Restraint in police use of force events: examining sudden in custody death for prone and not-prone positions

Journal of Forensic and Legal Medicine
Christine Alison HallGary M Vilke

Abstract

Little is understood about the incidence of sudden death, its underlying pathophysiology, or its actual relationship to subject positioning. We report data from 4828 consecutive use of force events (August 2006-March 2013) in 7 Canadian police agencies in Eastern and Western Canada. Consecutive subjects aged >18 years who were involved in a police use of force event were included regardless of outcome. Officers prospectively documented: final resting position of the subject (prone or non-prone), intoxicants and/or emotional distress, presence of features of excited delirium, and the use of all force modalities. Our outcome of interest was sudden in-custody death. Our study has 80% power to detect a difference of 0.5% in sudden death between the positions. In over 3.25 million consecutive police--public interactions; use of force occurred in 4,828 subjects (0.1% of police public interactions; 95% CI = 0.1%, 0.1%). Subjects were usually male (87.5%); median age 32 years; 81.5% exhibited alcohol and/or drug intoxication, and/or emotional distress at the scene. Significantly more subjects remained in a non-prone vs. prone position; but over 2000 subjects remained prone. One individual died suddenly and unexpectedly in the non-prone...Continue Reading

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Citations

Oct 5, 2015·Journal of Forensic and Legal Medicine·Jared Strote
Mar 29, 2016·Journal of Psychiatric and Mental Health Nursing·R BarnettP Orme
Apr 30, 2016·Journal of Forensic and Legal Medicine·Steven B Karch
Apr 30, 2016·Journal of Forensic and Legal Medicine·Alain Michaud
Jul 17, 2016·Journal of Forensic and Legal Medicine·Mark W KrollHoward E Williams
Aug 8, 2015·Medicine, Science, and the Law·Steven B KarchMark W Kroll
Jun 28, 2017·Journal of Forensic and Legal Medicine·Mark W KrollHoward E Williams
Dec 27, 2018·The American Journal of Forensic Medicine and Pathology·Mark W KrollSteven B Karch
Aug 4, 2018·The British Journal of Psychiatry : the Journal of Mental Science·Faisil SethiAileen O'Brien
Jan 23, 2020·The American Journal of Forensic Medicine and Pathology·Mark W KrollSteven B Karch
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Aug 23, 2020·Forensic Science, Medicine, and Pathology·Ellen M F StrömmerMichael D Freeman
Jun 28, 2019·Frontiers in Psychiatry·Xenia A K KerstingTilman Steinert
Dec 2, 2020·Journal of Forensic and Legal Medicine·S N KunzJ G Jónasson
May 27, 2020·Journal of Forensic and Legal Medicine·L G M DijkhuizenW L J M Duijst
Feb 13, 2021·JAMA Network Open·Christos BaliatsasC Joris Yzermans
Jan 21, 2020·Journal of Psychiatric and Mental Health Nursing·Nutmeg HallettAnthony J O'Brien
Sep 22, 2020·Journal of Forensic and Legal Medicine·Gary M Vilke
Nov 4, 2021·Medicine, Science, and the Law·Mark W KrollRichard M Luceri
Nov 4, 2021·Medicine, Science, and the Law·Alon Steinberg

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