St. Louis police investigating death of 29-year-old transported from train station area to hospital

What is known about the incident

A death investigation is underway in St. Louis after a 29-year-old man died two days after police transported him from the area around the city’s downtown transportation hub to a hospital, authorities said.

The man was identified by police as Mark Smith, 29. Officers responded Thursday, Feb. 12, 2026, to a reported disturbance in the 430 block of South 15th Street, described by police as near the bus station by Enterprise Center. Police said Smith was already being held by security when officers arrived shortly after 2:06 p.m.

Officers described Smith as combative, acting erratically and appearing delusional, and yelling incoherently. Police said officers believed he needed medical attention and requested an ambulance at about 2:11 p.m. Police said they were told no ambulances were available, delaying an EMS response.

Why officers transported him in a police van

Police said that because of Smith’s condition and the delay in EMS availability, officers transported him to a hospital in the rear of a marked department transport van.

During the ride, police said Smith continued to behave erratically and repeatedly rammed his head into the metal screen inside the vehicle. Police said that when officers arrived at the hospital, Smith was unconscious and hospital staff told police he was in critical condition.

Police said Smith died Saturday, Feb. 14, 2026.

Investigation and key questions

The St. Louis Metropolitan Police Department said its Force Investigation Unit is conducting the investigation. Such investigations generally examine officer actions, decision-making, and any use of force, as well as video, witness statements, dispatch logs, and medical findings.

Several factual questions are central to determining the sequence of events and accountability:

• What prompted security to detain Smith and what force, if any, was used before police arrived.
• Whether officers attempted de-escalation or other interventions before transport.
• What options were available while waiting for EMS and how the “no ambulances available” information was communicated and documented.
• What monitoring occurred during transport and whether any medical distress was recognized before arrival.
• What hospital clinicians documented upon intake, including injuries, vital signs, and any toxicology or behavioral health assessment.
• What the medical examiner determines as the cause and manner of death.

Police said an ambulance was requested shortly after 2:11 p.m. but none was available, and officers transported Smith to a hospital themselves.

What information has not been released

Police have not publicly released the name of the hospital, whether body-worn camera or facility surveillance video exists or will be released, or whether Smith was restrained during transport. The department has also not released details about Smith’s medical condition before the disturbance call or the nature and extent of any injuries identified at the hospital.

The investigation remains ongoing.