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Medical examiner rules in death of 38-year-old man restrained by police

Clifton Armstrong, 38, died after being subdued by police outside his mother's home in Oklahoma City. Family members said he was addicted to methamphetamine.
by Juliana Keeping Modified: July 19, 2013 at 8:50 pm •  Published: July 20, 2013

A condition called “excited delirium” paired with methamphetamine killed an Oklahoma City man while he was being restrained by four police officers, according to his autopsy report.

Clifton Armstrong, 38, died May 1 after police subdued him outside of his mother's home at 1421 NW 99. Family members said he was addicted to meth, which was found in his bloodstream, according to the autopsy report.

On the first page of the report, the state medical examiner states meth toxicity is the official cause of death. It later explains: “It is felt that the cause of death is regarded to be excited delirium. Most likely related to methamphetamine toxicity.”

The report notes Armstrong's physical confrontation with police was an “aggravating factor to his death.”

The death was ruled an accident.

Excited delirium

Experts define excited delirium differently — and some don't recognize it at all.

A definition used as a guideline in the state medical examiner's office comes from the book “Excited Delirium Syndrome: Cause of Death and Prevention” by Theresa G. DiMaio and Vincent J.M. DiMaio, M.D., spokeswoman Amy Elliott said.

“Excited delirium syndrome involves the sudden death of an individual, during or following an episode of excited delirium, in which an autopsy fails to reveal evidence of sufficient trauma or natural disease to explain the death,” the book states.

“In virtually all cases, the episode of excited delirium is terminated by a struggle with police or medical personnel, and the use of physical restraint. Typically, within a few to several minutes following cessation of the struggle, the individual is noted to be in cardiopulmonary arrest. Attempts at resuscitation are usually unsuccessful. If resuscitation is ‘successful,' the individual is found to have suffered irreversible hypoxic encephalopathy and death occurs in a matter of days.”

Deborah Mash, a neurology professor at the University of Miami, told National Public Media the condition typically arises when a large, agitated person, typically on drugs, is threatening violence during a confrontation with police and has to be restrained. Their temperature rises so fast, organs fail.

In the same article, a former Texas medical examiner said people die of an overdose of adrenaline during excited delirium.

The American Medical Association has no policy on excited delirium, an official said.

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by Juliana Keeping
Enterprise Reporter
Juliana Keeping is on the enterprise reporting team for The Oklahoman and Keeping joined the staff of The Oklahoman in 2012. Prior to that time, she worked in the Chicago media at the SouthtownStar, winning a Peter Lisagor Award...
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