New forensic commission chair a proponent of controversial 'excited delirium syndrome'

Governor Perry continued his musical chairs routine at the Texas Forensic Science Commission, giving the group its fourth chairman in the last three years, reported the Austin Statesman on Tuesday:

Dr. Vincent Di Maio, former chief medical examiner for Bexar County, was named chairman of the Texas Forensic Science Commission today by Gov. Rick Perry.

Di Maio replaces Dr. Nizam Peerwani, chief medical examiner for Tarrant County, as chairman of the agency that investigates allegations of misconduct or negligence involving forensic labs and facilities. Peerwani will remain on the commission, said general counsel Lynn Robitaille.

The governor appoints four members of the nine-member commission and names the chairman. Di Maio, a private forensic pathology consultant, joined the commission in October.

Who is the new chairman? In an interview with Dr. Di Maio on PBS Frontline after his 2006 retirement, he told PBS he favors separating medical examiners administratively from law enforcement. Of course, one of the ironies of his appointment, and Peerwani's, is that medical examiners and autopsies are specifically carved out of the Commission's jurisdiction as its governing statute is currently written, but at least his comments show an appreciation of  the need for high scientific standards in forensic settings. He also critiqued the professionalism of some law-enforcement death investigations: "Medical-legal investigation is mediocre, and the reason is that there are large areas of the country where medical-legal investigation is very poor and doesn't even involve physicians."

That said, Dr. Di Maio may be best known nationally for promoting the notion of "excited delirium syndrome," a diagnosis that hasn't been universally accepted by the medical community but is popular among police and medical examiners. (I first heard the phrase used in response to Taser deaths when I was Police Accountability Project Director for the ACLU of Texas.) The opening sentence of his seminal book on the topic, says Amazon.com, reads "Excited delirium syndrome involves the sudden death of an individual, during or following an episode of excited delirium, in which an autopsy fails to reveal evidence of sufficient trauma or natural disease to explain the death." In other words, it's a default when there's no actual scientific evidence to support any other explanation or sometimes, in the case of officer-involved deaths, when the evidence points to politically unpalatable possibilities. Or at least that's how it's been sometimes used in the field. Di Maio believes that "Of all in-custody deaths [not involving firearms], excited delirium syndrome is the most common form."

According to the Dallas News, "The American Medical Association does not recognize excited delirium as a condition, though the National Association of Medical Examiners does." As Grits wrote on the subject a couple of years ago, "The term always seemed bogus to me: I know of no other medical condition that occurs only while in custody of law enforcement."

Dr. Di Maio also received national notice as a defense expert in the first Phil Spector murder trial and with occasional speculation about forensic evidence from the JFK assassination. He was on the team that autopsied Lee Harvey Oswald's body after its 1981 exhumation and his book on Gunshot Wounds is cited by both sides debating the "single bullet theory" of the assassination, though he has come down on the side of the official story.

The new chairman has a connection to an arson-related complaint that's no longer pending at the FSC but which was never resolved after the Attorney General told them they couldn't hear cases from prior to 2005. Di Maio ran the Bexar medical examiners office when Sonia Cacy was convicted of arson based on allegedly flawed forensics, and has stood by his lab workers despite their apparent incorrect interpretation of gas chromatog­raphy-mass spectrome­try tests.

Dr. Peerwani, the Tarrant County medical examiner who Di Maio replaces as chair, will remain on the commission, which next meets two weeks from now in Austin, but it remains to be seen if this change in leadership will create similar drama to John Bradley's tumultuous, ill-fated chairmanship. They've got a full plate and there's little doubt the quality and effectiveness of leadership will influence what if anything the FSC can accomplish. The process was finally moving forward under Peerwani and Grits certainly hopes this change doesn't disrupt it.