SUSPECTS' DEATHS INCREASINGLY PINNED ON DISPUTED CONDITION

DALLAS (AP) -- Police found 23-year-old Jose Romero in his underwear,
screaming gibberish and waving a large kitchen knife from his neighbor's
porch. Romero kept approaching with the knife so officers shocked him
repeatedly with a taser gun. Then he just stopped breathing. His family
blames police brutality for the death, but the Dallas County medical
examiner attributed it to a disputed condition known as excited delirium.

Medical examiners nationwide have increasingly cited the heart-racing
delirium resulting from drug use or psychiatric problems when suspects die
in police custody. But some doctors say the rare syndrome is being
overused, and certain civil rights groups question whether it exists at
all.

"For psychiatrists, this is a rare condition that occurs once in a blue
moon," said Warren Spitz, a former chief medical examiner in Michigan.
"Now suddenly you are seeing it all the time among medical examiners. And
always, police and police restraint are involved."

Excited delirium came to doctors' attention in the 1980s as cocaine use
skyrocketed, said Vincent DiMaio, chief medical examiner in Bexar County,
Texas, and a proponent of the diagnosis. No reliable national statistics
exist on how many suspects die from excited delirium because county
medical examiners make the ruling, and some use different terminology.

In Dallas, at least three in-custody deaths in the last five months have
been linked to excited delirium. This prompted the police department to
implement mental health assessment training they say will stem the sudden
deaths.

Other police departments, including San Diego, have done the same in
efforts to prevent community protests, which have cropped up from
California to Maryland, and costly lawsuits. In Phoenix, a jury awarded $9
million in April to the parents of a restrained suspect whose death was
attributed to excited delirium.

The condition, described as an overdose of adrenalin, affects mostly young
men with histories of drug use or mental illness and what are thought to
be brain abnormalities, DiMaio said. He said most cases are triggered by
drugs such as cocaine and methamphetamine.

The drugs elevate blood pressure and heart rate, and the increase is
pronounced if a person is experiencing paranoia, hallucinations and
violent impulses, DiMaio said. Police often respond to calls of sufferers
stripping off clothes to cope with a soaring body temperature, breaking
glass and threatening others. The officers and the suspect struggle, and
the excitement stresses the suspect's heart until it fails, DiMaio said.

"You are gunning your motor more and more and more, and it is like you
blow out your motor," said DiMaio, who estimates that the condition kills
as many as 800 people nationwide each year. "You are just overexciting
your heart from the drugs and from the struggle."

Medical examiners and emergency room doctors know the syndrome well, but
psychiatrists seldom see it because sufferers almost always die before
they can get mental help, DiMaio said.

The most commonly used psychiatric reference, "The Diagnostic and
Statistical Manual of Mental Disorders," does not specifically recognize
"excited delirium" as a diagnosis. The International Association of Chiefs
of Police says not enough is known about it.