For decades, police across the United States have been warned that the common tactic of handcuffing someone face down could turn deadly if officers pin them to the ground with too much pressure or for too long.
Recommendations initially made by major police departments and associations culminated in a 1995 federal safety bulletin that explained that holding someone across the chest, in what is known as prone restraint, can dangerously restrict breathing. The solution: once they are handcuffed, turn them on their side.
Yet today, what some officers do on the streets conflicts with what has long been recognized as safe, a deadly disconnect that highlights ongoing flaws in police training, an Associated Press investigation has found.
The cases involving prone restraint are among more than 1,000 AP documented over a decade of people who died not from gunfire but after officers used force that was not intended to kill. In all, at least 740 of these encounters involved prone restraint, making it the most prevalent tactic. It was also commonly misapplied.
Each state sets its own standards, and individual departments and training centers determine what police officers hear in classrooms and gyms. The safest techniques don’t always reach officers.
What police officers learn about the risks of prone restraint depends on geography.
Nearly every state has a Peace Officer Standards and Training agency that defines what should be taught, so the AP asked each commission whether it required instruction in positional asphyxiation, which happens when the chest fails to expand, depriving the body of of oxygen. Among the states that responded, 10 said they did not require positional asphyxiation training and 20 states said they included such training.
To understand what officers knew before the deaths involving prone restraint, reporters combed through thousands of pages of interviews and statements.
In almost 100 cases, the AP identified documents that showed whether the officers were trained or aware of the risk of positional asphyxiation. In 80 deaths, at least one officer involved had been trained or knew the potential dangers, although they did not always remove someone from the stomach immediately. The officers responsible for another 14 deaths said they were untrained and did not know the risks; he couldn’t remember the training; or – in some cases – have been trained that the prone position is safe.
Some officers repeated two common misconceptions that experts and trainers have long tried to dispel: that if someone can talk, they can breathe, and that someone who struggles to breathe is resisting arrest.
To speak, air must pass through the vocal cords in the throat. To inhale oxygen and expel carbon dioxide, air must travel to and from the lungs. The additional short distance can be huge if someone is having trouble breathing.
“There’s a big difference between fighting the cops and fighting for breath,” said Seth Stoughton, a law professor at the University of South Carolina and a national expert on the use of force who, as a former officer and police instructor, has written extensively about prone restraint.
The California Legislature passed a 2021 law that said departments “shall not authorize transportation techniques or methods that involve a substantial risk of positional asphyxiation.” The sponsor of the legislation said he wanted to limit prone restraints. But the law hasn’t stopped some instructors at state-certified training centers from continuing to teach that holding someone face down is a recommended practice.
Among California’s most experienced instructors is David Rose, who in his 40 years as a trainer has taught thousands of police officers that prone restraint is safe. Rose said he instructs officers to hold a person face down with as little pressure as necessary unless they are combative. He said the methods he teaches do not contravene California law because prone restraint does not carry a serious risk of positional asphyxia.
“Positional asphyxia does not happen at all. On the field, that doesn’t happen,” Rose said in an interview at a regional training center in Sacramento.
“Putting weight on a person’s back in a lying position does not cause them to die unless it is enough to actually crush them,” he said.
Rose bases his belief on studies produced by lawyers, professors and police experts who defend police officers when they are sued in court.
Officers almost always used prone restraint with another force, and in the AP database, medical officials cited prone positioning or asphyxia due to restraint as the cause or contributing factor in 61 of the 740 cases involving the maneuver during the period of investigation from 2012-2021. In dozens of other cases, officers used prone restraint and “restraint” was cited as a cause or contributor to the death, but the prone position or restraint was not specified.
In many other cases, the cause of death centered on drugs or medical conditions rather than force. Due to the suppression of records, reporters were not always able to obtain the official determination.
The AP contacted the California Commission on Peace Officer Standards and Training and asked whether Rose’s teachings on positional asphyxiation aligned with state requirements. “POST is taking action and has notified the (Sacramento training) center that it is not complying with the law. The issue will be resolved,” spokeswoman Meagan Poulos wrote in an email Monday.
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Contributing to this story from the University of Maryland’s Howard Center for Investigative Journalism were Sean Mussenden and Mary Dalrymple.
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This story is part of an ongoing investigation led by the Associated Press in collaboration with the Howard Center for Investigative Journalism and FRONTLINE (PBS) programs. The investigation includes the Lethal Restraint interactive story, database and the documentary “Documenting Police Use Of Force,” which premiered April 30 on PBS and is available online. To see stories from journalists at the Howard Center for Investigative Journalism programs, click here.
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The Associated Press receives support from the Public Welfare Foundation for reporting focused on criminal justice. This story was also supported by Columbia University’s Ira A. Lipman Center for Journalism and Civil and Human Rights in conjunction with Arnold Ventures. AP is solely responsible for all content.
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Contact AP’s global investigative team at Investigative@ap.org or
This story originally appeared on ABCNews.go.com read the full story
