During my career as an FBI agent, I provided expert reviews on numerous in-custody death cases. A common point of confusion during legal review and risk management is the discrepancy surrounding the recognition of “in-custody death syndrome.” This term is acknowledged by the American College of Emergency Physicians (ACEP), but not by the American Medical Association (AMA).
The key distinction here is that “in-custody death syndrome” refers to a syndrome rather than a specific explanation of direct causes and effects. ACEP defines this syndrome as a combination of physiological, medical, and contextual factors that may contribute to death in individuals while in police custody, often exacerbated by elements such as stress, drug use, and restraint.
While the AMA is concerned with the treatment of individuals in custody, it does not formally recognize “in-custody death syndrome” in the same context as ACEP.
In medical terminology, “syndrome” describes complex presentations that may involve multiple organ systems and can manifest with a variety of clinical symptoms, especially when the exact cause is not clearly identified. This term serves as a valuable framework for clinicians, allowing them to communicate about a related group of signs, symptoms, and situations, even when the underlying etiology is not fully understood.
Overall, I support the use of “in-custody death syndrome” because it plays a crucial role in rapidly identifying, diagnosing, and treating critical and potentially fatal conditions that require timely recognition and intervention. For legal review and risk management, I concur with the AMA that each case must be assessed on its individual merits, with a focus on identifying the exact causes and effects.
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