Police arrest-related death: about four cases and review of the literature.

Unexpected deaths may occur in individuals during a police arrest. These individuals usually have had both physical and emotional exertion, associated or not with agitation and restraint by police. Further investigations in these cases often show an impregnation with drugs. Autopsy findings may raise medico-legal problems in these cases.We report four cases of deaths during police arrest in which multiple factors contributed to the death. In the first two cases, there was a combination of emotional and physical stress due to police pursuit and, the presence of mechanical asphyxia. We noticed the presence of cannabis and amphetamine; however, we couldn't relate the death to a drug intoxication. In the third case, the deceased lost consciousness when he was arrested by the police with no link to the intervention of law enforcement authorities. Death in this case was due to sepsis complicating endocarditis. The fourth case reports a rare cause of asphyxia that can occur in a police arrest related to a drug package. Death was due to upper airway obstruction in this case.The forensic pathologist should take into consideration every factor when explaining these deaths. Thorough autopsy and investigations are critical to understand the cause and circumstances of death.