MORE TRAINING NEEDED WHEN DEALING WITH EXCITED DELIRIUM

Robert Knipstrom's post-arrest death was an accident linked to
"excited delirium," a B.C. coroner ruled Thursday night.

Coroner Vincent Stancato said Knipstrom's death was caused by acute
ecstasy intoxication and excited delirium with physical restraint.

Excited delirium is a controversial term that has been used to explain
deaths of individuals in police custody. Symptoms of excited delirium
include extreme agitation, aggression, paranoia, rambling speech and
extraordinary strength. It has been linked to long-time drug users.

In his report, Stancato said all B.C. emergency services personnel
should receive more training on how to identify and deal with excited
delirium.

Knipstrom was arrested on Nov. 19, 2007, after police were called to
the EZE Rent-it Centre in Chilliwack where Knipstrom was causing a
disturbance.

He was Tasered at least six times, pepper-sprayed and struck in the
head with a baton before finally being subdued. Knipstrom, who was a
small man, died five days later in hospital.

Stancato ruled Knipstrom's immediate cause of death was due in part to
rhabdomyolysis, which is due to physical trauma.

Chilling post-arrest video of Knipstrom was shown to the coroner's
inquest held this week in Burnaby.

Knipstrom was shown laying face down screaming and covered in blood as
police restrained him. He was then loaded, handcuffed and face down,
onto an ambulance stretcher. According to testimony at the inquiry,
Knipstrom did not receive medical attention at hospital until he
stopped breathing.

He had arrived by ambulance at Chilliwack General Hospital at 4:01
p.m. and was not seen by medical staff until two RCMP officers and
paramedics noticed his face turning blue at 4:28 p.m.

Stancato also recommends health regions amend their procedures to
ensure better communication between the triage nurse and bedside nurse
and priority be given to people suspected of suffering excited delirium.

Toxicologist Dr. Walter Martz testified that Knipstrom had about seven
milligrams of ecstasy per litre of blood in his system. Martz noted
that moderate levels of ecstasy can be harmless to one person, but
fatal to another.

Martz also cited new research that pepper spray may contribute to the
death of agitated people high on drugs.

Forensic pathologist Dr. Danny Straathof said Knipstrom's cause of
death was "acute intoxication" with ecstasy, but he noted Knipstrom
had been "physically agitated," then restrained and handcuffed before
a "cardiac arrest," which led to "severe damage to the brain due to a
lack of oxygen."