Journal of Forensic Medicine

Background: EMS and police are often faced with violent subjects that require the use of force and the application of restraints. After gaining control and restraining subjects, he or she can be physically placed into a number of positions including prone, supine, on their side or sitting. However, due to cases of sudden death of restrained individuals, there has been increased scrutiny towards the positions in which a subject is left after he is restrained. Methods: This was an evaluation of prospectively collected data from a single law enforcement agency for all subjects in which a use of force was utilized during a one year study period. Data collected includes whether the patient was agitated, resisting arrest, the level of resistance the subject demonstrated and how long the subject resisted for after being placed in his final restraining position. Results: Of 2431 use of force incidents, 1535 (63.1%) patients ended up being placed in a prone restraint position, 43 (1.7%) were restrained lying face up, 64 (2.7%) were placed on their sides and 224 (9.2%) were placed in a sitting position. Of all of the subjects who were restrained, 1863 (76.6%) incurred no injuries. 354 (14.6%) subjects were treated at a hospital and then cleared for discharge. No fatalities were noted in any subjects of the research population. Conclusion: Use of force incidents commonly result in individuals placed in a prone restraint position, however, we found no fatalities of individuals placed in a prone restraint position.

Death due to fall from height is a complex forensic issue. It could occur in suicide, accident or even homicide. Study of fall from height in China seems to be rare. In this study, 250 individuals died in fall from height cases in Shanghai were collected retrospectively from the files of SPSB from 2002 to 2011. We evaluated the demographic data, the manner of death, forensic examination findings, and toxicological test results. Overall 250 individuals, 176 were male and 74 were female. 223 individuals were identified. Ages ranged from 1 year old to 86 year old. The average age was about 33.4 ± 15.3 years. The proportion of age from 18 to 29 was the highest. Among 223 identified individuals, 170 were Chinese and 53 were foreigners from 17 countries. Manner of death was mainly suicide (46%, 115/250) and accident (18%, 45/250), while the proportion of homicide was low (3.6%, 9/250). The proportion of undetermined was high (32.4%, 81/250). Forensic full autopsies were done in 87 cases. Ethanol and drugs detection were done in 118 individuals. Individuals’ psychiatric history was not collected in the files. In conclusion, the characteristics of fall from height cases in Shanghai, China, are summarized to these: manner of death was mainly suicide and accident, low proportion of homicide, and high proportion of undetermined cases. Males were more than females. Individuals were mainly young adults. The injuries recorded in forensic examination files were common to occur in the exposing areas of body.