SACRAMENTO, Calif. — Christmas time used to be Cassandra Quinto-Collins’ favorite time of year, but that all changed three years ago when her son, Angelo Quinto, died in Dec. 2020.

Quinto-Collins shares that her son Angelo suffered a mental health crisis on Dec. 23 of that year, fearing for his health, Angelo’s sister called 911 for help.

However, when officers arrived, Quinto-Collins says they restrained Angelo with their knees, causing him to pass out and be in need of medical attention.

Days later, Angelo was pronounced dead at the hospital.

“It was such a life-changing moment and experience. Me being there and seeing it — I don’t think I’ll ever forget that,” Quinto-Collins said.

The coroner in Contra Costa County determined Angelo died from excited delirium. However, an independent autopsy requested by his family found the cause of Angelo’s death to be positional asphyxia.

According to a report from the Physicians for Human Rights, or PHR, excited delirium is a controversial term used to describe a wide-range of symptoms, including paranoia, distress, agitation and confusion.

It disproportionately shows up in police reports when people — mainly Black and Brown men — die during police interactions.

Notably, it was used as one of the defense arguments during George Floyd’s murder trial. 

The term has been discredited by many medical organizations, such as the American Psychiatric Association and the American Medical Association.

“The concept of excited delirium has caused great harm and we as a medical affiliated association and professional medical associations have a particular duty to make sure that medicine — the name of medicine — is not used to cause harm.” said Dr. Michele Heisler, the medical director for Physicians for Human Rights.

Heisler co-authored the PHR report where she made the case for excited delirium, being a baseless diagnosis that has disproportionately been used as a cause of death for Black and Brown men like George Floyd or Angelo dying from police interactions. 

“Excited delirium has been a convenient and effective way to say, 'No, it wasn’t that this person had a knee on his neck for however many minutes. It was excited delirium,’” Heisler explained. “It has been used as a defense to evade accountability when law enforcement have used excessive violence which may have caused or contributed to death.”

While the pain of losing their son and brother is still palpable, the Quinto-Collins family took action and became strong advocates for banning the term as a cause of death.

Their hard work was rewarded this year as California became the first state to ban the term excited delirium when Gov. Gavin Newsom signed AB 360 into law.

Starting next year, excited delirium will no longer be recognized as a valid medical diagnosis or cause of death. It can no longer be used in police or corner reports.

“This is corporate sponsored terminology to defraud the American public using fraudulent medical science — and I’m really proud of the small role we’ve had in changing that,” said Angelo’s stepfather, Robert Collins.

Collins is referring to the company Axon, which manufactures Tasers used by police departments throughout the country. Axon advocated for excited delirium as a valid medical diagnosis for years.

According to the PHR report, Axon/Taser distributed medical literature, claiming excited delirium was a valid medical diagnosis at several medical and enforcement conferences. 

Heisler says in 2008, Axon funded a medical conference focused on excited delirium. What emerged after that conference was a White Paper report from the American College of Emergency Physicians that supported excited delirium as a medical diagnosis.

“So really the white paper for the last decade — when you look at the court cases seeking to exonerate police officers who had held people in restraint positions, this white paper was the paper that was cited,” Heisler added.

Shortly after AB 360 was signed into law in California, the American College of Emergency Physicians discredited the 2009 white paper that had supported the term. Across the country, that report had been used as the main piece of evidence when supporting excited delirium as a medical diagnosis.

The organization called their 2009 report outdated and emphasized it should not be used by any medical, public health or law enforcement professional.

“I think this legislation does reflect the growing medical consensus that there’s no scientific basis for this concept,” Heisler said.

The California State Sheriff's Association did not take a position on the bill, though CSSA president Sheriff Mike Boudreaux pushes back on excited delirium being used as a cover-up for police-involved deaths.

“If, in fact, someone died at the hands of an officer, the pathologist is going to say so. They’re going to say that they died from blunt force trauma, they’re going to say that they died from asphyxiation. Say, for example, someone’s knee was on the neck and they didn’t come off their neck and they die — they’re not going to be able to cover that up — it’s just not possible,” Boudreaux said.

Though the Tulare County Sheriff is not against doing away with the term, as he says, his main focus is on providing transparency to law enforcement.

“I don’t think it’s a convoluted issue. I think we’re in agreement. I think law enforcement does need to gain the trust of the community through transparency with the use of proper pathological terms through a pathologist that gives the public a true answer,” Boudreaux added.

Heisler praised California for being a leader in banning the controversial diagnosis; she hopes this will set an example for other states to follow.

“It was a tremendous victory for human rights, for health, for accountability. I think it is a crucial step also, in terms of us really re-thinking how we respond to behavioral health crises,” Heisler noted.

The Quinto-Collins family is proud to see California step up on this issue but acknowledge more needs to be done.

“If we really want a just society, we have to look at things like excited delirium and get rid of it and the systems that promote it,” Collins said.

He adds that while many learn about Angelo because of how he died, he’d rather people remember Angelo for how he lived. The 30-year-old was a navy vet who loved the arts, fishing, cooking and, above all, his family.

The Quinto-Collins family sued the city of Antioch and the Contra Costa County Sheriff’s department over Angelo’s death. Both lawsuits are ongoing.

Let Inside the Issues know your thoughts and watch Monday through Friday at 8 and 11 p.m. on Spectrum News 1.