Sudden Unexpected Death in Custody (SUDIC)

The Sudic Investigative Checklist

Any death occurring in police custody results in an intense investigation into the actions of the police, their judgment, and whether their use of force was appropriate [1]. In cases of police shooting or in judicial executions, the cause of death is obvious and the investigation focuses on the judgment of the police and whether proper procedures were followed. However, when death occurs suddenly and unexpectedly, speculation becomes rampant and the intensity of the investigation increases. Perhaps in no other circumstance is the failed logic of “post hoc ergo propter hoc” (“because of this, therefore this”) invoked: the death occurred in police custody, therefore the police must have caused the death. Although the assumption is not valid, it must be acknowledged that the actions of the police may, at times, result in the death of a subject. It is therefore the task of the forensic investigator (viz. Medical Examiner, Coroner, and their investigative agents) to both establish the cause of death to a degree of reasonable medical certainty, and to evaluate the contributory role of the police actions, if any, to the death of that person. Furthermore, the forensic investigator must evaluate whether the application of what is thought to be a nonlethal force (e.g. pepper spray, lateral vascular neck restraint, ligature restraint, CEW, etc.) may have contributed to the death, or perhaps even caused the death. Strict objectivity and attention to detail are paramount since the conclusions will be scrutinized by the public, by the news media, and in criminal, civil and administrative proceedings.

Unfortunately, the sudden unexpected death in police custody may spark political interests that may totally ignore the objectivity of the investigation and the scientific support to attain a “politically correct” outcome [2]. When this occurs, jobs may be lost, careers ruined, and the civil and criminal legal processes circumvented and frustrated. This becomes the unstated occupational hazard of both law enforcement personnel and forensic investigators alike. In some extreme cases this has resulted in very questionable criminal prosecutions of law enforcement officers [3].


Medical Examiner Vitreous Humor Automatic External Defibrillator Terminal Event Sudden Unexpected Death 
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  1. 1.
    Wetli, C.V. and Natarajan, G.A.: Death in Custody, United States of America. In Encyclopedia of Forensic and Legal Medicine, Vol. 2, pp. 65–73, Payne-James, Byard, Corey and Henderson (eds.), Elsevier, Glasgow, 2005 (ISBN: 0-12-547970-0 {set}).Google Scholar
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    Scheinin, L. and Wetli, C.V.: Sudden Death in Sickle Cell Trait Medicolegal Considerations and Implications. Amer J Forensic Med and Pathol, in press .Google Scholar
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    Armon, R.: 5 Summit Deputies Indicted in Jail Death. Akron Beacon Journal. Akron, Ohio, 2007.Google Scholar
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    Natarajan, G., M.D., and Fonseca, C., M.D. “Beyond Nose Jobs and Face Lifts: An Illustrated Technique of Facial Dissection”. ASCP Check Sample, Forensic Pathology, Volume 39, Number 8, 1998, ISSN-1056-5922.American Society of Clinical Pathologists.Google Scholar
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    Staley, J.K., Hearn, W.L., Ruttenber, A.J., Wetli, C.V., and Mash, D.C.: High Affinity Cocaine Recognition Sites on the Dopamine Transporter are Elevated in Fatal Cocaine Overdose Victims. J. Pharm. and Exptl. Therapeutics 271:1678–1685, 1994.Google Scholar
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    Pinckard, J.K., Wetli, C.V., and Graham, M.A.: National Association of Medical Examiner Position Paper on the Medical Examiner Release of Organs and Tissues for Transplantation. Amer J Forensic Med and Pathol 28(3):202–207, 2007.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  1. 1.Chief Medical Examiner and Director of Forensic SciencesClinical Professor of Pathology, SUNY at Stony Brook (retired)NYSuffolk

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