Finding into death of Odisseas Vekiaris

29y · Male·Unascertained causes on a background of agitated delirium state

A 29-year-old man with a 12-year history of mental illness died in police custody during transport to a police station. He had stopped taking his antipsychotic medication (Risperidone 4mg daily) following GP advice to reduce it, without follow-up. On the day of death, he stabbed a member of the public, leading to police arrest involving oleoresin capsicum spray and physical restraint. Ambulance paramedics cleared him for transport to the police station. During the drive, officers noticed positional changes but did not stop to reassess. He was found unresponsive and pulseless upon arrival. Toxicology showed methamphetamine, cannabis, and medication metabolites. Clinical lessons: (1) GP Dr V. failed to follow up antipsychotic medication reduction plan and was unaware of illicit drug use, which should have prompted psychiatry consultation; (2) police monitoring of handcuffed prisoner in the divisional van was inadequate—officers could only see legs on camera, not torso or face; when position changed, officers should have stopped to check welfare rather than passively accepting monitoring limitations; (3) no automated external defibrillator was readily available or known to staff at the police station initially. The coroner rejected 'Excited Delirium' as an unrecognised medical diagnosis in Australia.