For decades, police in the United States have been warned that the common tactic of handcuffing someone downwards can prove fatal if officers pin him or her to the ground with too much pressure or for too long.
Recommendations first made by major departments and police associations culminated in a 1995 federal safety bulletin explaining that holding someone on their chest in what is known as the prone position can dangerously restrict breathing. The solution: Once handcuffed, turn them on their side.
But what some officers are doing on the streets today violates what has long been considered safe, a deadly disconnect that highlights persistent failures in police training, an Associated Press investigation has found.
Prone cases are among more than 1,000 AP-documented cases of people who died not from a gunshot in the past decade, but after officers used force not intended to kill. In total, at least 740 of these encounters involved restraint, making it the most common tactic. It was also often misapplied.
Each state writes its own standards, and individual departments and training centers determine what officers hear in classrooms and gyms. The safest techniques do not always end up with agents.
What officers learn about the risks of prone positioning depends on geography.
Nearly all states have a Peace Officer Standards and Training agency that outlines what needs to be taught, so AP asked each committee if it needed instruction on positional asphyxia, which happens when the chest cannot expand, starving the body of oxygen . Of the states that responded, 10 said they did not require positional choking training and 20 states said they did offer it.
To understand what officers knew before deaths involving coercive force, reporters sifted through thousands of pages of interviews and statements.
In nearly 100 cases, AP identified documents showing whether officers had training or were otherwise aware of the risk of positional asphyxia. In 80 deaths, at least one officer involved was trained in or knew of the potential dangers, although they did not always immediately faze someone. Officers in another 14 deaths said they had no training and did not know the risks; could not remember 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 struggling for air is resisting arrest.
In order to speak, air must move past the vocal cords in the throat. To inhale oxygen and expel carbon dioxide, air must travel to and from the lungs. The short extra distance can be huge if someone is struggling to breathe.
“There’s a big difference between fighting the officers and fighting for air,” said Seth Stoughton, a law professor at the University of South Carolina and a national expert on use of force who, as a former officer and police trainer, has written extensively on restraints.
The California Legislature passed a law in 2021 stating that departments “shall not authorize techniques or methods of transportation that present a substantial risk of positional asphyxia.” The legislation’s sponsor said he wanted to limit the tendency toward restraint. But the law doesn’t stop some instructors at state-certified training centers from continuing to teach that holding someone face down is a good practice.
One of the most experienced instructors in California is David Rose, who in his four decades as a trainer has taught thousands of officers that the prone position is safe. Rose said he instructs officers to hold a person face down with as little pressure as possible unless he or she is combative. He said the methods he teaches do not violate California law because prone positioning does not pose a serious risk of positional asphyxia.
“Positional asphyxia does not occur at all. That doesn’t happen in the field,” Rose said in an interview at a regional training center in Sacramento.
“Placing weight on someone’s back in a prone position will not cause them to collapse unless it is enough to actually crush them,” he said.
Rose bases his belief on research compiled by lawyers, professors and police experts who defend officers when they are taken to court.
Officers almost always used prone positioning with other force, and in AP’s database, medical officials cited prone positioning or asphyxia due to force as a cause or contributing factor in 61 of 740 cases involving the maneuver during the 2012-2021 period of the study . In dozens of other cases, officers used the prone position and “restraint” was cited as causing or contributing to the death, but prone position or restraint was not specified.
In many other cases, the cause of death was related to drugs or medical conditions rather than violence. Due to data suppression, reporters could not always obtain the official determination.
AP contacted the California Commission on Peace Officer Standards and Training and asked whether Rose’s teachings on positional asphyxiation were in line with state requirements. “POST is taking action and has notified the Sacramento (Training) Center that they are not following the law. The issue will be resolved,” spokesperson Meagan Poulos wrote in an email Monday.
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Sean Mussenden and Mary Dalrymple contributed to this story from the University of Maryland’s Howard Center for Investigative Journalism.
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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 programs and FRONTLINE (PBS). The research includes the interactive story Lethal Restraint, the database and the documentary “Documenting Police Use Of Force,” which premiered April 30 on PBS and is available online. To view stories from journalists in the Howard Center for Investigative Journalism programs, go here.
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The Associated Press receives support from the Public Welfare Foundation for criminal justice-focused reporting. This story was also supported by Columbia University’s Ira A. Lipman Center for Journalism and Civil and Human Rights in partnership with Arnold Ventures. The AP is solely responsible for all content.
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Contact AP’s global investigative team at [email protected] or https://www.ap.org/tips/
