California becomes first state to ban ‘excited delirium’ diagnosis after George Floyd’s death

California has become the first US state to ban medical professionals from listing “excited delirium” as a cause of death, a move that has been hailed by human rights activists as a “watershed moment”.

Governor Gavin Newsom signed a bill on October 8 that prohibited coroners, medical examiners, physicians or physician assistants from listing excited delirium on a person’s death certificate or in an autopsy report. The law is due to take effect in January.

According to the bill, excited delirium means “a term used to describe a person’s state of agitation, excitability, paranoia, extreme aggression, physical violence, and apparent immunity to pain that is not listed in the most current version of the Diagnostic and Statistical Manual of Mental Disorders…

“... or for which the court finds there is insufficient scientific evidence or diagnostic criteria to be recognized as a medical condition.”

The new bill also means law enforcement will not be allowed to use the term to describe a person’s behaviour in any incident report, and testimony that refers to excited delirium won’t be allowed in civil court.

The term excited delirium has been used increasingly over the last 15 years to explain how a person experiencing severe agitation can die suddenly through no fault of the police. It was notably used as a defence in the murder trial of George Floyd.

Lawyers for former police officer Derek Chauvin, who was convicted of murdering Mr Floyd, argued that the excited delirium was real, and that Chauvin acted reasonably when he pressed his knee to Floyd’s neck for about 9 1/2 minutes to restrain him, even as Floyd said he couldn’t breathe and eventually became limp.

Joanna Naples-Mitchell, a lawyer with the New York-based Physicians for Human Rights, who who co-authored a 2022 report on the use of the diagnosis, told the LA Times: “This is a watershed moment in California and nationwide.

“In a wrongful death lawsuit, if excited delirium comes up, it’s a big hurdle for a family getting justice if their family member was actually killed by police. So, now it will be basically impossible for them to offer testimony on excited delirium in California.”

Though it is the first time the term has been banned in state legislature, several national medical associations have already discredited excited delirium as a medical diagnosis.

It comes after The American College of Emergency Physicians formally withdrew its approval of a 2009 paper on excited delirium, on Thursday. The organisation called the paper outdated and said the term excited delirium should not be used by members who testify in civil or criminal cases.