Introduction: Cases of sudden and unexpected deaths of criminal suspects in presence of police always have special forensic medical approach. Often, such deaths are preceded by a state of extreme psychophysical activity (excitated delirium) of suspects, when they may injure themselves. Police attempts to prevent that can inevitably lead to struggle. Immediately after the struggle ends (but also during a struggle), they abruptly become unresponsive, and develop cardiopulmonary arrest and death. Presence of drugs significantly intensifies the harmful effect of such state and leads to death.
Case outline: We present a case of death of a young man brought into custody during police interrogation. Autopsy showed injuries and presence of MDMA, with suspicion that death was preceded by the state of excitated delirium. After thorough analysis of the case (complete autopsy, toxicological screening, microscopic survey of all organs, circumstances of death etc.), our conclusion is that death was related to drug consumption--ectasy. Concentration ofectasy found in kidneys is the minimum concentration possible that could lead to heart malfunction and death.
Conclusion: Our opinion is that there are no medical data by which we could determine if, and in what dosage, undesirable effects of ectasy were enhanced by the circumstances of the case.