.By Alon Steinberg , Dhilan Patel , Amanda Frugoli

Introduction: Prone restraint by law enforcement has come under scrutiny due to its association with in-custody deaths and subsequent civil litigation. The true incidence, risk factors, and physiological mechanisms contributing to these fatalities remain poorly understood. This study aims to assess prone restraint-related death occurrences and identify associated risk factors by analyzing legal case records.

Methods: This retrospective study examined United States legal records from the National Legal Database, LexisNexis, covering 2010 to 2019. Cases were identified using the MeSH term "prone restraint cardiac arrest." Data extracted included demographic and case-specific variables such as age, gender, body mass index (BMI), duration of prone restraint, application of additional body weight, race, use of a conducted electrical weapon (CEW), presence of body camera footage, reports of excited delirium, drug intoxication, settlement amounts, and documented statements of "I can't breathe."

Results: A total of 229 cases met the inclusion criteria for analysis. The majority of subjects (98 %) were male, with an average age at death of 37 years. Among cases with available data, 38 % were African American, 33 % had obesity, and 64 % involved recreational stimulant drug use. In 58 % of cases, death occurred after one to 5 min of prone restraint. Additional body weight was applied in 80 % of cases, while CEWs were used in 39 %. Excited delirium was reported in 31 % of cases. More than 20 % of individuals were recorded saying, "I can't breathe." The average reported settlement in resolved cases was $2.5 million.

Conclusion: This study represents the largest case series of 229 reported prone restraint-related deaths to be reported in the medical literature, yet the true incidence remains uncertain. Further research is essential to better understand the prevalence, contributing risk factors, and potential mitigation strategies. Collaboration among the medical and forensic communities, law enforcement agencies, and policymakers is critical to accurately assess the scope of this issue and implement measures to reduce fatalities associated with prone restraint.

J Forensic Leg Med, 2025 May:112:102862.

doi: 10.1016/j.jflm.2025.102862. Epub 2025 Mar 31

By Noy Assaraf, Alejandro Mouro, Donald M. Papy, Noel Castillo & Barak Ariel

Objectives

Research on police body-worn cameras (BWCs) draws attention to the need for suspects to be aware of the devices for them to exert a deterrent, “civilising effect”, which can manifest as a reduction in the use of force in police-public interactions. This awareness can be manipulated audibly, visually, or both, yet no trials exist to test a visual stimulus that increases awareness of BWCs relative to BWCs without this function. In this field experiment, we test the effect of a visual warning of BWCs on use-of-force incidence.

Methods

A six-month cluster-randomised controlled trial involving spatiotemporal police units was conducted in Miami Beach, USA. The units were randomly assigned to the experimental group, which included officers who wore BWCs featuring multiple yellow stickers and “VIDEO & AUDIO” logo (used as a visual warning). Officers in the control group were equipped with BWCs without yellow stickers. Neither group was required to announce the presence of the BWCs, thus isolating the visual warning from the audial warning. Poisson regression models estimate the treatment effect, with confirmatory subgroup analyses based on the proactive versus reactive interactions.

Results

Statistically significant differences in the use of force by officers, but in the contrary direction: higher rate of use of force due to equipping officers with BWCs with yellow stickers relative to BWCs without the yellow stickers. Relative change analysis indicates that yellow stickers cause an increase in the rate of use of force in incidents involving proactive policing, with a less pronounced increase in reactive policing.

Conclusion

Without contextualising their use to citizens, raising awareness of the presence of BWCs can aggravate police-public encounters.

Journal of Experimental Criminology, 2024, 23p.