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Defense expert believes Cedar Rapids teen’s death resulted from ‘manic delirium’
Linn jury deliberates fate of 3 brothers accused in the death
Feb. 26, 2026 6:35 pm
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CEDAR RAPIDS — An expert witness, testifying Thursday on behalf of three brothers accused of tying down their younger brother to a mattress until he died in 2024, disputed a state medical examiner’s cause-of-death finding.
Dr. Bradley Randall, a South Dakota forensic pathologist consultant, said he believed Ezekiel Baseme, 18, of Cedar Rapids, was exhibiting signs and symptoms of “manic delirium” in the days leading up to his death on Nov. 4 or Nov. 5, 2024.
He said the condition’s symptoms include hyperactivity, aggressive behavior, homicidal and suicidal thoughts, delusional thoughts and seeing things that are not real.
Research has shown, he said, that the condition many years ago -- before the development of antipsychotic drugs -- led to sudden death Once patients started being prescribed those drugs, the deaths “dramatically” decreased, he said.
Randall, the second and last expert witness for the defense, said he reviewed the autopsy, police reports and other information about Baseme’s death.
He said he believed Ezekiel’s condition resulted in sudden death.
The defense lawyers for each brother charged in Ezekiel’s death — Christian, 30, Pierre, 27, and Azane, 24, Baseme, all of Cedar Rapids — rested after Randall testified.
Closing arguments followed the testimony, and the jury went into deliberations for a short time before going home about 5 p.m. They will resume deliberations at 9 a.m. Friday.
Each of the brothers is charged with involuntary manslaughter, assault causing serious injury and false imprisonment, accused of unintentionally causing their brother’s death. Their trial started last week in Linn County District Court.
Dr. Rory Deol, an associate state medical examiner, testified Tuesday that he had concluded Ezekiel died from “complications of probable starvation and dehydration in a setting of physical restraint.” The manner of death was homicide.
Randall in his testimony said he agreed with Deol’s autopsy findings but had concerns about his conclusions. Starvation occurs over several days, and there are other explanations for the elevated acetone levels Deol cited. Acetone is a marker for not having the right diet. The levels can increase if someone is dieting, he said.
Death from starvation and dehydration happens slowly over time, Randall said.
Randall said manic delirium — a natural disease process — started the chain of events resulting in the cause of death.
Randall said he concluded the manner of death was natural causes, and that his “degree of certainty was well over 90 percent.” Randall said he didn’t see anything in the records that would rule out manic delirium as the cause of death.
Credentials
On cross-examination, Randall said he graduated from the University of Iowa in 1971. According to his resume, he also graduated from UI College of Medicine in 1975.
Randall said he last performed an autopsy in 2010. He was a deputy Iowa state medical examiner from 1985-87; a county coroner in South Dakota from 1989-2010; and South Dakota Special Death Investigator from 1990-2010, according to his resume.
Assistant Linn County Attorney Jennifer Erger asked Randall about his self-employment after retirement.
Randall said he owns and operates Dakota Forensic Consulting and is hired by attorneys in civil and criminal cases to provide opinions regarding forensic pathology. He doesn’t typically perform investigations in the cases. He bases his opinions on the information he is provided.
In this case, he didn’t see Ezekiel’s body or perform an autopsy and that most of his information about Ezekiel came from the defendants. Randall said he didn’t have any information about Ezekiel’s food intake leading up to his death.
Randall said anyone could have missed the manic delirium conclusion as the cause of death because it rarely happens today because antipsychotic drugs are available.
Closing arguments
In the prosecutor’s closing statement, Erger said Ezekiel Baseme was confined and restrained by ropes, straps and twine as “he fought, he screamed and eventually he died” in November 2024.
The 18-year-old couldn’t recount what had happened to him, but the jury heard during trial about how he was tied to a mattress and then saw Christian Baseme show police how the brothers had restrained Ezekiel, Erger said.
They told police they had restrained Ezekiel because they didn’t want him to run away. He was an adult, and they restricted his free will. Ezekiel was fighting and attempting to break free, doing so three times, but the brothers tied him up again.
The brothers said they didn’t report their problems with Ezekiel because they believed they could it handle themselves, with each noting they’d had some training in their jobs as care providers for people with mental health and physical issues.
“It was three on one,” Erger said. “Force was not justified. Their actions were not justified. They had no authority to confine him to the bed until he died.”
Erger said the prosecution has proved each of the elements of the charges to show each brother recklessly committed the crime of assault or false imprisonment when they unintentionally caused the death of Ezekiel.
Defense closings
Doug Davis, Christian Baseme’s lawyer, argued the evidence presented by the prosecution doesn’t provide jurors with enough to return guilty verdicts.
The brothers tied down Ezekiel to protect him and their family. They made a conscious choice to restrain him but it was at the direction of their father. They didn’t intend to restrain him to the point of harming him, he said.
Ezekiel had started acting erratically and would run away from home. There was testimony that he went into a neighbor’s home and the brothers heard someone there talking about getting a gun to keep him away.
His behavior then escalated, and he was seeing snakes and had a confrontation with Christian and was fighting with his brothers, Davis said. They feared for his safety.
His behavior, he said, seemed consistent with Randall’s opinion of Ezekiel being in manic delirium.
Davis said the brothers’ father, Joseph Mbalama, was the controlling factor in this incident. They consulted him on what to do. They had certain religious beliefs. Mbalama testified he thought Ezekiel was possessed by a demon and believed he could pray and bring him back to life.
The family didn’t delay calling police because they were trying to cover it up, Davis said. They did it because they couldn’t accept Ezekiel’s death and thought praying a few days would bring him back.
Mark Meyer, the lawyer for Pierre Baseme, argued in his closing there was no evidence to show the brothers acted with specific intent to cause pain or harm or do something offensive to Ezekiel. Pierre only tried to help his brother.
Jeremy Elges, the lawyer for Azane Baseme, argued in his closing that a trial is a test of the prosecution’s case and that jurors have to decide if they passed that test.
He told the jury the prosecution must rule out every reasonable doubt in order to prove their case. Any lack of evidence “counts” as reasonable doubt.
Elges also reminded the jurors the defense doesn’t have to prove the case — that’s the prosecution’s job.
Assistant County Attorney Erger, in her rebuttal, said a father telling his sons to do something is not a defense. Religion is not a defense. It doesn’t justify tying up someone because one believes the person has been possessed by a demon.
Trish Mehaffey covers state and federal courts for The Gazette
Comments: (319) 398-8318; trish.mehaffey@thegazette.com
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