(KRON) — A controversial medical term was used by Contra Costa County investigators to explain why a man died during an encounter with police officers.

Ivan Gutzalenko, 47, of San Francisco, was experiencing “excited delirium,” and was under the influence of methamphetamine, when he died in the custody of Richmond Police Department officers, according to an investigation report released by the District Attorney’s Office Tuesday.

“In the case of Ivan Gutzalenko, the Contra Costa District Attorney’s legal analysis determined
that the officers’ use of force on March 10th, 2021, was reasonable given the circumstances,” the DA’s Office wrote.

District Attorney Diana Becton said, “Even in complicated cases like this one, it’s important for the public to know the details of an investigation and how my team and I reached our legal decision.”

The analysis also found insufficient evidence to prove that the force used by the officers caused Gutzalenko’s death.

On March 10, 2021, Gutzalenko was reported to police by alarmed business owners. The man was bleeding, making paranoid statements, and appeared to be intoxicated as he stumbled in and out of multiple stores. When officers found the man, they called for an ambulance and told Gutzalenko that he was being placed on an involuntary 72-hour psychiatric hold.

Gutzalenko told the officers that he wanted to leave, but the officers restrained him with handcuffs. The police officers believed that the man was in crisis, and possibly a danger to himself or others, according to the report.

While he was being restrained by officers, Gutzalenko said he was struggling to breathe. A witness told investigators that he heard the man say, “I can’t breathe,” three times while an officer held him facedown on the ground.

When Gutzalenko was lifted onto a gurney in handcuffs, a police officer said, “Hey, he’s blue,” the report states. Paramedics at the scene said, “Get the cuffs off of him,” and began CPR.

A coroner listed Gutzalenko’s cause of death as “prone restraint asphyxia and cardiac arrest while under the influence of methamphetamine.” The report quotes testimony from forensic pathologist Dr. Arnold Josselson, who says Gutzalenko experienced “excited delirium.”

Dr. Josselson performed an autopsy on March 11, 2021. He testified that “excited delirium is a condition that can occur when an individual is under the influence of methamphetamine and enters a highly agitated state due to drug use.” People in this state will “act out irrationally and get into struggles with first responders.”

During a struggle with police, a person experiencing “excited delirium” will fight back and eventually struggle to breathe, especially if they are forced into a facedown position, Josselson testified. This can cause the person to stop breathing, Josselson said.

The term “excited delirium” has been branded as unscientific by organizations including Physicians for Human Rights. The American Medical Association said in 2021, “Current evidence does not support ‘excited delirium’ as an official diagnosis, and opposes its use until a clear set of diagnostic criteria has been established.”

Notably, the term was used by investigators for the death of Angelo Quinto, a young Navy veteran who died after a struggle with Antioch officers in 2020. The Contra Costa District Attorney’s Office declined to file charges against Antioch police, citing that Quinto’s death was caused by “excited delirium.” 

Earlier this week, Antioch officials created the city’s first mental health crisis response team and named it after Quinto. Antioch City Council member Monica Wilson said, “This will ensure that a mental health breakdown is treated as that: a mental health breakdown, not a crime.”