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.
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.
The latest version of the Diagnostical and Statistical Manual of Mental Disorders — a catalog of mental disorders used by mental health professionals in the United States — does not list it, according to an official with the American Psychiatric Association.
Armstrong's sister, Brigette Armstrong, said her brother called police on himself May 1.
Officers responded to a call about a possible suicide attempt about 9 p.m.
Armstrong came out of the house and said he was “seeing dragons,” according to the medical examiner's report.
He was talked into a squad car before changing his mind and going back toward the house.
When officers tried to get him back into a car, the physical confrontation ensued. At some point, he stripped off his clothes, police said.
Officers placed Armstrong in handcuffs and used belts to restrain his leg movement. The “maximum restraint hobble system” entails the use of a belt system that stops combative people from kicking, police said.
Then he became unresponsive, the autopsy report states. Tasers were not used, the report states.
Paramedics performed CPR on Armstrong. After about 40 minutes of resuscitation efforts, he was pronounced dead, according to the report.
Family members said they saw grass up his nose. They worry his oxygen supply was cut off, said his sister, Brigette Armstrong.
The medical examiner's report describes numerous abrasions on Armstrong's body, on the back of his head, his neck, his shoulders and back. It notes abrasions and marks around his wrists and ankles, where he was bound.
Some of the abrasions on his back are described as “double linear” or serrated. The Oklahoman requested but didn't receive additional information about what “double linear” abrasions look like and might cause them.
The officers involved in the arrest were Jeffery Dutton, Gregory Franklin, Mohammed Tabaia and Daniel Holtzclaw. They were placed on administrative leave after the incident, but have returned to duty, Master Sgt. Gary Knight said Thursday. Officer-involved deaths in Oklahoma City spark separate criminal and internal investigations within the police department. The criminal investigation by the department's homicide units is not yet complete, Knight said.