Friday, December 5, 2014

No Choke Hold in Eric Garner's Death; More Media Lies

Not All Neck Holds Are Chokeholds

Short (relatively) version

Recently when I wrote wrote, "Garner did not die of asphyxiation, he died of heart failure." the response was; Nowhere does the report mention heart failure, (with the two attached links
Chokehold Police Custody Cause of Death 
Autopsy: Police Chokehold Caused NYC Man's Death

I responded;

From your first link: "The medical examiner said compression of the neck and chest, along with Garner's positioning on the ground while being restrained by police...caused his death".

From your second link: "Asthma, heart disease and obesity were contributing factors in the death."

Both sentences indicate the factors of his death; but they did not say he died of asphyxiation (which is the manner of death from a chokehold). The term "chokehold" gets used quite a lot, but just because an officer uses a neckhold does not mean it is a "chokehold" that stops breathing.

Question: It may sound technical and it may sound like it's semantics, but if one hold is illegal and the other is legal, that is a big distinction.
Dr Baden: That's a distinction, but in this case, doesn't make a difference to me because when we're looking at the autopsy findings, the autopsy findings, whatever we call it, chokehold, headlock, there was enough pressure on the neck to prevent the blood flow .www.foxnews.com/on-air/hannity...

In this case the neck restraint was described as restricting blood flow, not air flow; but air flow was restricted by Garner's positioning on the ground while being restrained by police; ie piled on top. It was a combination of factors that led to Garner's heart to stop. Since the heart stopping is the definition of death, not the cause, the medical examiner is looking for what caused the heart failure; and in this case is was a number of factors. The media however prefers a 4-5 word headline and 2-3 sentences in the body of the article glossing over a 27 page medical report;  they just throw out "He Was Killed By Chokehold," without explaining or going into any detail what the medical examiner was actually describing. It is also apparent that the medical examiner uses the terms chokehold and neckhold (like Dr Baden) interchangeably; however the terms are quite different when it come to the culpability of the police officer.

With the pressure on Garners chest and the other contributing factors (ie asthma), positional asphyxia, which is far more common cause of death, would be the likely suspect; a lateral neck restraint that only restricts blood flow has never to my knowledge been declared a cause of death. It should be noted that while a bar arm choke hold (which can crush the hyoid neck bone and lead to asphyxiation) is against NYPD regulation, but a lateral neck restraint (aka a coradid restraint) is not. You will see in the video, the police turned Garner on his side after he was handcuffed; this is done to help prevent positional asphyxia, which generally occurs in combination with drugs or other contributing factors. Unfortunately for Garner it was to little, to late.

 If you watch the video, Garner is grabbed in a neck hold @ 1:21; @ 1:33 (12 seconds later) the officer releases his neck restraint to grab Garner's outstretched right arm, to pull it behind his back to handcuff him; as another officer is holding down Garner's head. This is also the first time Garner says "I can't breathe". By 1:57 (24 seconds later) Garner is handcuffed and laying on his side and no longer saying "I can't breath." So at worst, the police caused Garner to have trouble breathing for 24 seconds; at this point the person taping the incident is also saying Garner might be having a seizure. If this is an indication that he went unconscious, your still dealing with a person that went unconscious and in 36 seconds subsequently died sometime later. That's a long time with police officers grabbing at you, throwing you to the ground, piling on you and forcing your hands behind your back to be handcuffed, but it is hardly enough time to be suffocated even to unconsciousness. .

There is also a big deal made of the fact that Garner's death was ruled a homicide by the medical examiner. The reason for this is there are only five manners of death the medical examiner can use; Natural, Accident, Homicide, Suicide or Undetermined. Since Garner death was the result of an interaction another person(s) it is by definition a homicide; the same would be the case in a death resulting from self defense

Longer version with pictures

In response to the OpEd on the Eric Garner death at the hands of the police, Eugene Robinson from the Washington Post got a lot of facts wrong. The Garner Case's Sickening Outcome (there certainly was a sickening outcome, but it was from the media not the Grand Jury).  First, the police have a right to overcome resistance when making a lawful arrests and that includes non-compliance. There is also a big deal made of the fact that Garner's death was ruled a homicide by the medical examiner. The reason for this is there are only five manners of death the medical examiner can use; Natural, Accident, Homicide, Suicide or Undetermined. Since Garner death was the result of an interaction another person(s) it is by definition a homicide; the same would be the case in a death resulting from self defense.

A chokehold is not defined as restraining a person by the neck, but that is how the media is treating it. While not a chokehold (meant to compress the suspects windpipe if they struggle), what you actually see is a neck or head take down, where due to the height disparity between the officer and Carter, the officers hand slipped over Carter's windpipe for several seconds. Then you see the officer holding Carter in a head restraint where there was no apparent pressure on his windpipe, so there was no chokehold. A classic chokehold (more properly called a "bar arm" neck restraint), is when the officer places his forearm across the suspects neck with one arm, grabs the subjects shoulder or his own bicep, then places the other arm behind the subjects head, holding the back of the head with an open hand (see below).  The reason choke holds have been banned is they put pressure on ones neck over the windpipe, that can result in tissue damage and/or broken neck bones, which in turn can cause swelling around the windpipe resulting in asphyxiation; however the coroner also found no damage to Garner's neck bones or windpipe, so the finding seems cryptic at best. I think someone should question the coroner to determine, if there was no damage to his neck bones or windpipe, how did a compression on his neck cause his death? I have sat in on numerous autopsies so I have some idea how "cause of death is determined", and this simply makes no sense.




On the other hand, there is another neck restraint that does not put any pressure on the windpipe,   called a "lateral vascular neck restraint", where the officer holds the suspect's neck, with the crook of his arm at the windpipe, so there is no pressure on the front of his neck.


With the Garner's arrest you see the officer holding Garner's neck more in line with a lateral vascular neck restraint.





While it's ambiguous whether there was any real pressure on his windpipe, the hold on Carter's neck lasted from about 1:21 on the video until 1:34 (13 seconds) when the officer released his neck restraint to grab Garner's outstretched right arm, to pull it behind his back. The coroner finding was the deadly encounter Thursday did not damage his windpipe or neck bones Autopsy says Garner Had No Throat Damage. However that was followed up with, compression of the neck and chest, along with Garner's positioning on the ground while being restrained by police caused his death. Garner's acute and chronic bronchial asthma, obesity and hypertensive cardiovascular disease were contributing factors. Timeline Eric Garner Chokehold Death Arrest  Besides, by the time Mr Garner was saying he could not breath, he was no longer being held in a neck restraint; the officer had released his hold on Mr Garner's neck to grab his free hand. Another officer was pinning Mr Garner's head on the ground when he was calling out.

The video, which captured the moments leading up to Garner’s death, showed the 350-pound man saying “I can’t breathe, I can’t breathe,” as Pantaleo placed him in a chokehold and wrestled him to the ground. Garner died of a heart attack on the way to the hospital, according to officials. Garner’s death was ruled a homicide by the New York City Medical Examiner, which identified the cause of death as “compression of the neck” as well as complicating health factors, such as Garner’s weight and asthma. New York state law defines homicide as “conduct which causes the death of a person.” No Indictment with Cop Chokehold death So what the medical examiner is saying is the neck compression caused Garner's heart attack. But since there is no way a neck compression by itself can directly cause a heart attack, the medical examiner is saying the activity surrounding the "neck compression" caused the Garners heart to stop. Again I do not dispute this at all. What I question is the media stating Eric Garner was killed by a choke hold, which he was not. An initial autopsy report shows no damage to his neck bones or windpipe. The likely cause of death (was) a heart attack, precipitated by the arrest, chokehold and takedown. Garner weighed 350 pounds and had chronic asthma, diabetes and sleep apnea."  Eric Garners Death


It appears is was the the indirect stress on Garner's heart from the police overcoming his resistance, that caused his heart to fail. The point being that even if a choke hold was used on Eric Garner (which, while being against NYPD regulations, is not illegal) it caused no damage. There is a huge difference between a suspect, due to a heart condition, dieing of a heart  failure as the result of a confrontation with the police, and the use of a choke hold directly casing the death by asphyxiation; to say that compressions on the Garner's neck caused his death, is a cryptic and dishonest finding that was meant to be misinterpreted for political purposes.

Next there is the numerous "I can't breathe"  statements from Eric Garner. The primary problem with this is, if someone is saying they can't breathe, the very action of them speaking means they are breathing. There are several reasons that Garner would have felt like he couldn't breath that has nothing to do with the police officer's head restraint; what was more relevant were the police officers stacked on top of him. First Garner was asthmatic and asthma attacks can be brought on by stress and/or physical activity. Also, when an overweight person is restrained with both hands pulled behind their back, it expand their chest, making breathing more of a chore; further if a handcuffed person is placed face down on the ground, the additional pressure on their chest makes breathing even harder. In the past there has been an attempt by defense attorneys to claim this position can cause something called "positional asphyxiation"; however this has never been medically verifiable.  In the video of Garner's arrest, you see once Garner stops resisting and is handcuffed, the officer turns Garner on his side; this is per the officer training to err on the side of caution regarding "positional asphyxiation."

In essence you have a lawful arrest gone bad that resulted in the tragic death of the suspect; but it was not due to any improper actions by the NYPD. But like the Brown slogan that never occurred (Hands up don't shoot"), the  headlines saying that a, "NYPD Chokehold" killed Garner is another fairytale, designed to sensationalize these incidents and inflame racial tensions. The reality is bad things can happen when you resist the police, so it is best in the vast majority of cases to respect the law and comply.

edit: In an interview Dr Baden who analyzed the NY medical examiners office said, ... "After he (Garner) loses consciousness, he still breathes for a few minutes -- before his heart stops." but Dr Baden seems to contradict himself in the interview. Dr Michael Baden Offers Insight Into the Death of Eric Garner

Baden: But I think the autopsy itself -- the medical examiner did a great job on this. There's 27 pages in the report. And the female (Medical Examiner), she found that there were 10 hemorrhages on the inside of the neck, in the muscles of the neck, petechial hemorrhages in the eye, hemorrhage in the tongue. And those are all evidence of neck compression. You're right, chokehold has many different meanings in all. What we're concerned at autopsy is was there pressure on the neck. In this statement Baden describes damage to the inside of Garner's neck, but makes no mention of his windpipe or the hyoid bone, which is almost always broken when a person is choked.

Question:   It may sound technical and it may sound like it's semantics, but if one hold is illegal and the other is legal, that is a big distinction.
Baden: That's a distinction, but in this case, doesn't make a difference to me because when we're looking at the autopsy findings, the autopsy findings, whatever we call it, chokehold, headlock, there was enough pressure on the neck to prevent the blood flow ... that you talked about, to prevent air flow, and pressure on the chest and face, so that when he's saying, I can't breathe, he's telling the truth...And he died of not being able to breathe.

In the final analysis,  Dr Baden makes the distinction between the pressure on Garners body, which   made it hard to breath and the pressure on his neck that interfered with blood flow (not the damage from a chokehold. And while Dr Baden says  "he died of not being able to breathe". This seems to conflict with the following statement,  "After he (Garner) loses consciousness, he still breathes for a few minutes -- before his heart stops." The most likely meaning is the pressure on Garner's neck may have rendered him unconscious, while the pressure on Garcia's body, exacerbated by his asthma and heart condition, caused Garner to have a heart attack.

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