Firearm deaths by law enforcement

Injuries Due to Law Enforcement Use of Force in the United States, 2006-2015: Trends in Severity and by Race

PURPOSE

The purpose of the study was to assess incidence and severity of hospital reported injuries related to law enforcement Use of Force (UoF) in the US over time, and by race.

METHODS

Data from the National Emergency Department Sample from the Healthcare Cost and Utilization Project and the National Electronic Injury Surveillance System (NEISS-AIP) from US Consumer Product Safety Commission were queried to identify UoF injuries. Regression analysis, t-tests, and chi-square tests were used in the analysis.

RESULTS

Between 2006-15, there were 529,259 emergency department admissions for UoF injury in the NEDS, and 870,779 admissions in the NEISS-AIP. In a model adjusting for year, sex, and age, the Injury Severity Score increased by 1.1% annually (p<0.0001). Black people were 6 times as likely to be admitted to the ED as White people or Native Americans/Alaska Natives, and 25 times as likely as Asians/Pacific Islanders. Black patients were 4 times as likely as White patients to be admitted as inpatients. Per arrest rate by race using FBI uniform crime reporting data, Black arrestees were 2.5-3.1 times as likely as any other race to be hospitalized for UoF injury.

CONCLUSION

The results of the study demonstrate that US law enforcement are injuring civilians more frequently and severely over time, and that Black people are disproportionately affected.

Outcomes of Hospitalized Injured Suspects Sustaining Gunshot Wounds From Law Enforcement Action

BACKGROUND

Although firearms are implicated in the majority of law enforcement intervention (LEI)-related deaths, scientific research is lacking. The present study sought to characterize clinical and financial outcomes between injured suspects and other gunshot wound (GSW) patients.

STUDY DESIGN

The 2016-2020 National Inpatient Sample was queried for patients ≥16 years old admitted following GSW. Patients were categorized as injured suspects (ISs) if they were injured in LEI and non-IS otherwise. The primary outcome was in-hospital mortality with complications, hospitalization duration (LOS), and costs secondarily considered. Multivariable regression models were used to adjust for patient characteristics, injury burden using the Trauma Mortality Prediction Model (TMPM), and hospital factors.

RESULTS

Of 143,125 hospitalizations, 1575 (1.10%) were IS. Compared to non-IS, ISs were less frequently Black (24.4% vs 54.3%) but had a higher proportion of psychiatric conditions (19.4% vs 6.4%) (P < .05). Although having a similar requirement for major operations and TMPM score, ISs more frequently underwent thoracic (11.4% vs 4.1%) and gastrointestinal operations (33.0% vs 25.7%) (P < .05). After adjustment, IS was associated with similar odds of mortality but was associated with greater odds of cardiac complications, respiratory failure, and need for intensive care. While LOS was similar, IS was associated with greater costs (β: +$14,300, 95% CI: 6,200-22,400).

CONCLUSIONS

Suspects injured during law enforcement intervention have similar in-hospital mortality but greater complication rates and costs. Through the quantification of the clinical and financial burden of IS, our findings may help inform further policy discussions regarding use of potentially lethal force in law enforcement intervention.

Penetrating thoracic injury from a bean bag round complicated by development of post-operative empyema

Bean bag guns were developed as a nonlethal means for law enforcement personnel to subdue individuals. The large surface area and lower velocities of the bean bag round theoretically result in transfer of most of the energy to the skin/subcutaneous tissue and minimize the likelihood of dermal penetration, thereby 'stunning' intended victims without causing injury to deeper structures. However, this technology has been associated with significant intra-abdominal and intrathoracic injuries, skin penetration and death. We present a 59-year-old man who sustained a penetrating thoracic injury from a bean bag gun. Although the bean bag was successfully removed, the patient developed a postoperative empyema requiring operative management. We discuss the unique aspects of thoracic trauma from bean bag ballistics as well as considerations in management of patients with this uncommon mechanism of injury.

Hostage Situation Homicide

Deaths related to hostage situations occur in many forms, as these situations can easily escalate as a result of many confounding variables. When approaching such cases, forensic pathologists and death investigators should be mindful of the many details that should be well-documented at the scene and during autopsy to ensure that the correct conclusions and death certification are determined. This case report highlights a death in a hostage situation and the importance of correlating scene information and autopsy findings. An elderly female hostage was ambulating with a walker away from her ex-husband's home, after police negotiations successfully convinced her ex-husband to release her. The ex-husband then appeared at the door, brandishing a weapon, at which time a police officer shot at the man. Instead of striking the man, the rifle's projectile struck the woman in the chest. Subsequent investigation revealed that, although the police officer had a "clear shot" via the rifle sights, the muzzle end of the rifle was obstructed by the back corner of an automobile, behind which the officer was positioned during the hostage situation standoff. The case highlights a rarely discussed safety rule related to firearms: recognition that the line of sight via a weapon's sights (or scope) is not identical to the barrel/bore axis.

Trends in Officer-involved Firearm Deaths in Oklahoma from 2000 to 2015

The purpose of this study was to collect data and disseminate trends in officer-involved firearm deaths in Oklahoma from 2000 to 2015. The Oklahoma Office of the Chief Medical Examiner (OCME) database was searched for civilian decedents with gunshot wounds inflicted by law enforcement officers and officer decedents with gunshot wounds inflicted by civilians. Five decedents were law enforcement officers, while 274 decedents were civilians. The number of civilian decedents throughout the study followed a quadratic trend. Civilian decedents were most commonly males (95%) between the ages of 20 and 39 (64%), had one or two gunshot wounds (46%), and had an increasing number of gunshot wounds over time. Postmortem toxicology testing most commonly detected ethanol, methamphetamine, cocaine, and PCP. Efforts toward increased tracking by various agencies and more scientific studies like this are needed to facilitate future analysis of trends in officer-involved firearm deaths.

Deaths Due to Use of Lethal Force by Law Enforcement: Findings From the National Violent Death Reporting System, 17 U.S. States, 2009-2012

INTRODUCTION

Several high-profile cases in the U.S. have drawn public attention to the use of lethal force by law enforcement (LE), yet research on such fatalities is limited. Using data from a public health surveillance system, this study examined the characteristics and circumstances of these violent deaths to inform prevention.

METHODS

All fatalities (N=812) resulting from use of lethal force by on-duty LE from 2009 to 2012 in 17 U.S. states were examined using National Violent Death Reporting System data. Case narratives were coded for additional incident circumstances.

RESULTS

Victims were majority white (52%) but disproportionately black (32%) with a fatality rate 2.8 times higher among blacks than whites. Most victims were reported to be armed (83%); however, black victims were more likely to be unarmed (14.8%) than white (9.4%) or Hispanic (5.8%) victims. Fatality rates among military veterans/active duty service members were 1.4 times greater than among their civilian counterparts. Four case subtypes were examined based on themes that emerged in incident narratives: about 22% of cases were mental health related; 18% were suspected "suicide by cop" incidents, with white victims more likely than black or Hispanic victims to die in these circumstances; 14% involved intimate partner violence; and about 6% were unintentional deaths due to LE action. Another 53% of cases were unclassified and did not fall into a coded subtype. Regression analyses identified victim and incident characteristics associated with each case subtype and unclassified cases.

CONCLUSIONS

Knowledge about circumstances of deaths due to the use of lethal force can inform the development of prevention strategies, improve risk assessment, and modify LE response to increase the safety of communities and officers and prevent fatalities associated with LE intervention.

Police shootings against civilians in Portugal: Contextual, forensic medical and judicial characterization

The aim of this study was to analyse the circumstances, the forensic assessment and the legal assessment of police shootings of civilians, according to the severity of the victim's injuries. Sixty-nine cases tried in Portuguese criminal courts were analysed. Of the 32 cases that resulted in death, 16 were on the public thoroughfare and 13 were in the victim's vehicle or in third-party vehicles. The majority of the lethal cases occurred when the region of the body hit was the thorax/abdomen. The firearm most frequently used was a semi-automatic 9 mm pistol. In cases resulting in death police officers involved were convicted whilst those involved in non-lethal cases were acquitted. The results of this study can be taken into account by Portuguese authorities for the implementation of policies that will allow the restriction of firearms use by police officers to situations of imminent danger of death or serious injury and that will make it possible to avoid shooting at fleeing civilians.

Injuries associated with law enforcement use of force

Prehospital personnel and physicians working in acute care settings need to be cognizant of the issues related to law enforcement use of force in order to properly evaluate and manage these patients. Types of force used by law enforcement range along a spectrum from physical presence to lethal use of firearms. Although the vast majority of use of force incidents does not lead to significant injury, certain weapons and situations may require more extensive evaluation and higher levels of concern.

Death certification of "suicide by cop"

Death certification of "suicide by cop" is controversial among some medical examiners and coroners. We present five such deaths that were certified as suicides and discuss the medico-legal issues involved with these certifications. To certify such a death as a suicide, certain criteria should be met. Suicide by cop is a circumstance that involves competing intentional acts that may result in dichotomous determinations of the manner of death. Despite the absence of direct self-infliction, there is overwhelming evidence that these five individuals intended to end their own lives. Their use of an unusual method to accomplish this goal may inappropriately result in a reflexive certification of homicide. All of the decedents possessed weapons or a facsimile of a weapon. We present five instances of suicide by cop and contend that these types of deaths are best certified as suicides.

Mental illness among police fatalities in Victoria 1982-2007: case linkage study

OBJECTIVE

The aim of the present study was to explore the mental health and offending histories for all cases that resulted in fatal use of force by Victoria Police between November 1982 and February 2007.

METHODS

Forty-eight fatalities were extracted from the Use of Force (UoF) Register, and then linked with the mental health and police contacts databases. These data were supplemented, where necessary, with relevant information from Coronial Reports and an Office of Police Integrity Report.

RESULTS

All but six cases had involved recorded histories with mental health and criminal justice systems before the fatal incident occurred. Rates of all Axis I disorders were significantly overrepresented, with estimated rates of psychosis and schizophrenia 11.3- and 17.3-fold higher than estimated rates in the general population (95% confidence intervals = 6.3-20.2 and 9.2-32.4, respectively). Although the number of fatalities has halved since inception of Project Beacon (32 before vs 16 after 1995), there has been no reduction in representation of mental illness among those fatally shot.

CONCLUSIONS

The significant over-representation of Axis I disorders, including severe mental disorders of psychosis and schizophrenia, is of considerable concern for both the police and the mental health providers. Functional interagency partnerships and police training on how to interact with people in distress are recommended to address the overrepresentation of mentally ill persons in these encounters.