EXPLAINER: Why is 'excited delirium' cited at Chauvin trial?

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In this image from police body cam video, Minneapolis police officers attempt to place George Floyd in a police vehicle, on May 25, 2020, outside Cup Foods in Minneapolis, as it is shown Wednesday, March 31, 2021, in the trial of former Minneapolis police Officer Derek Chauvin in the death of Floyd, at the Hennepin County Courthouse in Minneapolis. (Court TV via AP, Pool)

MINNEAPOLIS – The attorney for the former Minneapolis police officer on trial in George Floyd ’s death revisited the disputed concept of excited delirium Tuesday in an effort to show that the force Derek Chauvin used was objectively reasonable given Floyd's resistance.

Chauvin, 45, who is white, is charged with murder and manslaughter. Floyd, a 46-year-old Black man, was arrested outside a neighborhood market on May 25, accused of trying to pass a counterfeit $20 bill. A panicky-sounding Floyd struggled and claimed to be claustrophobic as police tried to put him in a squad car. Chauvin then kept his knee on Floyd's neck for 9 1/2 minutes while Floyd was pinned to the pavement, even after he stopped resisting.

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Thomas Lane, a rookie officer at the scene, can be heard on body camera video as officers hold Floyd down, asking whether Floyd might be experiencing excited delirium.

HOW HAS EXCITED DELIRIUM COME UP?

The subject came up again Tuesday as defense attorney Eric Nelson recalled Nicole Mackenzie, a Minneapolis police officer who trains other officers in medical care and testified for the prosecution earlier.

Mackenzie told the jury that new officers are told how to recognize the signs of excited delirium. Suspects may be incoherent, she said, exhibit extraordinary strength, sweat or suffer from abnormal body temperature, or seem like they suddenly snapped. They're taught that cardiovascular disease, drug abuse or mental illness can trigger excited delirium, she said.

But Mackenzie told the jury that she would defer to an emergency room doctor in diagnosing the condition. She also testified that she provides training on excited delirium only to new recruits. Judge Peter Cahill cautioned jurors that there is no evidence that the veteran Chauvin had the training.

WHY DOES IT MATTER?

A key question at Chauvin's trial is whether he used reasonable force in pinning Floyd to the pavement for 9 minutes, 29 seconds while Floyd was handcuffed and lying on his stomach, complaining that he couldn’t breathe. Minneapolis Police Department officials testified earlier that he did not — that Floyd was under control so force should have quickly ended.

Nelson has emphasized that Floyd was bigger than Chauvin, suggested that people can present a danger even when handcuffed, and that handcuffs can fail. He has also suggested that Chauvin was rightly concerned about angry onlookers. A defense use-of-force expert, Barry Brodd, a former Santa Rosa, California, police officer, testified Tuesday that Chauvin was justified in pinning Floyd to the ground because of his frantic resistance.

WHAT DOES SCIENCE SAY ABOUT EXCITED DELIRIUM?

Some medical examiners in recent decades have attributed in-custody deaths to excited delirium, often in cases where the person had become extremely agitated after taking drugs, having a mental health episode or other health problem. But there is no universally accepted definition of it and researchers have said it’s not well understood.

The American Psychiatric Association’s diagnostic handbook doesn’t list the condition and one study last year concluded it is mostly cited as a cause only when the person who died had been restrained.

Earlier in the trial, Dr. Bill Smock — an expert in forensic medicine who works as a police surgeon for the Louisville Metro Police Department in Kentucky and as a professor of emergency medicine at the University of Louisville — testified that he believes excited delirium is real. But he said Floyd met none of the 10 criteria developed by the American College of Emergency Physicians. A minimum of six signs are required for the diagnosis, he said.

A medical examiner in New York concluded that Daniel Prude was in a state of excited delirium in 2020 when police in Rochester put a hood over his head and pressed his naked body against the pavement. Prude, a Black man, lost consciousness and died. State Attorney General Letitia James issued a report recommending that officers be trained to recognize the symptoms of excited delirium.

Elijah McClain — a Black man put in a stranglehold by officers in Aurora, Colorado, in 2019 — was injected with ketamine after first responders said he was experiencing excited delirium. He wound up on life support and later died.

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Find AP’s full coverage of the death of George Floyd at: https://apnews.com/hub/death-of-george-floyd