‘Excited delirium’ emerges as key issue in trial of officers accused over George Floyd death

Use of the controversial label "excited delirium" by first responders when subduing people exhibiting signs of severe agitation has emerged as a key issue in the federal trial of three former Minneapolis police officers involved in the death of George Floyd.

Tou Thao, J Alexander Kueng and Thomas Lane are accused of depriving Floyd, a 46-year-old Black man, of his civil rights by failing to give him medical aid while he was handcuffed and lying facedown as their senior colleague Derek Chauvin proceeded to murder him on 25 May 2020.

Jurors in the civil rights trial of the three more junior ex-officers have heard that Kueng knelt on Floyd's back and Lane held down his legs, while Thao kept bystanders back. Kueng and Thao are additionally accused of failing to intervene to stop Chauvin, who was last year found guilty of Floyd's murder and sentenced to 22 and a half years in prison.

Chauvin admitted violating Floyd's civil rights in his additional federal case last December following Floyd's murder, which triggered protests worldwide and a re-examination of racism and policing.

All were fired from their jobs and arrested days after Floyd's killing in 2020.

Thao, Kueng and Lane have pleaded not guilty in both their federal joint civil rights case and their state criminal case, which is due later this year and in which they are accused of aiding and abetting murder.

In the current trial taking place in St Paul, the Minnesota state capital, one of the prosecution's key arguments is that they were trained to provide medical aid in emergencies, and that Floyd's situation had become so serious as police held him down that bystanders, even children with no medical training, knew something was wrong.

Kelly McCarthy, chief of police in Mendota Heights police department and chair of Minnesota's Police Officers Standards and Training board, testified last week that officers are specifically taught to reposition someone who is restrained face down, to ensure they can breathe.

Asked why, she said: "There were enough in-custody deaths that we needed to have a learning objective on it."

A day earlier, the head of the Minneapolis police department's homicide unit testified that the officers should have intervened to begin first aid or take action that even means moving another officer out of the way if necessary.

Lt Richard Zimmerman, who also testified at Chauvin's trial last year, said when the other officers saw Chauvin kneeling on Floyd's neck "the officers should have intervened at that point and stopped it".

But defense arguments have repeatedly focused on the condition termed excited delirium, and the training of police to respond to it, suggesting the officers were following procedure about restraining someone they thought was experiencing such a health syndrome.

The Minneapolis police department and the office of the city mayor, Jacob Frey, have said the city halted such training last year, after the American Medical Association (AMA) rejected the diagnosis of excited delirium.

The AMA, called it a "manifestation of systemic racism" that had been misapplied to justify excessive police force or

pharmacological interventions such as ketamine and "disproportionately cited in cases where Black men die in law enforcement custody".

But a Minneapolis police training video of the updated process, obtained through a public records request from the Minneapolis Star Tribune newspaper, showed officers still being trained using studies with "excited delirium" in the titles. The video included an emergency physician advising that the term had become "triggering" and suggesting that another term should be used, such as "severe agitation with delirium".

In either respect, the diagnosis is controversial. Federal prosecutors played a portion of Lane's body-camera video showing the officers describing elements of their struggle to try to put Floyd in their squad car after they had arrived outside a corner store following a report that he had tried to use counterfeit money.

"He kind of seemed like he was on something ... He was fighting the whole time," Lane said.

Lane's attorney later focused on how his client is seen on video calling for an ambulance and expressing concern that Floyd might be experiencing "excited delirium".

"Should we roll him on the side?" Lane asked. "I just worry about the excited delirium or whatever."

An autopsy later revealed that Floyd had fentanyl, a powerful opioid sedative and painkiller, and methamphetamine, a stimulant, in his system but neither were listed as the cause of death.

The issue came up in Derek Chauvin's trial last year when jurors heard from defense attorneys arguing Chauvin acted reasonably and that officers are taught how to recognize signs of the physical and psychiatric state known as excited delirium from incoherence, extraordinary strength, sweat, or suffering from abnormal body temperature, or if a person appears to have suddenly snapped.

Forensic expert Bill Smock testified that Floyd met none of the 10 criteria developed by the American College of Emergency Physicians. Prosecutors described the topic as a "story" created by Chauvin's defense to shift blame for Floyd's death after fatally depriving him of oxygen.

In the current trial, the court heard testimony from Derek Smith, a paramedic dispatched to the scene. He acknowledged the dispute over the diagnosis, indicated that in his experience it is real, and said he suspected Floyd had the condition based on what officers told him.

Controversy over the diagnosis is set to continue despite the change in name to "severe agitation with delirium". And according to the Star Tribune, the Minneapolis police department instructed officers to ignore the findings from a watchdog investigation that found police inappropriately asking paramedics to sedate uncooperative people.

Prosecutors have told the court that they will rest their case on Monday after three weeks of testimony.