Illinois Officer Raises Medical Safety of Suspects

Police officers need to think first about saving lives, not enforcing the law, when dealing with people in states of excited delirium, a Champaign police lieutenant said Tuesday.

Lt. Michael Paulus spoke at a daylong training session that may change how officers deal with people who are out of control because of drugs or mental illness.

“There’s a naked, sweaty guy – he needs to go to jail,” Paulus told more than a dozen officers from the Sangamon County Sheriff’s Office, the Springfield Police Department, the Sherman Police Department and a handful of other agencies. “Wrong. He needs to go to the hospital.”

If someone in a state of excited delirium isn’t a risk to himself or others, the first officer should wait until other officers and paramedics arrive before acting, Paulus said. Paramedics need to be part of the plan.

“We’re not the lead agency, we’re the backup,” Paulus said.

The analysis drew a wry smile from Springfield deputy police chief Mike Geiger.

“It’s usually not going to be an emergency medical person who’s going to make that initial move,” Geiger said in an interview. “In my experience, people will wait for us to do it.”

Trying to reason with a person in a state of excited delirium does no good because such people don’t know where they are or why the police are there, Paulus said. Some people can die even if officers follow standard training.

“Having a person die is not good,” Paulus said. “Simply saying officers followed use-of-force policies doesn’t sound good.”


In Champaign, paramedics use ketamine, a sedative often used as an anesthetic by veterinarians, to subdue people in states of excited delirium once officers have the person down and ready for cuffing.

“Is it fringe?” Paulus said. “Yes. Is it safe? Yes.”

No one knows why people in states of excited delirium die, Paulus said, but their demise is often so swift that officers don’t realize a life is at stake until it’s too late. They might have superhuman strength. They take their clothes off because they’re suffering from hyperthermia, and core body temperatures as high as 110 degrees have been documented upon death, Paulus said.

That’s one reason why officers need to get people into ambulances quickly, he said. Jail and charges can wait.

“If we can’t get him to live, there’s nothing we can do criminally,” Paulus said.

Paulus showed several videos of police handling people in states of excited delirium, with varying results. In a 2005 case handled by police in West Palm Beach Fla., Donald George Lewis, who was under the influence of cocaine, died while being arrested.

In critiquing the incident, Paulus noted that an officer stepped behind Lewis, who then ran into a street. Paranoid people don’t react well when someone steps behind them, Paulus said. In any case, he noted, cars in the street were stopped, and Lewis threatened no motorists.

“The question is, why do we have to go get him?” Paulus asked. “What is he hurting?”

Geiger spoke up.

“I think you’re damned if you do, damned if you don’t,” Geiger said. “If they let him dance out there in traffic and he gets hit, it’s our fault.”

Paulus said he wasn’t criticizing the officer, who did as he was trained.

“The issue I have is with (police) administration,” Paulus said. “If you want to keep doing what you’re doing, it’s up to you. … West Palm Beach hasn’t figured it out.”

But Geiger questioned the wisdom of waiting to intervene.

“I think I read this in some of the literature, maybe yours: The thing to do is nothing?” Geiger said. “

“Aren’t you doing something by getting the resources there?” Paulus responded. “Nothing is 100 percent, chief. All I’m doing is giving you options.”

The courts agreed with Geiger. A federal judge in 2008 dismissed a lawsuit filed by Lewis’ mother, and the U.S. Supreme Court in February refused to hear the case

Team effort

Subduing a person in a state of excited delirium requires coordination and communication, Paulus said.

Four to six officers is ideal, Paulus said, although three officers can do the job with proper training. The goal is to have the person cuffed and sedated within three minutes of being knocked to the ground with a Taser shock.

An officer is assigned to each extremity and a fifth is positioned near the head to give directions and call in a syringe-wielding paramedic when the moment is right.

Local police on Tuesday practiced for nearly an hour, with the only injury being a broken fingernail suffered by an officer who was putting cuffs on.

The real thing is far different, Geiger said. Someone in a state of excited delirium is typically overweight, often nude and sweaty and out of control – it’s akin to wrestling a catfish with bare hands, he said.

Whether local officers will adopt the methods isn’t certain. Among other things, dispatchers would need training to recognize signs of excited delirium, paramedics would also have to be trained, and the use of sedatives in the field would have to be approved. And police would have to find time to train officers.

“We’re here for informational purposes more than anything else,” Geiger said. “It looks like something we could benefit from. It’s going to take a lot of inter-agency cooperation to bring it on board.”

Sangamon County Sheriff Neil Williamson said he wants training for all local officers, emergency medical personnel and dispatchers.

“This is going to be a change in procedure and a mind-set change,” Williamson said.

Tuesday’s session took place nearly six months after the death of Patrick Burns, who died after a struggle with Sangamon County sheriff’s deputies who deployed Tasers more than 20 times. Burns, who was under the influence of cocaine, had broken into a woman’s home and assaulted her, but was sitting outside when police arrived. Burns was calm until a deputy tried to photograph him.

Williamson, who has defended the deputies who fought with Burns, said he expects a lawsuit. He also said he’s not concerned that people might think that revamped training is a signal that the sheriff’s department could have done a better job.

“If people want to say we’re reactive, so be it,” Williamson said.

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