Forensic Pathologist Testifies That Police Restraint Led to Death of Manny Ellis

Dr. Roger Mitchell said last Thursday he believes the way police restrained Ellis was ultimately what led to his death.

Dr. Mitchell has been a practicing forensic pathologist since 2007 and is currently the chair of pathology and the chief medical officer for ambulatory care at Howard University. His experience spans over a decade overseeing thousands of death investigations in New York, Washington D.C., New Jersey and Texas.

In addition to his duties, Mitchell teaches medical students and residents, including lessons about hypoxia and its effects.

On Monday, Mitchell was asked to expand on his findings about how Ellis died: mechanical asphyxia due to violent subdual and restraint by law enforcement. Mitchell said that because Ellis could not get enough oxygen in his body after expending energy in the altercation with police officers, his heart began to fail.

Mitchell noted that in the prone position that Ellis was placed in, it would have been harder for him to breathe and impacted his heart's ability to beat properly, with the added complication of the handcuffs and the hobble restraint that was placed on Ellis' legs. In a prone position, the diaphragm can be compressed by the stomach, limiting breathing, and giving the heart less room to pump inside the chest cavity. Ellis' ability to breathe and for his heart to pump would have also been impacted by the officer who was applying pressure to his back, Mitchell said.

Mitchell said when the heart doesn't get enough oxygen, it begins to slow down in an attempt to use less. Mitchell noted when medics arrived on the scene, Ellis' heart rate was slowing and eventually stopped, but his heart did still register electrical activity - something that is associated with respiratory arrest and hypoxia.

Source: KING 5 News (October 16, 2023)
https://www.king5.com/article/news/local/death-of-manuel-ellis/tacoma-trial-death-manuel-ellis-forensic-pathologist/281-5486525b-9e65-429c-a473-e1f4f318ff59

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The danger of death from positional asphyxia* as a result of being restrained is nothing new. There are multiple studies and reports of injuries and death of injuries who are placed in restraints.

* Positional asphyxia, also known as postural asphyxia, is a form of asphyxia which occurs when someone's position prevents the person from breathing adequately. People may die from positional asphyxia when the mouth and nose are blocked, or where the chest is unable to fully expand.

A 1992 article in The American Journal of Forensic Medicine and Pathology and a 2000 article in The American Journal of Forensic Medicine and Pathology said that multiple cases have been associated with the hogtie or hobble prone restraint position.

The New York Police Department’s guidelines, explaining protocols for mitigating in-custody deaths, were published in a 1995 Department of Justice bulletin on "positional asphyxia." The NYPD recommended that, “[a]s soon as the subject is handcuffed, get him off his stomach. Turn him on his side or place him in a seated position." A 1996 FBI bulletin said that many law enforcement and health personnel were being taught to avoid restraining people face-down or to do so only for a very short period of time.

A 2002 review of the literature published in the British Journal of Forensic Practice said that restraining a person in a face-down position is likely to cause greater restriction of breathing than restraining a person face-up.

A 2008 article in Medicine, Science and the Law said that the way the subject is restrained can also increase the risk of death, for example kneeling or otherwise placing weight on the subject and particularly any type of restraint hold around the subject's neck. Research measuring the effect of restraint positions on lung function suggests that restraint which involves bending the restrained person or placing body weight on them has more effect on their breathing than face-down positioning alone. (https://en.wikipedia.org/wiki/Positional_asphyxia)
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