The pathologist must assess several issues, including the following:
• Contribution of drugs (both licit and illicit), including drug and alcohol withdrawal
• Contribution of preexisting natural disease processes, both physical and psychiatric; family history may be relevant
• Contribution of excited delirium or related disorders
• Precise details of the restraint: timing, body position, areas of body contacted, etc.
• Timing and description of circumstances preceding collapse or cardiorespiratory arrest
• Causation of any injuries identified at autopsy (i.e., consequent to the violent behavior prior to or during restraint)
• Contribution of any injuries (particularly to the head) to the outcome
• Identification of occult injuries
• Identification of features potentially attributable to resuscitation endeavors (e.g., petechiae or laryngeal bruising) or agonal events (e.g., aspiration of vomitus)
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