Manner of Death for In-Custody Fatalities

Abstract

In-custody deaths are typically investigated by a medical examiner or coroner (ME/C) and include those that occur while in the custody of the police or in a government detention facility (e.g., prison). The potential manners of death are natural, homicide, suicide, accident, therapeutic complication, and undetermined. Once the cause of death is determined, the manner of death is certified based upon the cause and the circumstances of death. Deaths in custody may be challenging due to the potential for death at the hand of another (e.g., inmate, corrections officer, or law enforcement agent) or due to neglect. When a government takes a person's liberty, they have a duty to ensure safe and adequate housing, food, and medical care. Failure of a responsible party to exercise proper care of a person in-custody, may affect the manner of death. Since in-custody deaths at the hand of a government agent can be challenging to certify, we will focus on these manners of death including those associated with excited delirium (ED). Although manners are easily and consistently applied in most deaths, there are nuances in some instances which may result in jurisdictional variations in the determination of the manner of death. We will discuss these variations as the determination made by the ME/C is an opinion based upon his/her particular training, experience, and judgment.