DCCBCZR1992P6CR4: 291993c.2

NECK RESTRAINTSas a

USE OF FORCE

Report to the Policing in B.C./Commission of InquiryMr. Justice Wallace T. Oppal, Commissioner

93.08.20

I

Project No. B11-14nContract 93-101-Nt

Gil PuderUse of Force Research

LEGISLATIVE LIBRARY OF BRITISH COLUMBIA

3329800311 5111

TABLE OF CONTENTS

Title Page 1

Executive Summary ii

Table of Contents iii

Part One - Historical Introduction 1

Part Two - Techniques of Application 6

Part Three - Application Physiology 10

Part Four - Medical Concerns and Associated Risks 14

Part Five - Agency Survey 16

Part Six - Issue Discussion and Recommendations 22

Part Seven - Summary of Recommendations 32

Appendix I - Synopses of Interviews with Selected Medical Experts 33

Appendix II - Generic Response Options For Police Use of Force 40

Appendix ifi - Sample Generic Policy 42

References

EXECUTIVE SUMMARY

The use of neck restraints has a long history in martial and policing practices, and has

only come under close, scrutiny during the last two decades. Misuse, abuse and accidental deaths

have caused numerous agencies to question the suitability of neckholds for law enforcement

purposes.

The techniques of application are relatively simple and few in number, with the

physiological results fairly well understood. Referenced medical experts are highly consistent on

this topic, as well as the associated risks from neckholds. None of the medical experts advocated

prohibition of the technique.

A survey of enforcement agencies found little uniformity in policy, training or use.

Noteworthy trends were: (1) fatalities in jurisdictions with little or no ongoing training programs;

(2) “prohibitions” in jurisdictions experiencing fatalities, with little or no associated research; (3)

continued use of the technique, and “unofficial” training, in jurisdictions where the technique is

prohibited or highly restricted.

The report will recommend that the Commission of Inquiry define neck restraints and

include contextual placement within recognized use of force responses. A generic policy should

be developed for the consideration of the BCACP and B.C. Police Commission. Any

recommendations concerning training should address neck restraints (recruit and in-service), and

the Justice Institute of B.C.iPolice Academy should be funded to allow for development of

accountable training standards.

A future research project involving several referenced medical experts may be feasible,

in both cost efficient and expeditious manner. The author will notify the Commissioner of

Inquiry upon any proposed venture.

PART ONE

HISTORICAL INTRODUCTION

The use of neckholds to subdue people is hardly unique to modem law enforcement, in

British Columbia or otherwise. In fact, applying force to a person’s neck for punitive, martial

or enforcement oriented practices is nearly as old as recorded history. To develop an

understanding of both how and why B.C. police officers use neck restraints, it is worthwhile to

recount significant historical developments.

Martial Arts Evolution

During the Sixth Century A.D., a Buddhist priest named Dharma killed over 5000 slaves

to identify vital points on the human body. The neck was discovered to have several such vital

points.

Dharma’s knowledge was passed to the Shaolin temples in China, and utilized in the

development of the first organized “martial arts.” Today, variations of these Chinese arts are

known as kung J1~ and wu shu, and many styles have retained the use of some neckholds.

Although other cultures and nationalities used neckholds for martial purposes, the study and

refmement of these techniques spread from the Shaolin systems.

A critical event in the evolution of neckhold practice was the emergence of trade between

China and the island of Okinawa. Through this route Shaolin knowledge influenced all Okinawa

combative arts. These methods of bare-handed fighting were originafly known as Okinawa-te.

The development of unarmed fighting systems expanded in the 15th C. period, when King

Hashi of the Sho dynasty united the three principal kingdoms of the Ryukyu Islands.

To maintain authority while minimizing use of military forces, weapons were forbidden to the

general populace. Although practised in secret, empty land combatives became popular.

2

In the 17 C., the Chinese influence on Japanese combative arts increased, as the Lords

of Satsuma in Southern Japan (who ruled Okinawa) promoted a policy of trade with China. This

period saw many ju-jitsu schools advance the serious study of neckholds, known collectively as

shimewaza. The Japanese kimono, with its two heavy lapels, offered many possibilities for

neckhold applications .~

The next major event in the development of neckholds occurred in 1882, when ju-jitsu

master Jigoro Kano conceived the art of judo. Literally translated as, “gentle way,” judo sought

to move beyond mere combative techniques, combining self-protection, sporting competition, and

character development through physical training. Consistent with both a moral theme and

sporting practice, the more dangerous ju-jitsu techniques were abandoned. It is noteworthy that

most shimewaza have been retained in judo to this day, with a distinct absence of associated

fatalities. 2

Introduction To Policing

Communication of martial arts to the West did not truly begin until the MacArthur

Administration of post-WW II Japan. Although most martial arts, (including judo) were

temporarily banned by MacArthur, American servicemen (particularly military police) became

interested in their practice. As these servicemen returned to America in the late 1940’s and

1950’s, many entered civilian law enforcement. Thus martial arts knowledge began to influence

police use of force methodology.

Until the 1960’s, most police, “self-defense,” training consisted of boxing and wrestling

practice, which was usually integrated with a physical fitness curriculum. “Chokes,” and

neckholds familiar to wrestlers had been included, but were presented in a crude and poorly

documented fashion. Locally, both the R.C.M.P. (Depot Division) Academy and Vancouver

Police Academy training reflected this approach.

1 Kashiwazaki, Katsuhiko. Shimewaza: Judo Masterclass Techniques (Ippon Books, 1985)4.

2 Kowai, E.K., “Deaths Allegedly Caused by the Use of “Choke Holds” (Shimewaza),Journal of Forensic Sciences (JFSCA, Vol. 32 No. 2, March 1982) pp. 419-432

3

1968 saw the R.C.M.P. re-structure its self-defense programs, delivering the instruction

separately from physical fitness. A new section was dedicated solely to self-defense, and the

curriculum contained many martial arts-based techniques. Included were several “chokes,” and

neckholds.

Other training academies throughout North America began similar revisions of their

training, often including neckholds amongst various martial arts-based techniques. Unfortunately

the presentation of neck restraints was often very simplistic, and failed to address the differences

in application physiology between different neckhold techniques.

The crude nature of neckhold training in the sixties and seventies has been generally

attributed to three causative factors:

1) a shallow understanding of the techniques used, drawn predominately from judo and

ju-jitsu practices;

2) inability to accurately transmit knowledge across language barriers, (ie. from Japanese

to English); ~

3) training and research in use of force practices having a low priority for law

enforcement administrators.

An increasing number of police officers were being trained in the use of neckholds,

however, and using the techniques operationally with great regularity. Not surprisingly, (in

hindsight), the late seventies and early eighties saw a large number of fatalities attributed to law

enforcement use of neckholds.

~ Suzuki, K., “Medical Studies on “Choking” in Judo, With Special Reference to Electro

encephalographic Investigation,” Bulletin of the Association for the Scientific Studies on Judo,) (Kodokan, Tokyo: Report 1, 1958) 44.

4

Critical Incidents

Accompanying the fatalities was intense media coverage and a number of court actions.

Arguably the most highly publicized took place in Los Angeles, where an abnormally high

number of fatalities were attributed to the chokehold. Several intemperate statements by then

Chief of Police Danell Gates exacerbated the racial and political overtones inherent in this

jurisdiction.

A widely cited civil action arising from an L.A.P.D. fatality resulted in a U.S. Ninth

District Court of Appeals decision severely resthcting the use of, “chokeholds.” ~ Although

appealed, the United States Supreme Court ruled by a 5 to 4 decision that the Supreme Court was

not the appropriate forum to address local police methodology. The result was a varying range

of standards for the use of neckholds by American police agencies. The situation persists to this

day, with neighbouring states and even counties having widely disparate training and policy.

The American experience has been closely paralleled in Canada. Police neckhold

investigations regularly cited include:

- Inquest into the death of Eric Luther (British Columbia)

- Report of the Board of Inquiry into the complaint of 3m-is R. Laufers (Toronto, 1984).

- Public Inquiry into the death of Lorne Haildorson (Alberta, 1984).

- Inquest Report in the death of Gaston Harvey (Quebec, 1986).

- Public Hearing into the Complaint of Caroline Halliday/Public Hearing into the

Complaint of Michael and Steven Cooper (British Columbia, 1991)

) ~ Lyons V. City of Los Angeles, 656 F. 2d 417 (1981)

5

Cunent Situation

There are significant differences regarding neck restraint training and policy between

provinces, and occasionally jurisdictions within one province (see Part Five). In British Columbia

the situation is particularly fragmented, and requires attention from the Policing in

B.C./Commission of Inquiry.

Fortunately, the litigation and intrusion of politics into police practices have produced one

positive effect; that is, considerable research devoted to neck restraints over the past decade.

There appears to be adequate information to enable an investigative body to make informed

recommendations respecting this issue.

Subsequent to the formation of the Commission, two local incidents have focused media

and public attention on neckholds. The Inquest into the death of David Nicholl (1993) resulted

from a 1992 R.C.M.P. neckhold fatality in Kamloops. Recently a Lower Mainland security guard

used an unspecified neckhold, which resulted in a fatality. At this time the matter is under

investigation.

6

PART TWO

TECHMQUES OF APPLICATION

This part will describe those neckholds which are, or have been, used with some regularity

by law enforcement agencies. A “complete,” listing of the neckhold variations used in martial

arts and systems is beyond the scope of this research.

The neckholds will be listed in two groups, based upon the anticipated subject response

to correct application. The actual physiological results, and medical concerns, will be discussed

in Part Three and Part Four.

2.1. Respiratory Restraints

2.1.1- The Bar-Arm Choke

a.k.a. “chokehold”, trachea choke

These neckholds are variations of judo techniques referred to as, “ho4aka-jime.” The

common element in such restraints is direct frontal pressure applied to the throat. This pressure

is usually created by an officer drawing the radial surface of their forearm tight against the

subject’s throat.

The intent of a bar-arm choke is to achieve subject control through either: (a) the inherent

pain of the technique, and resulting voluntary subject compliance, or, (b) closure of the airway,

and induced unconsciousness through suffocation.

The most common application of a bar-arm choke is to simply clasp one’s hands together,

and, from the rear of a subject, draw the forearm tight against the front of the subject’s throat.

The near shoulder of the person applying the technique serves to prevent the head and neck from

moving back and away from the choke.

7

Variations include placing the hand of the “choking” arm inside the fold of the opposite

elbow, and placing the “free” hand behind the subject’s head. This serves to “scissor” the.

subject’s neck. Police officers have also been known to use batons and metal flashlights to

facilitate “bar” chokes.

2.1.2 The C-Clamp Chokea.k.a. “tigerciaw”

This technique involves placing one’s hand on the front of a subject’s throat, with the

thumb on one side and fingers on the other. The thumb and fingers are tightened in a pincer-like

fashion. This digital pressure serves to close the airway and cause asphyxia.

Application of digital pressure in this fashion may also create vascular restraint, dependant

upon the placement and directional pressure of the thumb and fingers. Police have also used a

similar technique to close the esophagus and prevent swallowing. This is used to facilitate the

search of dru.g suspect who are carrying contraband in their mouths.2.2. Carotid / Vascular Restraints

2.2.1 Standard Carotid / Vascular Restrainta.k.a.

carotid control

standard neck restraint

lateral, vascular neck restraint

carotid sleeper

This technique involves encircling the front of a subject’s neck with the arm, placing the

radial surface of the forearm on one side and the upper bicep/anterior deltoid on the other. The

throat of the subject rests in the elbow fold.

8

The officer applying the technique will generally be at the rear of the subject, and clasp

their free hand to that of the arm applying the restraint. Pincer lice pressure is applied to either

side of the neck.

The intent of this technique is to cause transient unconsciousness in the subject through

cerebrai ischemia,5 i.e. reduced blood flow to the brain.

2.1.2 Locked Carotid I Vascular Restraint

a.k.a.

carotid control with chancery

locked carotid control

This variation has the restraining arm in the same position around the subject’s neck. The

free arm, however, reaches across the back of the subject’s neck to grasp the shoulder of the

restraining arm. The hand of the restraining arm grasps the bicep of the “locking” arm, inside

the elbow.

As with the standard technique, the intent is to create transient unconsciousness..

Directional pressure on the neck is identical.

The purpose of the lock is to: (a) secure the neck for subject safety, preventing slippage

into a “bar” choke and; (b) increase the integrity of the technique, reducing the potential for the

subject to pull the restraint arm free.

~ Eisele, John W., and Reay, Donald T., “Death From Law Enforcement Neck Holds, The

American Journal of Forensic Medicine and Pathology (Vol. 3 No. 3: September 1982) 253.

9

2.2.3 “Japanese” Carotid Control

a.k.a. “figure four”

The R.C.M.P. is the only agency that the research uncovered which utilizes this technique.

For the most part, it is identical in application to the, “locked carotid restraint.” The

distinguishing characteristic is that the hand of the “lock” arm is positioned with the palm against

the rear of the subject’s head. This allows the police officer applying the technique to push the

subject’s head forward, into the arm applying the restraint.

2.4 Lapel/Collar Assisted Restraints

These techniques are drawn directly from judo, and apply lateral pressure to a person’s

neck. The pressure may be applied by various surfaces of the hands and fingers, or the actual

collar drawn tight. There are many variations of these techniques, which can be quite complex

and subtle in application.

2.5 Hol&Down Restraints

A person being held forcibly on the ground may be rendered unconscious through one of

the “scarf-hold” variations used in judo practice. A subject who is lying on their back, and

attempting to rise, is pinned by the applicant lying at an angle on their chest. The applicant’s near

arm encircles the subject’s neck, and grasps the free hand or clothing to secure the technique.

By contracting their arm, and applying body weight, the officer can: (a) create pressure

on one or both sides of the neck, and; (b) restrict the respiratory movement of the subject’s

ribcage. The result is reduced supply of oxygenated blood to the brain, and transient

unconsciousness.

)

10

PART THREE

APPLICATION PHYSIOLOGY

This part will detail the physical effects upon a normal human subject to whom neck

restraints are properly applied. Since the effects of respiratory restraints, (“chokes”), and vascular

restraints are quite different, the two neckhold types will be discussed separately.

3.1. Carotid / Vascular Restraints

3.1.1 Carotid Occlusion

The commonly cited effect of a vascular restraint is occlusion of the common carotid

arteries, which reduces the flow of oxygenated blood to the brain. The contributing role of

) carotid occlusion in creating an unconscious state has been known for many years 6 and has also

been the focus of empirical medical research. ~‘

Cranial blood flow is not completely restricted, however, due to collateral circulation from

the vertebral arteries through the Circle of Willis. The vertebral arteries are not normally

impacted by manual neckhold pressure. Although vertebral arterial flow will increase due to

carotid occlusion, the increase is insufficient to offset carotid restriction.8

3.1.2 Carotid Sinus Stimulation

The carotid sinus is a region of the internal carotid artery, located just above the

bifurcation of the common carotid artery. It is composed of nerve endings which axe extremely

6 Suzuki, 45

~ Holloway, G. Allen, and Reay, Donald T., “Changes in Carotid Blood Flow Produced byNeck Compression,” The American Journal of Forensic Medicine and Pathology (Vol. 3 No. 3:September 1982) 199-202

8 Eisele and Reay, 255

Ii

responsive to pressure changes. Nerve impulses are directed to the region of the brain which

reflexively controls the heart.9

Manual pressure to the carotid sinus can cause bradycardia (slowing of the heart) and/or

dilation of the blood vessels, which reduces blood pressure. This vaso-vagal response will

contribute to cerebral ischemia, and has been identified as symptomatic of vascular restraints for

some time.’°

The carotid sinus reflex is well understood medically, and in hypersensitive people can

cause fainting with only modest pressure (e.g. a tight shirt collar). Emergency health

professionals have long use carotid sinus massage to slow tachycardia (ie. racing heart) in

appropriate patients.

3.1.3 Veinous Occlusion

Manual pressure on the sides of a person’s neck can occlude the jugular veins, which

prevents the drainage of depleted blood from the brain. This would impair cranial circulation,

congesting arterial flow and reducing the blood oxygen saturation. Medical experts note that the

veins are more easily occluded than arteries, due to thinner and more pliant walls. Experts also

identify a rise in intracranial pressure,’1 despite reduced arterial flow, as evidence of veinous

occlusion.

3.1.4 The Valsalva Maneuver

The Valsalva maneuver is achieved by holding one’s breath and contracting the

diaphragm. This limits the volume of blood returning from the brain through the Superior Vena

Cava, and as a result inhibits arterial flow.

~ ibid, 256

10 Ikai, M., et al. “Physiological Studies on, “Choking”, in Judo, Bulletin of the Association

for the Scientific Studies on Judo, Kodokan (Tokyo: 1958) 11.

“ibid, 10

12

Since many subjects will hold their breath when involved in violent combatives, this

symptom has been cited as an effect of vascular restraints.12 Factors other than neckhold

pressure are required for a complete Valsaiva, however, and it’s relative contribution to restraint

induced cerebral ischemia is open to debate among medical experts. 13 The research indicates

that it would best be described as a secondary effect.

The combined result of these four potential effects is cerebral ischemia. This lack of

cranial circulation causes unconsciousness through hypoxia. Upon application of a vascular neck

restraint, the level and degree to which each of these four effects contributes to the ischemia is

not precisely known.

Experiments designed to test the effects of vascular restraints have noted that

unconsciousness occurs in seconds, over a reasonably predictable range of time for healthy

subjects (6.4-9.6 sees. 14; 8-14 sees. 15)• Situational and unforeseen physiological factors will

impact upon the actual result of a vascular neck restraint applied in a combative field setting.

3.2. Respiratory Restraints (“Chokes”)

3.2.1 Pain Compliance

Direct frontal pressure on a subject’s throat causes rearward movement of the laryngeal

framework. 16 With continued pressure comes compression against the larger structures of the

12 Siddle, B., and White, Wally. P.P.C.T. Defensive Tactics Instructor Manual, P.P.C.T.

Management Systems, Inc. (flhinois: 1991) 7-4.

13 Donald T. Reay, M.D., interview by Gil Puder, 93.07.22

A.J. (Tony) Salvian, M.D., interview by Gil Puder and Doug Farenholtz, 93.07.17

14 Holloway and Reay, 201

15 Ogawa, S., et al, “Physiological Studies on “Choking” in Judo,” Bulletin of the Associationfor the Scientific Studies on Judo, (Kodokan, Tokyo: 1963) 108

16 Holly Stevens, M.D., interview by Gil Puder and Doug Farenhokz, 93.07.19

13

neck. In normal subjects this results in extreme pain, 17 and the potential for submissive

compliance.

3.2.2 Asphyxia

With sufficient pressure on the throat comes airway closure. The pressure necessary to

collapse the trachea is significantly greater than that required for vascular restraints. ‘~

Respiratory inhibition will eventually result in a loss of consciousness through suffocation.

‘7Ikai,etal,9

18 Eisele and Reay, 255

14

PART FOUR

MEDICAL CONCERNS AND ASSOCIATED RISKS

This part will detail those injuries which might potentially occur to a subject on whom

a neckhold is appliecL A complete list of potential injuries would of necessity include all

structures in the neck, as well as the body systems to which they contribute. Consequently, the

research will be limited to pathological findings and the opinion of medical experts (see

Appendix I).

4.1. Cervical Spine.

Forced manipulation of the cervical spine always poses some risk of injury. The

squeezing pressure of neckholds is believed to pose a low risk of injury, with the greater danger

coming from unpredictable subject resistance’9. Dislocation, fracture, and/or spinal cord injury

can result from excessive force, or an officer using the neckhold to attempt lifting or moving the

subject’s body20.

4.2. Laryngeal Structures

Several aspects of the larynx have shown a predisposition to injury from neckholds:

•fractured hyoid

•fractured thyroid cartilage

•fractured cricoid

•fractured trachea ring

19 Kornblum, R., “Medical Analysis of Police Chokeholds and General Neck Trauma,”

Trauma, February and June 1986 (Matthew Bender and Co.: New York) No. 1 pg. 45

20~ Eisele and Reay, 255

15

Such injuries are associated to direct tracheal pressure from a “bar” choke, or a carotid!

vascular restraint which has slipped into a chokehold21. A properly applied lateral, carotid!

restraint should not impact upon the larynx or trachea~.

3. Circulatory System

Formation of a thrombus (clot), caused by pressure to either the vertebral or carotid

arteries can result in a stroke, potentially debilitating or fatal. Coronary artery disease renders

people vulnerable to carotid sinus stimulation, which has caused cardiac arrest in some

cfrcumstances~. Both, “street,” and certain prescription drugs may predispose the user to

cardiac arrhythmia~, triggered by the application of a carotid/vascular restraint.

21• Eisele and Reay, 257

~. Stevens, interview

~. ibid

~ibid

16

PART FIVE

AGENCY SURVEY

In this Part, the research will review the results of a survey covering B.C., Canadian, U.S.

and other police agencies. The time constraints of this project necessitated a survey conducted

largely by phone/fax; while acceptable, such a survey is highly dependent on the reliability of

contact information. Background materials contain the specifics gathered from contributing

agencies. -

5.1 B.C. Police Agencies

5.1.1 3. I. B. C. Policy Academy

The J.I.B.C. Police Academy is mandated to provide use of force training to all recruit

level B.C. Municipal Police officers. Exemption candidates from the R.C.M.P. and other

agencies receive Block TV/V training only. A short-lived Use of Force Coordinator position

provided some in-service training to a variety of agency candidates.

Lateral, vascular neck restraint training is provided in all Police Academy control tactics

programs:

Block I 4 hours

Block ifi 4 hours

Block TV/V 3 hours

OS/SC (In-Service) 3 hours

The use of force model used by Police Academy programs recommends lateral, vascular

neck restraint as a unique and separate response option, to be used when lesser means (aerosol

irritants, impact weapons, empty hands) are ineffective or inappropriate.

17

5.1.2 Municipal Police Dept. Training and Policy

Upon completion of Block V, and Certification as a Municipal Police Officer, the mandate

to train passes from the J.LB.C. Police Academy to the individual police department.

Currently, Central Saanich, Delta, Esquimak, Port Moody, Nelson, and New Westminster

have neither in-service training nor relevant policy regarding neck restraints.

All of these agencies fielded candidates in the five Officer Safety/Subject Control

programs delivered at the Justice Institute l992i~3. Central Saanich and Esquimak also made

use of the Victoria P.D. in-house programs. These measures trained only a small percentage of

the operational agency personnel.

Saanich, Vancouver and Victoria P.D. all have in-service trainers and relevant policy.

Matsqui P.D. has policy, and utilizes their member seconded to the Police Academy to

provide the training. West Van P.D. has policy, and had training until the unexpected resignation

of their trainer; they are unsure as to future direction. Oak Bay P.D. has draft policy but no

training.

Prior to the formation of the Commission of Inquiry, only Vancouver and Victoria P.D.

had either policy or training programs concerning neckholds.

5.1.3 R.C.M.P.

The R.C.M.P. provides recruit training in, “carotid control,” at their Depot Division

training academy. B Division provides no in-service re-qualification training, although this

subject is under review. The R.C.M.P. has no operational policy respecting neck restraints.

5.2 Selected Canadian Jurisdictions

5.2.1 Alberta

Alberta has no provincial regulation governing the training or use of neckholds. Neither

Calgary nor Edmonton departments train officers to use neckholds. Edmonton has restrictive

policy governing neckholds, while Calgary has none.V-I

18

5.2.2 Saskatchewan

Saskatchewan municipal police officers receive recruit level carotid restraint training using

the, “Koga,” corporate system, administered at the Saskatchewan Police College. There is no

provincial regulation, although the Saskatchewan Police Commission is reviewing use of force

issues. Neither Saskatoon nor Regina departments have in-service programs or operational

policy.

5.2.3 Manitoba

Manitoba has no provincial regulation concerning neck restraint training or use. Neither

Winnipeg nor Brandon departments train their members in its use. Winnipeg has operational

policy prohibiting the use of neckholds, while Brandon does not.

5.2.4 Ontario

A directive from the office of the A/D/M - Ministry of the Solicitor General to all Chiefs

of Police prohibited any use or training of carotid restraint, effective Sept. 4, 1992. Although

carotid restraint is ~ included in the Policing Standards Manual guidelines re: Approved Force

Options (0211.01(a)), it would conceivably be permitted under the provisions for a, 11reasonable

weapon of opportunity, “(0211.01(b).

The Ontario situation is somewhat confusing, with the Solitor General’s Ministry

providing potentially contradictory direction to police. A high degree of controversy is present

amongst police trainers, administrators, and the Ministry.

5.2.5 Quebec

Quebec municipal police receive recruit level training at the Quebec Police Institute.

Carotid restraint is included in the curriculum. The research could not uncover any in-service

training within Quebec agencies, nor relevant policy.

There is no regulation concerning training or use of neckholds at the provincial level; the

research was unable to uncover policy in municipal agencies.)

19

5.2.6 New Brunswick

There appears to be no provincial regulation respecting training or use of neckholds.

Municipal police officers receive recruit training in lateral, vascular neck restraint at the Atlantic

Police Academy.

The Moncton Police Department has no in-service programs, and some unspecific policy

regarding its use.

5.2.7 Nova Scotia

The Dept. of the Attorney General recently prohibited training or use of neck restraints

by police officers. Municipal police officers receive training at the Atlantic Police Academy,

however, which includes lateral vascular neck restraints.

Halifax P.D. has cancelled its in-service training, and now has prohibitive policy regarding

carotid restraints.

There is no apparent standard in Canada concerning neckholds. When examining police

related neckhold fatalities, one consistent trend is a lack of in-service training and operational

policy on the part of the employment agency.

~1

20

5.3 International Jurisdictions

The bulk of highly publicized neck restraint fatalities have occurred in the United States;

there is, however, no, “American,” standard regarding training or use of the technique.

Amongst national agencies, the F.B.I. and D.E.A. include carotid restraint in their agent recruit

training and provide regular in-service refresher programs.

Both Washington and California are states which have mandated training requirements

for municipal police departments. Both the California P.O.S.T. Commission and Washington

State Criminal Justice Training Center have included carotid restraint amongst specified recruit

training requirements.

At the in-service level, however, there are huge variations between agencies. Seattle P.D.

allows use of the technique but provides no training; it is classified as “deadly force.” Bellevue

P.D. has prohibited use or training of the technique; this policy is currently under review.

In California, San Francisco P.D. provides in-service training and approves use of neck

restraint. L.A. P.D. provides irregular in-service training, but has effectively removed the

technique as a viable option by having policy equating it with the firearm.

Santa Ana P.D. has prohibited training with the technique, while Modesto P.D. allows its

use and provides in-service training. There is no scientific trend which appears from the survey.

Arguably the most liberal use of neck restraints is found in Kansas City P.D., whose

academy also trains several smaller regional agencies. The Lindell lateral vascular neck restraint

training system was designed in Kansas City P.D., and provides for use of the technique against

even modest levels of resistance. It is a priority in training, with 24 recruit and 8 annual in-

service hours mandated.

Actual operational use has recently been monitored by a reporting system; while a

comprehensive study was unavailable, training staff cited 15-20 applications per day without

injury, in the decade that the Lindell system has been taught.

The Lindell system is now offered as a private concern, and has been adopted by many

U.S. agencies. It has also been adopted by the Pressure Point Control Tactics Management

Systems training concern.

21

Amongst agencies which have adopted the Linddll approach is Metro-Dade County P.1)..,

which has a pristine safety record. This contrasts with Miami P.D. (overlapping jurisdictIons)

where a recent neckhold fatality by an untrained officer resulted in a high profile civil action.

San Diego P.D., until recently, had utilized the Lindell system in its recruit and in-service

programs. A Custody Death Task Force Report (1992) resulted in modification of training and

policy, whereby neck restraints are now used when nothing short of deadly force is a viable

option. Ongoing training and use has remained in place.

An observed trend is that jurisdictions which have prohibited training or use of neck

restraints frequently have done so in response to a fatality. A noteworthy example is Portland

Bureau of Police.

In 1987 a black suspect died after a neck restraint was applied by a white police officer.

There was considerable media and political attention, and the police executive cancelled existent

recruit training. No in-service programs were present. An immediate policy change equated use.

of neck restraints with firearms use. -

Members of the police officers association began distributing t shirts exhibiting the slogan,

“don’t choke em’... smoke em.” The two officers were summarily dismissed on the same day as

the funeral of the decedent.

~The officers began a civil action against the Chief and the City of Portland. The action

was successful, and the officers were reinstated. Apparently officers still use carotid restraint

with some regularity, despite a continued training prohibition.

This vignette example illustrates a common theme; in agencies where the technique is,

“prohibited,” the process has been political, as opposed to court, educational, or training study.

Outside of North America, neck restraints are used in New Zealand policing; the province

of Victoria in Australia recently enacted a training prohibition. Again there appears to be no

logical trend or standan.I.

22

PART SIX

ISSUE DISCUSSION AND RECOMMENDATIONS

In this Part, the research will discuss critical issues and make supportable

recommendations, for the consideration of the Commission of lnquiry. The issues will be

discussed in the following order:

6.1 Definition and Context

6.2 Operational Policy

6.3 Training

6.4 Future Research

Several issues have been previously addressed, in both oral and written submission, before

this Commission. The research will reference those submissions where appropriate.

6.1 Definition and Context

Any recommendations concerning carotid/vascular restraints are premature, unless this use

of force has been both: (a) defined, and; (b) placed in context with other uses of force (often

referred to as, “force options,” or “force continuum”).

When defining the technique, one must take substantial guidance from the medical

experts, who unanimously opined that this was a potentially lethal use of force. Any definition

must also concern itself with the likelihood of such an occurrence, which is admittedly very low.

What becomes problematic when defining neckholds is the unpredictably of an accident.

The Criminal Code addresses the issue of, “deadly force,” by describing, “force that is

likely or intended to cause death or grievous bodily harm.” There has been no suggestion that

carotid/vascular restraint is intentionally used in this fashion, and the medical risks, while real,

are of a low probability. Since carotid/vascular restraint is both unlikely and not intended to

cause death or grievous bodily harm, it does not meet the codified definition of, “deadly force.”

A definition of carotid/vascular restraint should not only warn of potential consequences,

but distinguish this use of force from those which are inherently destructive and more dangerous.

23

The medical experts, and recently the RCMP Public Complaints Commission ~ and Ontario

Chief Coroner, have described carotid/vascular restraints as preferable to baton strikes to the head

or firearms use. This opinion is supported by the Vancouver Regional Coroner.

Recommendation 6.1.1

The Commission of Inquiry should define carotid/vascular restraint as potentially

deadly force, and distinguish this tactic from deadly force (ie. cranial targets for impact

weapons and firearms use).

Any use of force, once defined, must be examined in the broader context of all uses of

force. In this fashion, an officer seeking guidance, or investigator reviewing an incident, might

ascertain whether any force contemplated was the least violent reasonable means.

For over two decades, law enforcement trainers and administrators have used models in

an attempt to guide officers who may be required to u~e force. Inherent in most use of force

models is a progressive categorization of types of force, often referred to as, “force options,” or

a, “force continuum.”

Since 1990, the development of a standardized escalation of options, and the nomenclature

and definition attached to each, has been a source of great dissension amongst B.C. law

enforcement trainers and agencies. A significant portion of the controversy stems from the

definition and contextual placement of neck restraints.

There are three approaches used in B.C. policing:

1) no model save reliance on case law direction;

2) five step, “force options theory.”

3) eight step model.

~Robinson, L., et al, Public Hearing Into the Complaints of Michael and Steven Cooper,”R.C.M.P. Public Complaints Commission, Victoria, B.C. (1991) See findings (E) and (F),Recommendations 4 and 6.

24

The research has been unable to find case law respecting neckholds, in which written

judgement places the technique in context amongst other uses of force. For this reason, the

research does not support the, “case law,” approach.

The five-step, “force options,” model has been presented by the BC. Federation of Police

Officers~ and B.C. As~ociation of Chiefs of Police~ as a uniform standard. In this model,

carotid/vascular restraint is described as the highest level of empty hand force, yet presented as

a lower level force option than compliance tools (ie. o.c. aerosols and impact weapons).

This contextual placement of neckholds, and consequent direction to officers, is difficult

to reconcile with the controversial, albeit infrequent fatalities. Particularly problematic is the fact

that the, “higher level,” compliance tools are quite different in both use and effect, and unlikely

to cause death save through gross abuse and/or intent.

The medical experts referenced do j~ support this contextual placement of neckholds,

nor does the B.C. Coroner’s Service. Contrary to the submission of the B.C. Fed, this “force

options,” model is ~ used in most police departments. (see background materials for various

models). Consequently, this approach is not supported by the research.

The eight-stage progression of options (JIBC, Victoria,) categorizes neck restraints as a

higher level of force than all options save deadly force. This contextual description is closest

to that recommended by the medical experts, and is also used by a large number of the agencies

reviewed. It also becomes consistent with Recommendation 6.1.1.

Accompanying any recommended definition of neck restraints, must be consistent,

unambiguous contextual placement. The B.C.A.C.P. submission, in Part 11.5, recognizes that,

“policy must ensure that relevant terminology is properly defined.” A definition of

carotid/vascular restraint wifi only give direction and guidance when placed in context with the

broader use of force issue.

)~McKay, J.K., Submission on Use of Force, Force Reporting, Vascular Neck Restraint, The

B.C. Federation of Police Officers, 92.12.2 1

~McKenzie, I., Interim Submission of the B.C. Association of Chiefs of Police, B.C.A.C.P.

25

Examination of the force options and potential responses included in departmental policies

gives a confusing presentation of carotid/vascular restraint. A wide range of terminology is used

interchangeably, and some agencies have included two models within the same policy.

Prior to recommending policy for use of carotid/vascular restraint, and after defining the

technique, the Commission of Inquiry should carefully consider standardizing progressive

response options respecting potential uses of force. This will clarify the context of

carotid/vascular restraint, and other potential uses of force.

The Commission of Inquiry may approve as many, or as few, “options,” for police use

of force as it sees fit. The number is not important, but a clear, consistent presentation of

potential police responses is critical. A standardized approach is central to B.C.A.C.P.

Recommendation No. 66, which recognizes that the B.C. Police Commission should create a

generic use of force policy.

Any and all responses approved by the Commission of Inquiry should be presented in

group context. Ideally the progression of response options would be in order of preferred use.

While a situational relationship would always determine the actual response, police should receive

guidance respecting the rank order and preference of considered options. The research

overwhelmingly supports carotid/vascular restraint as the penultimate option, i.e., nothing short

of deadly force is reasonable or practical.

Recommendation 6.1.2

The Commission of Inquiry should consider approving a list of response options for

police officers considering use of force. The list should be in progressive rank order, with

the carotid/vascular restraint considered after impact weapons, yet prior to the firearm or

head strikes with an impact weapon. This response option progression, or continuum,

should be included as part of a generic B.C. Police Commission use of force policy. (Sample

Model, Appendix II).I

26

6.2 Operational Policy

If the Commission of Inquiry chooses todefme carotid/vascular restraint, and place it in

context with other potential uses of force, it is logical to recommend a generic operational policy

specific to neck restraints. Generic policy is supported by the B.C.A.C.P., and may be considered

for reference by the B.C. Police Commission.

The critical decision respecting carotid/vascular restraint is whether or not policy will

prohibit use of the technique. This decision will also impact upon inclusion or preclusion from

any considered use of force model (See 6.1).

The advocates of prohibition regularly note that carotid/vascular restraint is dangerous,

potentially deadiy, and that numerous alternatives are available?8 At the other extreme,

proponents of its use often claim the technique is safe when properly applied, and are resistant

to direction concerning its use.

Unfortunately, “prohibition”, has often proven to be an exercise in futility. Training

experts contacted during the research were unanimous that neckholds w~e used by officers in

their jurisdiction, including those where the technique is, “prohibited,” and not taught.

Put quite simply, it is impossible to restrict information. Most ju-jitsu and judo schools,

and a large number of private trainers, regularly instruct neckholds. Instructional videotapes can

be ordered through martial arts publications, and textbooks are available in many bookstores.

An organizational prohibition will not prevent officers from leaning, and potentially using the

technique.

It is also questionable whether the fact that a technique carries risk renders it unfit for use.

Firearms are issued to police officers and the law permits their use, albeit under defined

circumstances; there has been no groundswell of public opinion to, “disarm police.”

Any number of trainers (public or private) or product representatives tout, “alternatives

to neck restraints.” Often these opinions are noticeably coincidental to political interests, or

product marketing, and are occasionally accepted by police officials.

Unfortunately, a police officer has many “alternatives,” to choose from when resolving

an incident; the critical issue is selecting that which is most reasonable. To replace any

~Sorochan, D., Presentation to the Commission of Inquiry, 93.07.07

27

technique, another must not only be an alternative but a substitute, i.e., equally reliable and

satisfactory in all circumstances.

The introduction of oleoresin capsicum aerosols to law enforcement has drastically

reduced the circumstances where neckholds are needed. Trainers contacted were quite consistent

in opining that use of ó.C. as a lower level of force would reduce reliance on neckholds, and this

philosophy was endorsed by the Vancouver Regional Coroner.

Agencies using O.C. have documented some noteworthy failures, however, and Victoria

P.D. statistics approximate a 10% failure rate. Often the failures involve dangerous subjects, and

situational factors often preclude the use of O.C. The advent of O.C. aerosols does not invalidate

the advice of a noted U.S. law enforcement trainer, “because weapons are not always at hand or

justifiable, they must be rejected when seeking a close quarter fighting system.”29

A Toronto PD. trainer has recently opined that using empty hand techniques to strike

nerve motor points is a suitable replacement for neck restraints.30 Unfortunately this opinionmakes dangerous assumptions about the ability of officers to strike both effectively and

accurately in a combative environment, and also does not account for unpredictable subject

responses.

Martial arts and systems have long distinguished between grappling and striking, and the

two are not interchangeable. The C.O. Bick College report equates carotid/vascular restraint

induced unconsciousness with that caused by cranial impact; clearly this is not supported by the

medical experts. The research would indicate that striking is no more a replacement for

carotid/vascular restraint than O.C. aerosols.

Both O.C. and select impact techniques will, however, reduce use of carotid/vascular

restraints, if presented in policy which sets their respective context. Many neckhold policies

allow the use of carotid/vascular restraints, “when no less violent means are available,” and then

fail to specify what those means are.

) ~Parsons, K., “Techniques of Vigilance,”: A Textbook for Police Self-Defence, (Portland,USA C.E. Tuttle Co., 1980) p.230

30Smith, D., “Report on the Lateral Vascular Neck Restraints (Carotid Restraint),” C.O. BickCollege, Toronto. 1992

28

Consequently, a generic policy must be accompanied by a definition and context (See 6.1)

and presented in consistent, plain language fashion.

Recommendation 6.2.1

That the Commission of Inquiry recommend generic policy regarding

carotid/vascular restraint, which is consistent with any approved use of force response

model, for consideration by the B.C.A.C.P. and B.C. Police Commission. (See Appendix III).

6.3 Training

Should the Commission of Inquiry select a policy attempting prohibition of neck

restraints, the question of training becomes moot. Under any situation where neck restraints may

be allowed, however, the issue of training becomes critical.

An identified trend in the agency survey conducted during the research, was that

jurisdictions which had experienced neckhold fatalities: (a) had minimal recruit level training,

and/or; (b) had no in-service retraining programs.

The State of California mandates recruit-level neck restraint training through its P.O.S.T.

Commission, yet that training mandate passes to the individual agency for in-service programs.

Many agencies, however, then either neglect or prohibit in-service training.

It becomes problematic that a taught skill which is easy to learn and widely utilized, is

then allowed to deteriorate or become subject to individual preferences and experimentation.

This would seem to increase the likelihood of mishap, and/or abuse by police officers.

Without exception, all Canadian neckhold fatalities the research uncovered, occurred in

jurisdictions which supplied no in-service training. Unfortunately, this situation exists in several

B.C. Municipal Police departments and the R.C.M.P.

When contrasted with the Kansas City P.D. model, where regular retraining and y~

liberal use of neck restraints has produced no fatalities in a decade, training becomes a critical

area for recommendation.

29

The failure of some agencies to provide ~ training to its members concerning neckholds

is not supported by the research. Alberta, Ontario and Nova Scotia have adopted this approach

with the apparent rationale of training their police to use other means to control violent subjects.

Unfortunately, where the subject cannot be controlled short of unconsciousness, this leaves

officers dependent upon cranial impact or the firearm, both of which were described by the

referenced medical experts as much less desirable.

There are also the troubling statements of trainers from these jurisdictions that police

continue to use the techniques. Clearly, information and knowledge cannot be restricted.

March 2, 1993, the Calgary Chief of Police approved use of O.C. aerosols. In the same

directive, carotid restraint training was discontinued. The clear intimation is that O.C. aerosols

will replace neck restraints.

As has been discussed in the previous section, this is not likely to be the case. There is

a complete absence of empirical data for comparison; many trainers, however, (including the

researcher) believe that use of O.C. will reduce the uses of neck restraints.

Some individuals have opined that since use of neck restraints will likely decrease, it is

no longer worthy of priority status in training. This opinion seems to fail the test of logic, and

direction given by the civil law.

When addressing the issue of, “foreseeabiity,” courts regularly examine:

(a) the probability of occurrence, and;

(b) the consequences of the event, should it in fact occur.

Although the probability of occurrence is low, and the consequences likely to be benign,

there is the possibility of a death. This must be of overriding concern.

If this were not the case, it might make sense to extend the contrary argument to the areas

of firearms training (minimal probability) and firearm retention (negligible).

Recommendation 6.3.1

That any recommendations the Commission of Inquiry chooses to make, which

mandate either recruit or in-service training programs, include as a component the subject

of neck restraints.

30

A related issue concerns the suitability and adequacy of any contemplated training, as well

as that which currently exists. Certainly it would seem desirable, and feasible, to present a

uniform training package to B.C. Municipal Police Officers.

Any such standardized program must allow for growth and instructor inventiveness, to

accommodate agency distinctiveness and avoid the trap of micro-management. It is certainly

reasonable to train instructors to a credible level, however.

There currently exists no uniform instructor standard, anywhere, including B.C. Although

certain private trainers will offer, “instructor certification,” such programs are often highly

opinionated and not consistent with J.I.B.C. policies or programs. The public is not served by

having standards set by individuals and organizations who are not accountable.

Since an employer will, in most circumstances, be held at least partially liable for tortious

acts committed by on-duty employees, allowing private U.S. training concerns to set standards

creates a dangerous situation. With municipalities often bound by collective agreement for any

:1 liability incurred by on-duty officers, as well as common law principles of vicarious liability, the

taxpayer will eventually incur any assessed damages and costs. With an outside concern setting

standards, the police agency will then be held accountable without assuming the inherent

responsibility.

The J.I.B.C. Police Academy Control Tactics Instructor Certificate Program, ideally, could

provide such skills and standards. Unfortunately, some agencies either do not require or cannot

afford to send candidates on 14 week courses.

Additionally, any apprenticeship program is highly dependent upon practical application

of the learned skills. With no Use of Force Coordinator position, a variable (currently very

small) number of recruit training hours, and no mandate for in-service programs, the credibility

of this 14 week program is now in question.

Recommendation 6.3.2

That the Justice Institute of B.C.fPolice Academy be mandate to design, and hold at

regular intervals, a Carotid/Vascular Neck Restraint Instructor Certification Program.

31

6.4 Future Research

6.4.1 San Diego P.D. Custody Death Task Force Report, 1992

This report was unavaliable for reference, and should be added to the Commission of

Inquiry library. Although the results were discussed with San Diego P.D. personnel, some details

may be relevant which were not uncovered through interview. It is suggested that the

Commission obtain at least one copy.

6.4.2 Empirical ResearchlV.G.H. Vascular Lab

Several of the referenced medical experts noted that arrival of new, non-invasive

equipment at Vancouver General Hospital, which might provide a clearer picture of the

physiological consequences of neckholds. The experts were interested in the possibility of a

research project.

This would be of great significance to contemplated training programs. Although not

specifically within the Commission of Inquiry mandate, the author of this report will advise of

any future developments.

)

32

PART SEVEN

SUMMARY OF RECOMMENDATIONS

6.1.1 The Commission of Inquiry should define carotidlvascular restraint as potentially

deadly force, and distinguish this tactic from deadly force (ie. cranial targets for

impact weapons and firearms use).

6.1.2 The Commission of Inquiry should consider approving a list of response options for

police officers considering use of force. The list should be in progressive rank order,

with the carotid/vascular restraint considered after impact weapons, yet prior to the

firearm or head strikes with an impact weapon. This response option progression,

or continuum, should be included as part of a generic B.C. Police Commission use

of force policy.

6.2.1 That the Commission of Inquiry recommend generic policy regarding

carotid/vascular restraint, which is consistent with any approved use of force

response model, for consideration by the B.C.A.C.P. and B.C. Police Commission.

6.3.1 That any recommendations the Commission of Inquiry chooses to make, which

mandate either recruit or in-service training programs, include as a component the

subject of neck restraints.

6.3.2 That the Justice Institute of B.C./Police Academy be mandated to design, and hold

at regular intervals, a Carotid/Vascular Neck Restraint Instructor Certificate

Program.

)

Appendix I

Synopses of Interviews

With

Selected Medical Experts

)

34

Forensic Pathology

Expert Reference: Dr. Donald Reay, M.D.

King County Medical Examiner

325 9th Ave., Seattle, Wa. 98104

Ph: (206) 223-3232

Interview Date: 93.07.22 @ 1330 hours

Dr. Reay has studied numerous neckhold fatalities over the past decade, and has published

empirical research on the subject (see References). He has provided expert evidence at the

request of the R.C.M.P. Public Complaints Commission and B.C. Coroner’s Service. Dr. Reay

was consulted to elicit an opinion on the inherent risks of neckholds, as well as recommendations

for policy and/or training.

Dr. Reay stated unequivocally that vascular/carotid restraints were, “good,” holds, and he

supported their availability for use by police officers. That being the case, Dr. Reay cautioned

that police must be properly trained, including appropriate C.P.R./after care. Training and policy,

he believes, must highlight the potential dangers, and appropriate context for use of neckholds.

Concerning use of force context, Dr. Reay’s opinion was that impact strikes to the body

and limbs were preferable to the use of a neckhold. Vascular restraints were preferable, however,

to baton strikes to the head and neck, or firearms use. Dr. Reay opined that these last two uses

of force were destructive by their nature; a neckhold, while holding the potential for fatality, need

not necessarily be so.

Dr. Reay’s preference was to categorize neckholds generally as, “deadly force,” although

less dangerous than cranial baton strikes or firearms. Since there is an inherent level of

unpredictability, Dr. Reay’s reasoning was that this description is necessary to ensure that officers

are alert to the potential consequences.

35

Dr. Reay was uncertain as to the likelihood of mishap when a vascular restraint is used.

Although some groups of people could be identified as, “high risk,” exactly what that risk is

cannot yet be determined. Discussion centered on the reluctance of law enforcement agencies

to maintain accurate records on uses of force, including neck restraints. Since a cost-benefit

analysis was impossible, due to the absence of records, Dr. Reay felt that this rendered many

agencies unable to withstand scrutiny following a contentious incident.

A critical is sue was the training of police officers in appropriate fIrst aid. Dr. Reay

opined that police must be prepared for those unpredictable cases of abnormal subject recovery.

Discussion focused on the general need for a regular, “first responders,” program for police,

including regular recertification intervals.

Training priorities suggested, included an emphasis on securing the lateral, vascular

restraint, avoiding slippage into a bar choke. Retraining at specified intervals was noted as a

) necessity. Dr. Reay suggested that any policy address neckholds generally, since a narrow focuson the carotid restraint ignored the potential for accidental chokeholds.

)

36

Orthopaedic Medicine

Expert Reference: Dr. Peter Wing, M.D.

Head of Orthopaedics, Spinal Cord Unit

University HospitallShaughnessy Site

4500 Oak Street, Vancouver, B.C.

Ph: 875-2036

Interview Date: 93.07.08 @ 1600 hours.

Dr. Wing was interviewed to elicit an opinion on the potential for injury to the cervical

spine, created when a neckhold is applied to a resistant human subject. Dr. Wing was provided

with some illustrative literature, as well as a demonstration by the researcher.

Dr. Wing stated that there is potential for either soft tissue or fracture injury when

directional pressure is applied to the cervical spine. That being the case, the squeezing pressure

of a vascular restraint was not in itself believed to be significantly dangerous. Of greater risk

to the subject are the unpredictable forces generated by combative resistance, coupled with the

officer’s attempts to hold the subject in position.

The forward positioning of the subject’s head, recommended by JIBC and PPCT/Lindeil

training methodology, was endorsed as the safest of viable alternatives. With forward flexion

described as the safest, lateral flexion with twisting was explained as the most dangerous

directional force. The amount of force, combined with the angle and degree of flexion, were

described as the critical risk factors.

A certain percentage of the population (low) may have bone disease or congenital

malformity which renders them susceptible to injury; there is no “field diagnosis,” available for

a police officer.

Dr. Wing stated that predictions of injury are difficult, in the absence of empirical tests

utilizing neckhold techniques. Such tests, utilizing cadavers, may be possible should further

research be funded.

37

Otolarvngology

Expert Reference: Dr. Holly Stevens, M.D.

Ears, Nose, and Throat Clinic

University HospitallShaughnessy Site

G-359 4500 Oak Street, Vancouver, B.C.

Ph: 875-2045

Interview Date: 93.07.19 @ 1500 hours

Dr. Stevens was interviewed to elicit an opinion on the potential for injury to the

laryngeal structures, created when neckholds are used on resistant human subjects. Dr. Stevens

was provided with the pathology of some neckhold injuries. Additionally, the researcher

provided a demonstration of both a bar-arm choke and lateral, vascular restraint on Mr. Doug

Farenholtz, who was present for the interview.

Dr. Stevens opined that the potential for injury was substantially greater with the bar-aim

choke than the lateral, vascular restraint. In Dr. Stevens opinion, the amount of force required

to generate injury would be considerable, even when using a bar-arm choke. When addressing

the issue of laryngeal damage, Dr. Stevens felt that the duration of the hold would be a relevant

factor.

With the researcher demonstrating a lateral, vascular neck restraint, Dr. Stevens observed

that there was very little pressure on the larynx of the subject (Doug Farenholtz). This did not

change when extreme pressure was applied to the restraint.

As a consequence of the demonstration, and subsequent discussion, two factors were

identified as critical to prevention of laryngeal injury:

(a) preventing a lateral, vascular restraint from slipping into a “bar,” choke.

(b) gaining control as quickly as possible, to preclude the unforeseen consequences of

subject resistance.

Dr. Stevens suggested that laryngoscopic examination would be possible while a subject

was experiencing a neckhold. This is a promising area for future research.

38

Vascular Surgery

Expert Reference: Dr. A.J. (Tony) Salvian, M.D.

7081750 W. Broadway, Vancouver, B.C.

Ph: 874-0532

Interview Date: 93.07.14 @ 8:00 a.m.

Dr. Salvian was consulted to elicit an opinion on the effector mechanisms of a vascular

restraint, as well as potential risks and medical concerns. Dr. Salvian was provided with some

literature, as well as a demonstration by the researcher (on Mr. Doug Farenholtz, present for the

interview).

Dr. Salvian found that the reasoning behind the physiology of application (Part Three) was

sound. Dr. Salvian opined that, upon lateral arm pressure to a person’s neck, the jugular veins

would be occluded before the carotid arteries. Dr. Salvian also noted that a vaso-vagal response

(through carotid sinus stimulation) was likely a strong factor. The Valsalva maneuver was

believed to be a less reliable effect of the restraint.

Regarding risk, Dr. Salvian endorsed the pathology of reported cases. Dr. Salvian also

noted that in some individuals, carotid sinus stimulation and the subsequent vaso-vagal response

is sufficient to cause cardiac arrest.

Dr. Salvian opined that actual level of risk to individuals can be more accurately estimated

through an analysis of cranial blood flow. New technological advances have made non-invasive

measurement of intracranial circulation possible. Dr. Salvian will be discussing with the

researcher the possibility of a future experimental study.

)

39

Neurosurgery

Expert Reference: Dr. F.A. (Felix) Durity, M.D.Division of Neurosurgery

UBC Faculty of Medicine

#300-700 W. 10th Ave.

Vancouver, B.C. V5Z 4E5

Phone: 876-5811

Interview Date: 93.07.28 @ 0800 hours

Dr. Durity was consulted to elicit an opinion on the neurological consequences of

neckhold application, in particular the contributing factors to cerebral ischemia and consequent

loss of consciousness.

Dr. Durity opined that of the noted effects of a carotid/vascular restraint (Part 111.1),

) carotid occlusion and a carotid sinus induced vaso-vagal response are the likeliest contributorsto cerebral ischemia. Although occlusion of the jugular veins is likely, the brain has an extensivó

collateral drainage system which would largely offset induced congestion.

Dr. Durity had spoken with Dr. Salvian (see Vascular Medicine) prior to the interview;

there is potential for a collaborative research project utilizing new technology (trans-cranial

Doppler) in the V.G.H. vascular lab. The researcher wifl be meeting with Dr. Durity et al in

August, to discuss further research of relevance to the Commission of Inquiry.

)

Appendix II

Generic Response Options

For

Police Use of Force

41

A. The following response options are endorsed as guidelines for officers required to use force.

Consistent with a philosophy of resolving an incident at the lowest reasonable level of force, the

options are presented in rank order of preference. The actual option used will, of course, be

dependent upon a totality of circumstances including situational and officer variables.

1. Officer Presence

2. Dialogue

3. Open Hand Control Tactics

‘physical superiority

‘pain compliance

•lever and joint manipulation

•throws and takedowns

•mechanical control

•handcuffs and restraint devices

4. Aerosol Irritants

•oleoresin capsicum

5. Empty Hand Impact

‘striking techniques

6. Impact Weapons

•batons

7. Neck Restraints

•carotidJvascular restraint to be considered potentially deadly force

8. Deadly Force

•firearms

‘impact weapon strikes to the head

‘vehicle weaponry

B. Should police officers find the aforementioned options insufficient, unavailable or

inappropriate, they may use any reasonable weapon of opportunity to defend themselves or

members of the public.

APPENDIX III

SAMPLE

GENERIC POLICY

43

The Commission recognizes that police may be required to use neck restraints to control

violent subjects. Officers considering use of any such technique are directed by the following

guidelines:

1. Any neck restraint is to be considered potentially deadly force.

2. The recommended technique is a carotid, vascular restraint. Chokeholds are strongly

discouraged.

3. A violent subject must require immediate control, whereby there is a real and imminent danger

of harm to the police or members of the public,

4. Lower level force responses were ineffective, or considered to be inappropriate and

unreasonable.

5. When a subject has been rendered unconscious through the use of any neck restraint, the

member shall, when reasonable to do so:

(a) handcuff the subject behind the back;

(b) place the subject in the 3/4 prone recovery position;

(c) monitor the subject’s vital signs;

(d) if the subject does not regain consciousness within 30 seconds, notify Provincial

Ambulance Service;

(e) if the subject exhibits an abnormal recovery, including respiratory difficulty, notify

Provincial Ambulance Service;

6. Police are reminded at all times that they may be required to provide emergency first aid to

a subject upon whom a neck restraint is applied.

) 7. When a controlled subject is then turned over to the custody of another officer, then thatofficer must be advised that a neck restraint has been previously applied.

44

REFERENCES

Eisele, John W., and Reay, Donald T., “Death From Law Enforcement Neck Holds”, 2i~American Journal of Forensic Medicine and Pathology (Vol. 3 No. 3: September 1982)

Holloway, G. Allen, and Reay, Donald T., “Changes in Carotid Blood Flow Produced by NeckCompression”, The American Journal of Forensic Medicine and Pathology (Vol 3 No. 3:September 1982)

Ikai, M., et al. “Physiological Studies on, “Choking”, in Judo”, Bulletin of the Association forthe Scientific Studies on Judo, Kodokan (Tokyo: 1958)

Kashiwazaki, Katsuhiko. Shimewaza: Judo Masterciass Techniques (Ippon Books, 1985)

Kornblum, R., “Medical Analysis of Police Chokeholds and General Neck Trauma,” Trauma,February and June 1986 (Matthew Bender and Co.: New York) No. 1

Kowai, E.K., “Deaths Allegedly Caused by the Use of “Choke Holds” (Shimewaza), Journal ofForensic Sciences (JFSCA, Vol. 32 No. 2, March 1982)

Lyons V. City of Los Angeles, 656 F. 2d 417 (1981)

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