A Chilliwack man died accidentally two years ago due to brain damage caused by the lack of oxygen and due to the rapid breakdown of muscle tissue that led to massive organ failure, BC Coroner Vince Stancato ruled late Thursday.

He also ruled "acute intoxication" with the drug commonly known as Ecstasy and a condition known as Excited Delirium with physical restraint were "antecedent" causes of the death of Robert Knipstrom.

Knipstrom, 36, died five days after a violent confrontation with Chilliwack RCMP officers in which he was tasered at least five times, pepper-sprayed and hit with a metal baton on Nov. 19, 2007.

The use of tasers, in light of the death of Polish immigrant Robert Dziekanski a month earlier at Vancouver International Airport in which tasers were also used by RCMP officers, raised immediate questions about Knipstrom's death.

But it now appear tasers had little, if anything, to do with Knipstrom's death.

He was in the throes of a drug-induced "Excited Delirium," according to testimony heard at the inquest, which brings about a psychotic state characterized by extra-ordinary strength and resistance to pain.

These findings were made in earlier autopsy and toxicology reports, but were not released publicly until the coroner's inquest was called two years later, on Nov. 16. The inquest was held in Burnaby.

A coroner's jury of three women and two men has now made eight recommendations that focus on Excited Delirium and the physical restraint of those who suffer from it.

The jury recommends B.C. firefighters, paramedics, and police officers get "regular re-orientation" on Excited Delirium, and RCMP police officers in the province should request paramedics with Advanced Life Support training when they expect to arrest a person with Excited Delirium.

The jury is also recommending the BC Ambulance Service "review or create a standard operating procedure with respect to Excited Delirium."

The jury said the procedure should include a crew member notifying the receiving hospital that a suspected Excited Delirium case is on the way, and to have appropriate medical resources assigned to the patient.

The jury also recommends the ambulance service review its policy and guidelines on the positioning of restrained patients to ensure an "internally consistent and clear policy" is developed.

During the inquest, paramedics, police and fire officials testified that after Knipstrom was subdued, he was handcuffed with his hands behind his back and allowed to remain lying on his stomach, because he fought off all attempts to turn him over.

He was allowed to remain in that position in the hospital's emergency ward until he suddenly went into cardiac arrest at about 4:28 p.m., about 27 minutes after his arrival.

A forensic pathologist said leaving Knipstrom in that prone position, perhaps making it harder to breathe in addition to the oxygen deprivation caused by the large amount of Ecstasy he had taken, "possibly" contributed to the cardiac arrest.

But he also agreed that Knipstrom could have gone into cardiac arrest, even without the physical restraint.

"That's a possibility," he said.