Sheldon Haleck, a 38-year-old former Hawaii Air National Guardsman, died four years ago following a chaotic encounter with police officers who pepper-sprayed him about a dozen times and tried three times to shock him with a Taser, all within about five minutes. After falling to the ground and being cuffed by officers on South King Street, Haleck became unresponsive and stopped breathing. He never regained consciousness and died the next morning at The Queen’s Medical Center.

But it wasn’t the actions of the police that contributed to or caused Haleck’s death, according to an expert witness called by city attorneys who are defending three officers accused of using excessive force in a lawsuit brought by Haleck’s family. Rather, Haleck died from excited delirium syndrome induced by methamphetamine, Stacey Hail, an emergency medicine physician from Dallas, told jurors Thursday.

The controversial syndrome, which some medical doctors doubt exists, has been cited in dozens of deaths across the country involving struggles with law enforcement, and some argue it’s been used to cover up the use of excessive force.

Attorneys for the Haleck family sought to cast doubt on the legitimacy of the diagnosis as they cross- examined Hail, referencing opposing scientific and medical views and noting that excited delirium isn’t recognized by many medical associations.

Hail didn’t waiver in her assessment. “There absolutely is such a thing,” she said.

Hail said she ruled out any prior medical conditions, the pepper spray and Taser as contributing to Haleck’s death. Whether the Taser actually worked on Haleck is a matter of dispute in the trial.

Hail said Haleck exhibited many of the signs associated with excited delirium. He wasn’t responding to officers’ commands, exhibited fear and paranoia, resisted being detained physically, exhibited superhuman strength, was breathing fast and seemed impervious to pain, among other signs. Haleck also had a history of mental illness and methamphetamine abuse, which are contributing factors, she said.

Haleck’s autopsy report, however, attributes Haleck’s death to a physical altercation with police while being acutely intoxicated with methamphetamine. The report classifies Haleck’s death as a homicide, signifying that the actions of officers contributed to his death. The term is used in the medical sense and does not imply criminal intent to harm Haleck or mean that the officers didn’t follow protocol.

The autopsy report does note that symptoms exhibited by Haleck, including delirium, agitation and psychosis following drug use, have been described in medical and forensic pathology literature as “excited delirium syndrome.” But the report notes that there are “currently no well established diagnostic criteria for this syndrome and the terminology represents a heterogeneous constellation of medical findings.”

Asked by an attorney for the plaintiffs whether the autopsy concluded that Haleck died of excited delirium, Hail said, “It’s close enough.”