physical altercation developed during which officers restrained and handcuffed
him. However, within 2 minutes, the subject began to
lose consciousness. Officers summoned emergency
medical personnel who pronounced him dead at the
scene and attributed his death to a cocaine overdose.

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Case Study
Three officers responded to a complaint of a male running in and out of traffic. As they
arrived at the scene, an ambulance crew was dealing with an individual, wearing only a pair
of jeans, lying on his back in the middle of an intersection. The man was screaming and
slapping his fists against the roadway. As the emergency medical workers retrieved a
stretcher from the ambulance, the male abruptly removed his pants, stood up, and ran naked
down the street. With the officers in foot pursuit, he ran to another intersection and, once
again, laid down. As one officer approached the irrational subject, a physical altercation
ensued. The officers were having difficulty controlling the male until additional police
personnel arrived at the scene to assist in physically restraining him. To do so, officers
placed the man face down on a stretcher, strapped him into place, and put him in the
ambulance. As this occurred, the subject continued to struggle against the straps. While
being transported to a nearby hospital, he lapsed into respiratory arrest. Ambulance personnel administered CPR and briefly stabilized the man. However, at the hospital, he lapsed into
a coma and died 2 days later.

been stabilized and released
from a medical center.
To prevent incidents of positional asphyxia, police personnel should try to avoid pressing
down on the trunk portion of the
body during restraint. A safer
method of achieving control of
a combative individual involves
restraining the subject’s limbs.
Upon restricting the movement
of the person’s arms and legs, it
becomes possible to bind and
restrain the ankles and wrists.
This method of restraint proves
considerably safer than alternatives that include kneeling on
someone’s back.
Conclusion
The author’s research points
out to officers the importance of

recognizing that some methods
of less lethal force and body
restraint may increase the risk
of death. These findings also
illustrate the complexities that
surround police intervention of
people in a state of temporary
mental confusion and clouded
consciousness. These individuals may be emotionally charged,
physically unfit, under the
influence of a drug, or mentally
ill. In some instances, they may
experience a combination of
these factors.
Unfortunately, law enforcement officers are placed in the
precarious situation of having
few options and little time to
affect successful intervention
strategies. As society’s protectors, they must control violent,

combative people who may not
understand officers’ good
intentions in attempting to keep
them from hurting themselves
and others. This sometimes
results in tragedies that law
enforcement professionals sadly
must endure in their efforts to
safeguard the communities they
serve.
Endnotes
1

Richard Parent, “Aspects of Police
Use of Deadly Force in North America:
The Phenomenon Of Victim-Precipitated
Homicide” (Ph.D. diss., Simon Fraser
University, Burnaby, BC, 2004); and
William A. Geller and Michael S. Scott,
Deadly Force: What We Know—
A Practitioners Desk Reference on
Police-Involved Shootings (Washington,
DC: Police Executive Research Forum,
1992).

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