The Independent Source of Criminal Justice Defensive Tactics Information
by Sgt. Jeff Martin
San Jose Police Department
San Jose, CA
The Problem
During the past few years, “Sudden in custody death syndrome” has become an incredible thorn in the side of working law enforcement. While “Positional As- phyxiation” is frequently identified as a primary cause, and therefore, easily blamed on police by plaintiff’'s attorneys and the media, the other underlying causes and contributing factors frequently go unidentified.
As a result, pathologists, defensive tactics trainers and me manufacturers of restraint devices have all been telling us, “Don’'t hog-tie violent subjects.” However, little has been offered as a definitive solution to the problem of immobilizing those incredibly violent persons we frequently encounter. One trainer in my area otters only that the ankles of psychotic, violent subjects be tied with a cord, and that cord be anchored by placing it outside of a patrol car door.* Such statements reflect not only how out of touch one is as to what it actually takes to immobilize the ultraviolent, but also a lack of understandingthat such persons may be at immediate medical risk.
This reference is not to be confused
with the “Violent Prisoner Restraining Device” introduced by Sgt. Maryann Foxwell of the Maryland Stale Police in the April. 1996 issue of ihe DTN.
The current solutions offer only a slight modification in how such subjects are immobilized without any significant improvement in equipment. Instead of the traditional “hog-lying”, which constitutes placing the subject face down and connecting a cord from the subject’'s ankles to the handcuffs, it is now commonly recommended that a second cord be secured around the subject’'s waist. The cord from the ankles is then connected to the waist cord. This does not arch the back thereby relieving the pressure on the chest cavity, allowing for easier breathing. It is also much less injurious to the suspect’'s wrists, and until now, has been the only practical method of immobilizing the subject’'s legs.
The other common recommendations include not to apply weight or pressure to the subject’'s torso which could inhibit breathing: place the subject on his or her side and have an additional officer ride in the patrol car with the sole responsibility of monitoring his condition, i.e., making sure the subject continues breathing.
Complete Identification of Causes
As previously stated, positional asphyxiation is the factor most fre quently cited by law enforcement critics. The American Civil Liberties Union has unsuccessfully tried to place blame on O.C. Spray, but the objective literature has ruled this out.
What must be understood by all, especially the public, is that no matter what benevolent, reasonable and preventive actions law enforcement personnel may take, the ultra-violent may still die. In order to understand why, here is a brief review of the four, currently identified conditions.
Positional Asphyxiation:
This occurs when the body is in a position, or oilier force is exerted which makes breathing difficult. The subject literally suffocates. The likelihood of occurrence increases when combined with pre-existing physical factors, e.g.. over-weight and/or excited delirium. Cocaine Abuse and Toxicity: Simply put, the subject overdoses. This may occur due to “increased sensitivity” to the drug(s), and/or the potentiating effects of alcohol used in combination.
Cocaine-Induced Excited Delirium: Most commonly characterized by violence, paranoia, hallucinations, shouting, superhuman strength and removal of clothing due to hyperthermia. This condition, with emphasis on hyperthermia is frequently linked with sudden death.
Neuroleptic Malignant Syndrome: Resulting in similar behavior asdrug-induccd excited delirium, it is generally found in psychiatric patients who may or may not be on psychiatric medication. It is thought that the fear, stress and anxiety generated by the subject’'s mental illness is simply too much for the heart to take, resulting in heart failure.
It should be noted that other substances, including methainphelamines, PCP, LSD or other hallucinogens may be the substance causing the violent behavior. Cocaine is cited since it is the substance mostcommonly found in such cases, and is one of the most dangerous to the subject.
Even while taking the recommended precautions with the current devices and methods available, positional asphyxiation may still occur. This is because the chest cavity is stretched when the legs are immobilized by folding them behind an individual. This restriction of breathing, combined with the fatigue, stress and other pharmacological factors which inhibit respiration increases the risk of in-custody death.
Some experts arc finally pointing out that many of those who die while in police custody, would probably have done so had the police not encountered them. Dr. Steven Karch, a Pathologist for the City and County of San Francisco has gone so far as to recommend that law enforcement personnel try not restrain such persons. Citing that such individuals sometimes expire on their own, he suggests that we simply wait for them to do so, thereby protecting ourselves from wrongful death claims. Unfortunately, when a maniac is running around, attacking pedestrians or cars in moving traffic, the public expects us to intervene.
The “Equipment” Breakthrough
I recently attended a four-hour “Train the Trainer” course regarding a new device called “The Wrap”. It was held at the Fremont, California Police Department. In addition to being exposed to the latest research and information regarding in custody deaths, the story behind The Wrap was presented by its developers, Ron 0 ''Dell and Craig Zamolo. Ron O’'Dell and Crag Zamolo are sergeants with the Walnut Creek, California Police Department. Both are also veteran defensive tactics instructors. About three years ago, they were asked by their Police Chief, Karel Swanson, to evaluate the restraint devices available. Upon completing their research, it was apparent that there was a need for a betlerrestraint device which could be deployed in the field.
They quickly figured out that it is feasible to immobilize the legs by simply splinting them, thereby eliminating the ability of the subject to flex his knees. After evaluating test models in both classroom and field settings for two years, combined with input from several defensive tactics instructors “The Wrap” was bom.
The Wrap is one of those things you see during a lifetime making you slap your forehead and say, “Why didn’'t I think of that!” The ingeniously simple device is approximately two feet square, and has three metal rods sandwiched in a vinyl-like material marketed as “Herculite”. Three, heavy-duty Velcro straps tighten it around a subject’'s legs. There is a metal link in the back to which the handcuff chain is secured. Straps leading from the top of the device to the waist of the subject prevents him from squirming out of it. Keeping the subject in a seated, upright position is accomplished by placing his back to a wall, a patrol car door, the raised back of an ambulance gumey or a leg of an officer.
They Did it Right
Throughout the development of The Wrap, the originators sought-out the involvement of the top medical experts on custody death in the country. Not only did they contact Dr. Donald T. Reay, me Chief Medical Examiner for King County, Washington, but they put him in touch with Dr. Darrell Ross. Dr. Ross is a use of force and custody death expert who teaches for PPCT Management Systems.
For further consultation and an empirical evaluation of The Wrap, Ron and Craig contacted Dr. Harry J. Mac Dannald of John Muir Hospital in Walnut Creek. Dr. Mac Dannald conducted a “Respiratory Analysis” of The Wrap. This study compared “recovery time” between persons sitting in an unrestrained position, in a “hog-tied” position, and in The Wrap. “Recovery time” referred to the lime it took for a subject’'s heart rate to drop below 100 beats per minute and oxygen saturation to return to a baseline level, after exercising to 80% of predicted maximum heart rate.
The importance of “recovery” becomes apparent when you consider that it is not uncommon for violent subjects to sometimes fight harder when arresting officers apply body weight to their torso. This may be due to the subject struggling to breathe freely, but may be interpreted by officers as further attempts on the part of the subject to free himself. Therefore, it may behoove officers to get the subject into a position of optimal “recovery” as soon as practical. This allows the subject to not only “catch his breath” and therefore not panic, but eliminates an important factor which may contribute to positional asphyxialion.
The study clearly indicates that respiratory recovery is much grealer when a subject is restrained using The Wrap when compared to traditional “hogtying”. What I found impressive was the finding that subjects restrained in The Wrap took only 9% longer for the heart rate to return to less than 100 beats perminute, and 17.5% longer for oxygen saturation levels to return to baseline, as compared to subjects allowed to sit in an unrestrained position. Simply put. they were almost the same.
Fringe Benefits
During actual field uses, it was noted that once subjects were restrained in The Wrap, they tended to calm down. This can play an important part in avoiding a custody death from any of the contributing conditions noted. It is clearly a more humane form of treatment, and does not restrict blood circulation to any of the restrained appendages. Perhaps the greatest benefit is that a person restrained in The Wrap is a much easier “package” to handle and transport. Once secured, the subject can be placed directly onto an ambulance gumey, then moved to a hospital gumey. This eliminates the need to unhandcuff the subject (and possibly struggling with him to do so) and apply the four-point restraints used by medical facilities. It even has wrist straps, so that the handcuffs can be removed, and the hands secured on each side of the waist. This increases comfort while further decreasing the risk of handcuff related injury to the subject.
Three officers can easily pick-up and transport an average size subject in The Wrap. I can think of an occasion only a few months ago when a woman was apparently having a violent, psychotic episode in an upstairs room of an old boarding house. The tire department personnel did not want to place her on a stretcher due to the unusually narrow, spiral stairway leading downstairs. Their suggestion was for my officers to carry the thrashing woman down while only in handcuffs. The Wrap would have clearly made the woman safe to carry in this unusual situation.
A Complete Package
The Wrap is marketed by Safe Restraints, Incorporated. They have already assembled lop medical experts in the field who are available as defense experts in civil suits. A “Sample Policy” is also available, facilitating the adoption of The Wrap by any agency. Upon review, 1 found the policy to be sound. avoiding the use of such words as “shall” and “will”, which might offer weaknesses to exploit by plaintiff’'s attorneys.
The Wrap is easily transported, and a carrying bag is also available. At $250.00 per unit, it might seem expensive when compared to the current devices used in the field. However, if an agency fails to purchase such equipment due to “costs”, a civil jury might quickly conclude that police administrators assign a low dollar amount to a human life. If this occurs, be sure that a jury could respond with a tremendous dollar amount in the form of an award to a plaintiff.
In my opinion. The Wrap is the best device available for field use for the restraint of the ultra-violent, custody death candidates we encounter. It is not a matter of “if we encounter them, only a matter of “when”. Not only is it currently the best we can do for such individuals, but it offers greater safety to law enforcement personnel as well.
Endnotes:
1. U.S. Department of Justice, National Law EnforcementTechnology Center, June, 1995 Bulletin.
2. IACP Executive Brief, “Pepper Spray and In-Custody Deaths.” March, 1994, page 4.
3. Ibid. pages 3-4.
4. Taped interview with Dr. Steven Karch, KGO-TV News Story, “Too Hot Too Handle,” airdate April 8,1996.
ABOUT THE AUTHOR:
Sergeant Jeff Martin is a 15-year law enforcement veteran with the San Jose. Califomia Police Department. He is currently assigned to the Airport Division and has previously worked in Parks Enforcement, Narcotics, and as a Field Training Officer. He is also a consultant specializing in assessing safety and liability exposure of law enforcement agencies. He can be reached by telephone or fax at (510) 490-4126.