'Syndrome killed custody man'

By Cindi John
BBC News Online community affairs reporter

Roger Sylvester was being treated for a manic illness

The inquest into the death of Roger Sylvester has been told a controversial syndrome led to his fatal heart attack.

Mr Sylvester, 30, died in January 1999, a week after he was restrained by eight police officers.

On Wednesday, forensic pathologist Dr David Raus told the inquest that Excited Delirium (ED), a condition some doctors believe can lead to a heart attack, was responsible for Mr Sylvester's death.

Last week, two psychiatrists had ruled out the possibility that ED had killed Mr Sylvester and questioned such a diagnosis.

'Pathological diagnosis'

But Dr Raus, who was present at the first post mortem on Mr Sylvester, said he had exhibited typical symptoms, including paranoia, hallucinations, confusion and hyperthermia or over-heating.

Dr Raus said he was not surprised that the psychiatrists did not acknowledge ED. "It's a pathological diagnosis, the end result of other conditions," he said.

Under cross examination by the Sylvester family's lawyer, Ian McDonald, Dr Raus denied his theory was all supposition. He said ED was well documented in numerous cases in the US.

Asked to explain the lack of cocaine in Mr Sylvester's system - the drug said to be one of the major causes of ED - Dr Raus said approximately a quarter of documented cases were not cocaine-related and other drugs were capable of bringing on ED.

A post-mortem revealed that Mr Sylvester had cannabis in his system when he died.

Restraints

Last week a pathologist employed by the Sylvester family, Dr Nathanial Carey, told the inquest that Mr Sylvester's death was due in part to a lack of oxygen caused by his struggling against police restraints.

Questioned further by Mr McDonlald, Dr Raus admitted that restraint played a part in Mr Sylvester's death.

He said: "It is part of the overall sequence of events leading to his death, but it is not what I would regard as the cause of the death.

"Restraint is often seen in cases of ED. Cases where it is not present I can count on one hand," he said.

Deep bruising

But he said restraint was way down the list of factors causing ED. The most important factor was an agitated mental state.

Dr Raus also told the inquest that deep bruising found on Mr Sylvester's neck did not prove officers had held him around the throat.

Holding down a struggling man's head could have caused similar injuries, he said.

The hearing continues.