Warning: this article contains details that may disturb some readers.
A video showing deputies laughing as a mentally ill man died after being restrained for nearly two days has been described as "extremely painful to watch" by a law enforcement representative.
The footage obtained by The Tribune shows Andrew Holland, a schizophrenic prisoner at San Luis Obispo County Jail in California, collapsed on the ground following a blood clot as medical staff attempt to revive him.
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At the same time, however, an officer can be seen giggling with a colleague in the foreground as Mr Holland lay motionless just metres from them.
In the 46 hours preceding Mr Holland's death, he had been restrained in a chair and forced to sit in his own faeces and urine. Use of the chair has now been prohibited at the jail.
Mr Holland's family has since been paid US$5 million after it was found that his sitting in the same position for a lengthy period of time was likely to have caused his blood to clot, ultimately killing him.
However the footage of an officer laughing while he died is a new development in the saga, and County Administrative Officer Wade Horton said the video was "extremely painful to watch".
"Although we can't bring Andrew back, our county has made and continues to make changes in response to this terrible event," he told The Tribune.
It's not clear whether the deputies in the footage had been disciplined over the incident.
Mr Holland's family has formed an advocacy group for mentally unwell prisoners with some of the money they were awarded.