Criminal – "Excited Delirium" (March 6, 2026)
Podcast by Phoebe Judge | Vox Media Podcast Network
Episode Overview
This episode examines the death of Angelo Quinto in police custody and the controversial diagnosis of "excited delirium," which is often cited in such deaths. Using the Quinto Collins family's harrowing story as a starting point, host Phoebe Judge, the family, attorneys, and experts explore the fraught history, racial undertones, and lack of medical legitimacy surrounding the term "excited delirium." The episode also documents the family's quest for answers, legal developments, and recent reforms prompted by cases like Angelo’s.
Key Discussion Points & Insights
1. The Night of Angelo Quinto's Death
- Setting: December 23, 2020, Antioch, California.
- Family context: Angelo (30s), Bella (18), and mother Cassandra, newly moved into their home. Angelo had a history of anxiety and “episodes” following a head injury.
- That night, Angelo’s anxiety escalates. He becomes increasingly paranoid, causing distress in the family.
- Bella: "He required a patience that spanned eight hours sometimes." (05:03)
- Call to police: Bella dials 911 after Angelo restrains family members. She reports he’s acting aggressive and had tried to use a hammer.
- Police arrive, restrain Angelo face-down, handcuffing him. Family claim police put knees on Angelo’s neck for several minutes; police say only “brief” restraint (08:49). Angelo pleads, "Please don't kill me" (09:37), then becomes unresponsive.
- Angelo is transported to hospital, where he is declared mostly brain-dead; he dies on December 26.
Memorable Moment
- Cassandra: "As soon as they flipped him and they saw blood coming out from his mouth... It became very quiet." (11:48)
2. Aftermath and Quest for Answers
- The family experiences opaque communications with police and hospital. Hospital staff reportedly barred by police from sharing details with the family (18:09).
- Family commissions an independent autopsy for $18,000, which concludes Angelo died of asphyxiation.
- The official county autopsy provides a different controversial diagnosis: "excited delirium syndrome." The family’s reaction: shock and deep skepticism. (32:09)
Notable Quote
- Bella (on hearing the term): "I thought that sounds really stupid. Does not sound very sophisticated at all." (32:09)
3. Excited Delirium: Origins and Controversy
Historical Origins
- Coined in 1980s amid US cocaine epidemic by forensic pathologist Dr. Charles Wetli.
- Originally used to explain sudden deaths of people found with cocaine in their systems, often involving police restraint.
- Wetli theorized, without clear evidence, that the victims died from their “excited delirium” rather than violence or restraint.
- The term is later discredited in a notorious Miami serial killer case — where Wetli wrongly classified strangled, predominantly Black female victims as "excited delirium" deaths. (29:04–30:35)
- Renu Ryesum (Reporter): "[Wetli] said that Black women were more prone to dying this way... It was the combination of cocaine and sex that led to their death." (28:11)
Institutionalization of the Term
- Popularized in police and medical contexts despite lack of diagnostic criteria or biological markers (25:13–25:48).
- Promoted via a 2009 "white paper" by American College of Emergency Physicians, some of whom had links to Taser manufacturer Axon (46:22–48:06).
- Used to attribute deaths in police custody to the victims, rather than to the methods of restraint.
Training Materials and Racial Stereotyping
- Police materials consistently describe victims as having "superhuman strength," tolerance to pain, and non-compliance, reinforcing racial stereotypes (50:22–53:52).
- Arjun Baiju (Doctor, on the narrative): "In that description are all these very loaded terms with all this baggage, like monster and animal-like behavior... that plays on racial stereotypes because overwhelmingly, these are Black men." (52:24)
- Materials even include "I can’t breathe" as a sign of excited delirium, a phrase widely recognized from the George Floyd case (51:20).
Medical Rejection and Legal Shifts
- Professional organizations like the AMA, APA, and WHO do not recognize "excited delirium."
- 2021–2023: White paper retracted; increasing legal and medical rejection of the term.
- Renu: "...the American College of Emergency Physicians retracted that 2009 white paper, and they said, we got it wrong." (55:45)
- 2023: California becomes first state to ban use of the term in official contexts (56:26).
Memorable Quote
- Ben Nissenbaum (attorney): "If I told you it [excited delirium] meant nothing, then I think that would be accurate." (21:32)
4. The Coroner’s Inquest and Legal Outcome
- Coroner’s inquest in August 2021: Official pathologist blames "excited delirium syndrome" for Angelo's death, referencing mild stimulant drugs rather than illicit substances. Crowd reacts with disbelief (38:25).
- Jurors, told only to decide cause and manner—not responsibility — rule Angelo’s death an accident. (41:42)
- In later depositions, pathologist admits restraint played a role and, had certain blood markers (petechial hemorrhages) been found earlier, asphyxiation would have been part of diagnosis (42:23–43:04).
Memorable Moment
- Ben Nissenbaum: “Even if you believed in the pseudoscience of excited delirium... to blame it on tobacco and cigarettes and this other thing that prevented you from sleeping, which had never had any deaths, meant that they had the flimsiest case..." (39:09)
5. Reform, Family Impact, and Moving Forward
- 2021–2024: California bans the term; restraining practices causing asphyxiation are outlawed.
- Settlement: Antioch City settles with Quinto Collins family for $7.5 million (57:46).
- Reform: City launches non-police crisis response team—the "Angelo Quinto Community Response Team"—to handle mental health calls.
- Bella: "Now there’s somebody else to call. It’s named after Angelo." (58:40)
- The family still brings out Angelo’s Christmas gifts every year in his memory (57:46).
- The episode ends with a reflection on the family’s loss and ongoing efforts for justice and systemic change.
Notable Quotes & Timestamps
- “Please don’t kill me. Please don’t kill me.” – Angelo Quinto, during police restraint (09:37)
- “As soon as they flipped him and they saw blood coming out from his mouth...It became very quiet.” – Cassandra Quinto Collins (11:48)
- “If I told you [excited delirium] meant nothing, then I think that would be accurate.” – Ben Nissenbaum, attorney (21:32)
- “[Wetli] said that Black women were more prone to dying this way...It was the combination of cocaine and sex that led to their death.” – Renu Ryesum (28:11)
- “I thought that sounds really stupid. Does not sound very sophisticated at all.” – Bella Quinto Collins, on hearing about ‘excited delirium’ (32:09)
- “Now there’s somebody else to call. It’s named after Angelo.” – Bella Quinto Collins (58:40)
Timestamps for Major Segments
- 01:45–12:50: The night of the incident and family’s experience with police response
- 13:34–18:46: Aftermath, hospital process, lack of transparency
- 20:12–22:00: Family meets with attorneys, introduction to “excited delirium”
- 25:13–32:00: Reporting on history, origins, and misuse of “excited delirium”
- 35:53–43:04: Coroner’s inquest, autopsies, legal challenges
- 46:00–54:00: Entrenchment of the term in policing, racialized stereotypes, and medical backlash
- 55:09–58:40: National reforms and impact, legacy and remembrance
Episode Tone & Style
The episode is empathetic, somber, and investigative. It weaves the family’s personal loss together with critical journalistic inquiry and legal critique, grounding systemic analysis in intimate human experience.
For Further Listening or Action
- California’s ban on “excited delirium” and similar diagnostic terms marks a major step forward in policing and public health reform.
- The Angelo Quinto Community Response Team serves as a local model for non-police mental health crisis intervention.
This summary reflects sensitive material including police violence and contested causes of death. Discretion advised.