There’s been growing national backlash against law enforcement using the disproven medical diagnosis “excited delirium” to explain when someone dies in custody. Now, a federal judge in San Diego has banned the term in an upcoming police misconduct trial.
The decision comes six months after California lawmakers banned the term from many official proceedings, making it illegal for police to include it in their reports and for coroners and medical examiners to use it as a cause of death.
That was what happened in the case of Oral Nunis who died after Chula Vista police officers forced him against the ground in March 2020. The Medical Examiner’s office didn’t say definitively why Nunis died, but said “excited delirium” was the likely reason, according to a copy of the autopsy filed in court. The San Diego County District Attorney cleared the officers of any criminal responsibility.
Those findings have drawn new scrutiny as leading medical organizations have disavowed the medical theory. Nunis’ family has sued the city of Chula Vista, accusing the officers of using unconstitutional deadly force and targeting Nunis because he was Black. And one month ago, an attorney for the family asked the judge in the case, Todd Robinson of the Southern District Court of California, to exclude any mentions of “excited delirium” from the approaching trial.
Last week, Robinson granted that request.
Nunis was a Northern California business owner, originally from Jamaica, who ran a trucking operation in the Central Valley.
In March 2020, he was in town to visit his daughter, Kimone, who lived in Southeast Chula Vista. Nunis, Kimone and her boyfriend were at Kimone’s apartment on the evening of March 13 when Nunis started experiencing a mental health crisis.
Kimone, worried that he might hurt himself, called 911 for help.
Police body camera footage shows officers handcuffed Nunis, despite him and his family asking them not to, and said Nunis would cooperate. Then multiple officers used their weight to force him against the ground. They wrapped his arms and legs with an additional restraining device and covered his head with a mesh hood. Paramedics then took Nunis to an ambulance — but minutes later, they told police he had stopped breathing. Nunis was driven to a local hospital and pronounced dead later that night.
The next day, the San Diego County Medical Examiner’s office performed an autopsy. In his report, Deputy Medical Examiner Robert Stabley said that Nunis was healthy overall and died when his heart and lungs failed in a “sudden cardiorespiratory arrest” while in police custody.
“This is likely an excited delirium-type scenario,” Stabley wrote.
But Kimone and Nunis’ wife Roxie don’t agree with the police version of events. In late 2020, they both filed wrongful death lawsuits against Chula Vista.
Law enforcement have for years used the “excited delirium” theory to explain why people, disproportionately Black Americans and other people of color, died during encounters with police — including George Floyd and Elijah McClain.
That's despite critics who have long argued that it has no consistent definition and is not grounded in scientific evidence, leading the American Medical Association and other major medical groups to publicly disavow the term in recent years.
Police, paramedics, coroners and medical examiners often invoke the phrase to describe a person who becomes agitated and then dies suddenly in custody — especially when that person was experiencing mental health issues or using drugs.
The phrase is also widely used in law enforcement policies and training manuals, and police have relied on it as a legal defense while facing civil lawsuits.
But investigations over the years have repeatedly found that “excited delirium” is rooted in racism and has little scientific evidence to back it up. One of the earliest uses of the term occurred in the 1980s when a Florida medical examiner used it to explain the deaths of 12 Black women who were later found to be the victims of a serial killer.
A key turning point came when another Northern California resident, Angelo Quinto, died in the custody of Antioch police and was also diagnosed with “excited delirium” in 2020. Quinto’s family began advocating for reforms that would bar law enforcement from using the medical theory in the future.
Their story reached Assemblymember Mike Gipson (D-Carson), who introduced an assembly bill that would ban the diagnosis. In October, Governor Gavin Newsom signed it into law, making California the first state to formally outlaw “excited delirium” as a cause of death.
A number of other states are now considering similar laws. Just last week, Colorado also banned the term.
The ban on the use of “excited delirium” in Nunis’ trial is an important step, said Gipson.
Joanna Naples-Mitchell, a research advisor at Physicians for Human Rights who wrote a report on the term, also said the ban signals a shift.
“That's definitely a significant departure from the cases we examined when we were working on our report,” she said. “I think that's a really important step, and it's a sign of how much the needle has moved in just two years.”
To Gipson, the judge’s decision brings Nunis’ family one step closer to the truth of how their loved one died.
“The real cause of death needs to be placed on someone's death certificate — not something that's not based on data and science,” he said. “The family needs closure.”
