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Desensitized to Website & Resources www.mckaytrainingconsulting.com Death [email protected] Strangulation Assessment & Prosecution Resources
Presented by Articles Kelsey McKay McKay Training & Consulting Calendar of Training [email protected] Testimonials
Challenges in How is strangulation Strangulation/Suffocation DIFFERENT than other types • Lack of visible injury of assault, abuse and • Lack of investigation violence? • Lack of understanding • Lack of victim • Lack of concern
Overcoming Obstacles My Philosophy • Developing a Protocol • Implementing Training • Utilizing a Strangulation Supplement Catch ‘em • Validating Voices • Linking the Chain before they kill • Coordinated Taskforce ‘em • Keeping Track!
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Strangulation represents an Lethality & Fatality escalation of force
Continuum of Violence 90% prior history of DV
After ONE non-fatal strangulation... 7-9 x 43% Women who were more likely to be murdered had been killed strangled in the last year
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Catch ‘em while It takes a certain they are killing kind of rage…
Haruka Weiser
Loyalty Before Betrayal
•“He didn’t look like himself, it wasn’t him in his eyes” • Clenching teeth; Gritting teeth; • Squeezing so hard veins were coming out of his head; • Bulging eyes; • Bugged out eyes, angry; • Mad face Trust no bitch, Love no bitch • He had black in his eyes
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David Adams • If you had access to a gun… • Only 1 of the 8 stranglers said And a certain he would have used a gun (vs 4/6 stabbers) kind of • “I wanted to know what it felt like to kill someone” enjoyment… Source: D. Adams, Emerge
“Whenever V was about to pass out, D would let go just enough to allow V to gasp for air, and then would continue strangling V. She believed he was going to kill her. V stated that it looked like D was enjoying Why? strangling her and described his eyes as having a 1,000 yard stare. She described the pain as being so bad that she hoped she would die just to make it stop.”
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What is his criminal history?
It isn’t about his criminal history, its about his future criminality.
It is about how this crime predicts who he is, what he is going to do and what type of criminal he will be.
How we KNOW these are the WORST abusers… Studies show that 30%-50% of perpetrators who kill police They have the rage officers have a DOCUMENTED PUBLIC RECORD of intimate They enjoy it partner strangulation.
They get away with it
The Perpetrator
• Domestic Violence/ Strangulation • Serial Murder • Sexual Assaults • Elder Abuse • Disabled Abuse • Police Killings
These are crimes of POWER AND CONTROL
© Training Institute on Strangulation Prevention www.strangulationtraininginstitute.com
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In the context of a DV A form of power and relationship, why does the control to let the victim abuser use strangulation? know that he could kill her! That he is capable and willing to do so at any given point in time.
Strangulation & Domestic Violence Ruth
• It directly and immediately places a “Actually, when I came out of that victim’s life in the hands of the abuser. [strangulation incident], I was more • Practicing homicide submissive – more terrified that the next • Desensitizing murder time I might not come out – I might not • Power & Control: Victim more submissive make it. So I think I gave him all my power from there because I could see how easy it was for him to just take my life like he had given it to me.”
Documenting the Quotes Power & Control •“He was putting all his power into choking her, his eyes wanted her dead” • “When asked how hard he squeezed her throat Rosario stated ‘hard enough to scare me, hard enough to let me know he was in control.”
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• “I could kill you right now and no one would know that you’re dead.” • I’m going to end you, I’m going to destroy you • Look at me while you are dying. • “I don’t care if I go to prison, I want to make sure you are dead before I go away.” • The only way you are leaving me is in a body bag • “I’m going to end this today” • “Are you ready to die bitch.” • I will kill you in this room
Documenting the Blame • “Is this what you wanted?” • “Cry drama queen, cry” • “You made me do this!” Documenting the Rage • Do you want to die?
“Say Goodbye.” Casey Gwinn Why don’t you die already? I am going to kill you bitch, you’re going to die! Even if we never prosecuted Bitch I fucking hate I don’t give a another man who punched or “tonight is fuck bitch, die! you! I wish you were slapped a woman and instead went the night!” dead. I can only be happy when your after every man who strangles a asleep so I will be woman, we would reduce domestic happy when you die. “Do you want violence homicides and officer involved deaths in this country by DIE to die?!” more than 50%. “This is your last day” ALREADY
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The Perfect Crime?
• Results in compliance (scary and effective) 99% • Hard to prove • …this is where we have to dig deeper Perpetrators are male and look at evidence in a different way. • Use the weaknesses to our advantage. • Rethink our investigations.
WHAT IT IS: Legally The Law Anatomically
Idaho Law Delaware 18-923 Attempted Strangulation Code, Title 11, Section 607: CLASS E 18-923. Attempted strangulation. A person knowingly commits the (1) Any person who willfully and offense of strangulation if the person knowingly or intentionally unlawfully chokes or attempts to impedes the breathing or circulation strangle a household member, or of the blood of another person by a person with whom he or she applying pressure on the throat or has or had a dating relationship… neck of the other person.
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Class D if: • The person used or attempted to use a dangerous instrument or a deadly weapon while committing the offense; or STRANGULATION • The person caused serious physical injury to the other person while vs committing the offense; or • The person has been previously CHOKING convicted of strangulation.
DEFINITION: CHOKING
Choke means to keep from breathing in a normal way by accidentally obstructing the windpipe; adulterating available air; or to block entirely the windpipe (hard candy or food).
Choke vs. Strangulation
• Investigation tip: talk about/listen to the act not the technical terms. – Same with suffocation –“He put his arm on my throat” or “He pinched my nose shut” • A victim will often use the term “choke” or “choked out.” Quote her language. • Important to educate V’s about the seriousness of strangulation. • Use correct term in offense report/court, etc.
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ATTEMPTS TO STRANGLE Definition of strangle strangled; strangling play \-g(ə-)liŋ\ transitive verb Only 3% of victims 1a : to choke to death by sought medical compressing the throat with attention something (as a hand or rope) : “Attempt” = non-fatal?
Don’t Overestimate Medical Care Radiographic Protocol & Strangulation Assessment Card
Washington Law Texas Penal Code 22.01 (b-1)(3) WASH. REV. CODE ANN. § 9A.36.021. THIRD DEGREE FELONY ASSAULT IN THE SECOND DEGREE
(1) A person is guilty of assault in the second degree if he or she, under circumstances not amounting to assault in the first degree: (g) Assaults another by strangulation or suffocation. Intentionally, knowingly or recklessly impeding the normal breathing or (26) “Strangulation” means to compress a person's neck, thereby obstructing the person's blood flow circulation of the blood of the person by or ability to breathe, or doing so with the intent to obstruct the person's blood flow or ability to applying pressure to the person’s throat breathe; or neck or by blocking the nose or mouth of the person. (27) “Suffocation” means to block or impair a person's intake of air at the nose and mouth, whether by smothering or other means, with the STRANGULATION intent to obstruct the person's ability to breathe; SUFFOCATION
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Washington Law Idaho Law WASH. REV. CODE ANN. § 9A.36.021. 18-923 Attempted Strangulation ASSAULT IN THE SECOND DEGREE (2)(a) Except as provided in (b) of this subsection, assault …is guilty of a felony in the second degree is a class B felony. (b) Assault in punishable by incarceration for the second degree with a up to fifteen (15) years in the finding of sexual motivation state prison. under RCW 9.94A.835 or 13.40.135 is a class A felony.
Idaho Law 18-923 Attempted Strangulation Visible Injury
(2) No injuries are required to prove Injury sufficient to attempted strangulation. photograph 15% No Visible (3) The prosecution is not required to Injury show that the defendant intended to kill Injury too 50% minor to or injure the victim. The only intent photograph required is the intent to choke or attempt 35% to strangle.
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Strangulation as a Felony STRANGULATION
• New laws are more in line with the seriousness and recognize the danger of strangulation. A form of asphyxia (lack of oxygen) characterized by intentional closure • They don’t provide us with a framework on how of the blood vessels and/or air to investigate or prosecute it as a felony. passages of the neck as a result of external pressure on the neck. • Ultimately to be successful, we have to convince a jury beyond a reasonable doubt that the defendant has committed a felony.
DEFINITION: STRANGULATION How much pressure?
In other words, pressure placed on • Obstruct the neck where that pressure causes a disruption in the blood • Impair flow to the brain that results in a • Impede lack of adequate oxygen being delivered to the brain. • Prevent
IMPEDE ABILITY TO BREATHE • What is normal BREATHING? • Total closure? • What is NOT normal breathing? • How much closure? • Does the victim have to lose consciousness? • Certain amount of time?
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“Just one breath” When does touching the neck become strangulation?
Neck touching is NOT a felony. Having visible injury on the neck is NOT a felony.
Video Summary
• The brain needs 20% of the oxygen you breathe to function normally (which comes in the form of fresh blood coming from the heart) • “Light headed” = brain being suffocated • “warm and fuzzy feeling” = brain cells dying!
Courtesy of Dr. William Smock
How is strangulation different than other types of assault? • NOT so much about injury to soft tissue with external injury. Example? • MORE about obstructing the blood and oxygen flow to the brain and internal organs.
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Three Forms of Strangulation Strangulation
• Hanging: Suspension from a cord wound around the neck • Ligature strangulation: Strangulation without suspension using some form of cordlike object • Manual strangulation: Strangulation using the fingers or other extremity
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Examples: Suffocation Strangulation v Suffocation
• Strangulation –Trying to make her stop – oxygen to brain screaming –Duct tape over face • Suffocation –Head inside plastic bag – oxygen to all organs –Pillow over mouth and nose –Sitting on chest • Combination: accelerates damage to the brain. Common in fatal cases.
PHYSICALLY Anatomy & Pressure
Jugular Veins Carotid Arteries 4.4 psi 11 psi
Major vessels Major vessels that transport that transport deoxygenated oxygenated blood from blood from the brain back the heart and to the heart lungs to the brain
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Airway & Trachea 30 psi
Press Oxygenated blood your is the battery that throat! powers and feeds the brain.
Pounds Per Square Inch of Neck Anatomy Vulnerable Pressure to just slight Carotid pressure, Jugular Vein = 4.4 psi Arteries Not a lot of Carotid Artery = 11 psi protective structures Trachea = 30 psi in the Jugular neck… …for 5-10 seconds of consistent Veins pressure it will render someone unconscious. Press your throat!
Exact Anatomic Location of Quantity of 4-6 Applied Force Applied Force
Jugular Vein = 4.4 psi 22 Carotid Artery = 11 psi Trachea = 30 psi
Surface Area Duration of Of 80 Applied Force Applied Force
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Duration of Applied Force • Pressure released immediately, consciousness will be regained in 10 seconds.
• 50-seconds is the “point of no return” because a person’s bounce-back reflexes become inoperative.
• Brain damage can occur in less than a minute.
• Death will occur within 1 to 5 minutes, if strangulation persists.
Pressure for Loss of Consciousness Understand hypoxic brain 5-15 SECONDS injury and how it can make the CONSISTENT PRESSURE victim appear. Jugular • No blood flow to the brain Carotid • Brain isn’t recording • No/different memory • She is “inconsistent” • Evidence instead of impeachment Airway
Other Observations: Other Observations: She appeared dizzy and “V was difficult to follow stated she felt like she needed to vomit. She had and did not flow trouble putting together linearly.” her thoughts at first and seemed disoriented and exhausted.
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Where else might this apply?
• A child victim who has been strangled. • A child who has witnessed a Anatomy and Pressure person/parent be strangled. • A parent/guardian who outcries of being = NO Visible Injury strangled during the course of a child abuse investigation. • Other at risk populations (elderly, disabled) with similar dynamics.
Pediatric Strangulation
• What do we know? –Basic anatomy and physiology
• What do we not know? –LACK OF RESEARCH!
www.strangulationtraininginstitute.com * Webinar on Pediatric Strangulation
Pediatric Strangulation Patients
Anatomical Differences • Head proportion larger • Neck structures less developed How to Investigate and • Lighter body weight Prosecute Strangulation
www.strangulationtraininginstitute.com * Webinar on Pediatric Strangulation
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Law Enforcement • Focus on proving the case…… –Treat as a Felony!!!!!! –Ask the Questions??? INVESTIGATION –Do a well-articulated Report –Document Injuries –Medical treatment –Assume NO follow-up
Who usually does have In law enforcement, when it external visible injury? comes to strangulation we have to restructure how we define • SUSPECT assault by “visible” external • Why? injury • What type? • Life threatening?
Interpreting Injuries/Defensive Wounds • Always get a detailed explanation • On victim: self-inflicted defensive injuries (neck, chest, face) of how she fought back, because it – Usually a victims hands are either clawing at her neck own will be self-defense case if he is neck or the suspect to get the suspect to release his grip. injured. • Defendant to have more (and worse) superficial visible injuries than the victim. –Does her explanation make sense? – Scratches, claw marks (on D’s neck, face, chest; V’s neck) –Does it fit the physical evidence? – Bite marks • Evidence of the terror V experienced.
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Defensive Wounds on Victim
Courtesy of Phoenix Police Department
8 year old female Defensive
www.strangulationtraininginstitute.com * Webinar on Pediatric Strangulation
Chin Contusions
Family Justice Center Alliance @2011
Family Justice Center Alliance @2011
Courtesy of Jill Rable RN, Scottsdale Healthcare
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Anyone know this case?
Physical Evidence
15% statistic was based on officers with no specialized training
Thorough Physical Examination Types of Visible Injuries
• Examination should spread beyond a brief • Redness or flushed glance at the neck and should extend to other areas. • Bruising • Swelling • Examination needs to look for injuries beyond a handprint on the neck. • Petechiae (certain combination) • Scratches/Abrasions/Lacerations • Understanding injuries • Finger imprints • Goal: Every victim should receive a forensic • Fingernail imprints (half moon) exam by a qualified medical professional.
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Fingernail Marks
Injuries that otherwise might seem insignificant from an “external injury” standpoint, become more relevant when you understand the burden is based on the amount of pressure… not the extent of the injury.
Examine Beyond the Neck Petechiae (Tiny Red Spots) • Very specific combination for a period • Face • Head, hairline of time. • Eyes • Chest – Allow the jury to visualize it so that they • Eyelids • Shoulders can understand it. • Nose • Neck – Helium balloon • Ears (on and • Mouth (tongue, behind) palate) • If it exists, that’s great! • Chin • If it doesn’t, USE THAT TOO!
Behind Ears
What combination of blood restriction was occurring when she felt this?
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Lift Up Hair
Petechiae on Ear Petechiae - one red spot in eye
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Soft Palate: Petechial Hemorrhage
Courtesy of Dr. Smock
Courtesy of Jill Rable RN, Scottsdale Healthcare
Courtesy of Dr. Smock
Family Justice Center Alliance @2011
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Thumbprint Bruise
Family Justice Center Alliance @2011
Fingertip Bruising Bruising Behind Ears Sternocleidomastoid Muscle
Family Justice Center Alliance @2011 Family Justice Center Alliance @2011
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Suffocation
Photos
Take Plenty of Photographs and Follow-up Photographs – Distance photo - one full body photograph of the victim from a distance will help identify the victim and the location of the injury. – Close-up photo(s) - multiple close-up photographs of the face, neck area (front, back, and sides of the neck, lifted) at different angles will make it easier to see the injuries clearly. A minimum of 8 photos of the neck. – Picture of the defendant’s hands!! (and the defendant) – DOCUMENT THE INJURIES ON THE SUSPECT. – Full body shot of victim, hands, etc. – Overall shot – Crime Scene photo (corroborate the story)
Photograph 8 camera angles of the neck
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Officer Sophia Loera Officer Sophia Lorea
• December 7, 2009 • Patrol response to a check welfare urgent. • Suspect: Garrett Mosley, w/m, DOB: 9/21/79, 6’3, 230lb
Evidence of Strangulation Evidence of Strangulation
• “I couldn’t get a breath in” • Felt the tightness of his grip—kept getting tighter, non- stop. • Heard a popping sound, like knuckles cracking, • I could feel every finger and his thumb on my neck. multiple times from my neck • The pressure started as a 6, then it went to a 10. • Tried to calm myself down, told myself “don’t panic” • Before I lost consciousness, it felt long over a minute “in • Other officers tried to get the suspects arm off of her, my mind.” it took the strength of multiple men • I was trying to keep my anxiety down, I kept thinking of the other officers and thinking, “they are going to take • Saw spots care of me.” • Saw white all around • Felt a gush of air go into much lungs when he let go • At first it was black in the middle, then it shot out and • At first, after he released, I didn’t feel anything. I passed out. • I thought “I couldn’t breathe,” felt like an asthma attack. • The officer thought he might have to use deadly • It took me several minutes to catch my breath force, he got out the tazer
Evidence of Strangulation Evidence of Strangulation
• I don’t remember getting up, that process is hazy. • That night there was some scrapes and bruises • Felt weakness in my legs on my arm. • My legs felt numb, as if my leg was asleep. • I drove myself to the hospital • Dizziness. • The next day… • I had to hold onto the wall and lean on the balcony rails. – Bruises in the shape of fingers • The paramedic asked: “are you ok?” – Couldn’t move my neck • Not wanting to show weakness, I thought I was OK, I – Neck was stiff didn’t realize until they left that I wasn’t OK. – Couldn’t speak right, it was rough and deep • I kept thinking “I’ll get over it” now I realize that it – Doctor gave her pain killers affected me and that I didn’t realize how serious it was.
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Evidence of Strangulation • I couldn’t eat or drink. For over What do you think a week, I couldn’t swallow. this defendant was • Several years later it is still sometimes difficult to swallow; convicted of out of easy for me to choke. this incident?
Evidence of Strangulation in the offense report “Could not breathe”
How could this have been Is this evidence, or investigated better? Is this an element?
First Responders need the tools…
Developing Evidence of Strangulation
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OFC 1: “This form actually makes it easy, I thought it was BS and I know a lotGUIDANCE of people bitched about it, but…” OFC 2: “Yeah, it also helps figure out if they are BS’ing, they are not goingCREDIBILITY to be able to answer some of these questions…”
Finding Design Research in the Criminal Justice System
By Ryan Menefee
Evidence of Strangulation DV Case: Legal Design Research Offense Report “Thank you Mr. Menefee for uncovering great design in the wild that helps to better serve humanity. The tool showcased in your article functions to answer one of the • “grabbed her around the neck with both most difficult questions a person can hands and began to apply pressure” face… how do you describe an • “as a result of the strangulation she was unable to scream or even breathe for ; I applaud your indescribable event? approximately one minute” bravery in tackling this sensitive topic and • “didn’t think she blacked out, but wasn’t bringing to awareness the power of design.” far from it” --Jaskirit Gill MD, 1/24/17 • No significant visible injury
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Use Charts
• Jot down signs/symptoms during testimony • I generally divide it into four columns, “During/Emotional”; “During/Physical”; “After/Sensations”; “After/Injury” • Mark as an exhibit and offer before expert testifies. • Make it easy: categorize & link it up for the jury
How did we get that evidence?
I ASKED!!!
Just because they were M Train interviewers to ask about: strangled… doesn’t – What questions to ask make them an expert! – How to ask the questions • Blame themselves because they don’t – How to document the signs/symptoms in remember, lapses in memory. their report • Blame themselves for being – How to properly examine a victim manipulated. – How to do follow-up • Left confused – Defensive wounds in strangulation cases • Not validated and trauma reactions • Don’t understand
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Ever been strangled in a Signs & mixed martial arts, military or Symptoms law enforcement training or setting?
DWI INVESTIGATION Examples:
• Nausea or vomiting, dry heaving. OBSERVATION • Hoarse/Raspy Voice (50%) • Urination/defecation, the urge to urinate or ↓ defecate, loss of bladder control. • Dizziness, seeing stars or change in vision. EVIDENCE • Change in sound or sensations in the ears. • Feeling/sensations in the body/head. • Disorientation, loss of memory, ↓ headache/migraine. • Asthma attack. ELEMENT • Miscarriage.
POSSIBLE SIGNS/SYMPTOMS Restricted Airway WHICH MAY OCCUR DURING OR AFTER THE STRANGULATION • Unable to Breathe • Tenderness/Pain to neck, • Difficulty swallowing • Difficulty Breathing throat, etc. • Pain with swallowing • Rapid Breathing • Dizziness • Shallow Breathing • Headache/Migranes • Difficulty breathing • Physical Pain • Feeling Faint • Wheezing • Coughing Blood • Disorientation • Constant coughing • Nausea • Loss of Memory • Hoarse or raspy voice • Vomiting/Dry Heaving • Other? DESCRIBE IN DETAIL!!!! • Drooling It is critical to appreciate that although breathing changes may • Constant Spitting initially appear to be mild, underlying injuries may kill the victim up to 36 or more hours later due to decompensation of the injured structures.
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VOICE AND SWALLOWING CHANGES What evidence is Voice Changes: Swallowing Changes: • Painful to Speak • Trouble Swallowing there during those 15 • Raspy/Hoarse Voice (saliva, food, drink?) • Coughing • Painful to Swallow seconds? • Unable to Speak (saliva, food, drink?) • Whispering • Neck Pain • Other • Other Tracheal Injury? ………
HEARING • Felt her face get hot and could hear a rushing sound in her ears; • Felt like she was in a subway station • sounded like sound was coming through a can • sounded like a tunnel, sound was fading • sounded like a shell over my ear • Feeling of being temporarily disoriented like from the noise the first time she shot a gun. • Gurgling • Ear muffs • Sounded like a radio being turned down
EARS VISION • Ears popped • Got blurry; cloudy • Felt like she had cotton in her ears • Tunneling; Everything faded; Saw dots • Felt like water in my ears • Ear felt like it was gushing • Darker and darker; felt like a slow blink; • Ringing in her ears sounded like a train • Felt like I had sand in my eyes • Fuzzy around the edges; • Like a shrinking tunnel; • Eyes started to water and buldge • Felt like an old timey movie; • Felt like cameras flashing
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HEAD • pressure in head; pulsating • felt like eyes were popping out; • Felt like cold water running down my face • her head felt big and red; • felt a tingling sensation around her lips; • Felt as if she was trying to blow up a tiny water balloon, • Felt her heartbeat in her head • Could feel her heartbeat in her head • hot, like it was going to explode,
BODY THROAT • no strength; like a noodle; • Neck muscles felt tired like she had worked • woozy; throbbing; wavy, out • Felt like heartburn; • Felt like a brick was on top of her • Felt like she was hanging upside down • He was “drilling his fingers into her neck.” • Body felt like ants crawling on the back of her neck • her head felt big and red; • Throat burned • She felt her body twitch and thought she was having a • Felt fullness in her neck seizure • It felt like the sides of her throat were • felt like a rag doll; touching • Felt like ants crawling down my body • Stuffy • Felt a burning sensation in her throat while he • Bladder felt heavy was squeezing • No control over her body • Throat felt itchy; throat felt clogged
Other Descriptions Other Descriptions • Felt like it wasn’t real • Neck muscles felt tired like she had worked out • Felt like a roller coaster • Felt as if she was drowning, like she was deep • Mouth felt foamy underwater and not able to breathe (suffocation) • Messed with her sinuses causing her eyes to water • Tried to yell but her voice wouldn’t come out • Felt like she was floating • Twitching • Total numbness • Felt like she was hanging upside down • Like trying to suck air through a straw and someone pinching it in the middle and not being able to • Felt like a brick was on top of her • I felt frozen • Felt like she was dreaming • Like a real dream • Felt fullness in her neck • Felt like I was on painkillers • Felt like I woke up from a good nap
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What do we do with these non- visible injuries? Expert: Chart • Turn them into “injuries” to the jury • Provide the jury with support for each element • Make a copy of the signs/symptoms chart • Use an expert to describe what assaultive act offered into evidence through various testimony causes each injury and explain how it relates and have the expert go through each one, to impeding air or blood flow. identifying what that particular S/S is evidence • Allows the jury to visualize the assault of: – Airflow = A • Provides them with evidence – Blood flow = B • Someone must have asked the victim for this – Pain/Bodily Injury = P evidence, we can’t expect her to tell. • Offer into evidence!!!
CHART IT! WHY
B A B A B A Connect the dots for the jury. P P P A
B A B A B A/P A/B P B Hoarse voice A B P B A B B A Hurt to talk A State’s Exhibit
Kelsey: But first… I recently tried a case where the victim recanted to law • You have to convince “them” why visible enforcement, my office and on recording to the public defender investigator. Her visible injuries consisted of a injury is silly, pointless, unnecessary so that one-inch scratch on her neck and a small bruise on her back they feel shameful even mentioning it… near the shoulder. Kelsey, The officer used a specialized form to document internal symptoms, and I called an ER doc to educated the jury and This is the most uphill case I've had explain what it all meant. I used these skills and techniques in years. She's recanted 3 times, and the jury convicted in 2 hours. once to defense investigator, and Thanks for your help! physical evidence is scant. I'll let Brett you know how it goes. –Brett, ADA
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Jury Feedback
“Both the paramedic and the social services expert played key roles in our decision. From my perspective here is what really made the Jury Feedback case for me personally… The paramedic provided an invaluable link between the testimony of the witness and the nature of the assault illustrated by connecting the symptoms with the causes (A/B). ”
“The young man from EMS was very Strangulation is a unique enlightening on the human anatomy. His crime. It has more in common descriptions of how strangulation affects the human body and what are with sexual assault crimes the common symptoms the victim than basic assault. may experience was very helpful.”
Washington Law WASH. REV. CODE ANN. § 9A.36.021. ASSAULT IN THE SECOND DEGREE (2)(a) Except as provided in (b) of this subsection, assault in the second degree is a class B felony. (b) Assault in the second degree with a finding of sexual motivation under RCW 9.94A.835 or 13.40.135 is a class A felony.
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Sexual Assault Prosecution Sexual Assault & Strangulation
Sexual assault was the motive • Very common overlap in 66% of female victims of • Criminal accountability for unfiled sexual ligature strangulation and in assault 52% of those due to manual • Aggravate the sexual assault • Creates inherent lack of consent in sexual strangulation assault • Autoerotic asphyxiation…. SAX V’s are strangled 35% of – Three questions the time. – Can not consent to deadly force in many states!
National Coalition for Sexual Freedom Consent: Texas Code 22.06 • “Not a single appellate court decision anywhere has accepted consent as a defense in an assault or (a) The victim's effective consent or the abuse prosecution arising from BDSM conduct" actor's reasonable belief that the victim • They cite to case law: consented to the actor's conduct is a defense – "Even where both participants agreed that the to prosecution under Section 22.01 (Assault), acts in question were consensual, the courts have 22.02 (Aggravated Assault), or 22.05 (Deadly held consent cannot be a defense" Conduct) if:(1) the conduct did not threaten Commonwealth V. Appelby. or inflict serious bodily injury "As a matter of policy, a person cannot avoid criminal responsibility for an assault that causes injury or carries a risk of serious harm even if the victims asked for or consented to the act" P v. Duffy.
Filed Strangulation Statistics 36% increase in the 18 months before and after the supplement 580
500 480 450 406 400
350 333 314 300 AFTER SUPPLEMENT 48/month 40/month 250 230 37/month BEFORE SUPPLEMENT 200 150 100 30.6/month 27.75/month 50 19.2/month 26.2/month 0 2010 2011 2012 2013 2014 2015
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NOT JUST Emotional & QUANTITY, BUT Trauma Evidence QUALITY
Thoughts of a Why do we care about the homicide victim emotion? INTENT CREDIBILITY MOTIVATION TO CONVICT …take the jury on her journey.
Documenting Emotion “OH MY GOD, • Always ask, “What did you think was going to happen MY BABIES!” during the strangulation?” • “At what point did you “She thought she know…” would die in front of her children!”
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Quotes from Counselor Contact • …she could feel her life going away Understand trauma reactions from her when he was choking her. and the impact that • All she could think about was that strangulation can have on how she wasn't able to say goodbye to victims may present after they her daughters. have been strangled. • …when he took my life from me, even though it was only 30 or 45 seconds- I don't ever want to go through that again."
Don’t be scared of the trauma Educate in and emotion. Voir Dire DOCUMENT IT!
Voir Dire • FV Stuff • Levels of Assault Voir dire should be an – What makes an assault more serious (SBI, weapon, strangulation) education that the jury gives – History of strangulation (past: murder or class A; aggravated assault) themselves… • Ways strangulation is more serious than just bodily injury? • Context of FV, how is strangulation used by the …and that your evidence then abuser? becomes consistent with. • Neck anatomy and pressure (hand dynamometer) – Pressure: Handshake example – Neck vulnerability: Child on back example
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Voir Dire
• Involvement in Mixed Martial Arts – Military or Law enforcement? – Anyone ever been choked out? – Visible injury? What? Carotid – Have them describe feeling of helplessness Arteries – Have them describe sensations (visual, auditory, body/head)…shifts their focus to s/s! – …these will match up with V’s s/s • Educate about pressure. Jugular • Educate about how vulnerable the neck is to Veins touch. • How the structures in the neck feed the brain.
EXPERT WITNESSES The Translator
HOW do experts help juries? FV Experts on Strangulation
• TRANSLATOR for the jury – Can discuss escalation in violence with • NORMALIZE behavior that might strangulation as key. otherwise be misinterpreted and –Strangulation in the context of the power and hurt credibility. control dynamic. • CONVERT OBSTACLES into – Strangulation to obtain compliance. powerful evidence. – Lethality statistics. • CONNECT the dots. – Minimizing and lack of belief. • Turn doubt into conviction. – Trauma related to strangulation and Stages
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WHAT is a “Strangulation Expert?” (but lets call them a medical expert). • Someone who understands the anatomy of the neck, body and blood and airflow. Medical Experts • Someone who can communicate this on a basic level to a jury. • Someone who the jury likes. • Someone who has reviewed medical articles relevant to strangulation. (eh? Or just stay away from this entirely)
WHO is a “Strangulation Expert?” Qualifications
• Law enforcement officer with specialized training? • Prepare them (articles, etc) • Anyone with medical background? • Focus on knowledge of anatomy and – Medical Examiner evaluations of relevant structures. – ER Doctor or other doctor – Paramedic/EMT –Paramedic: Hangings – SANE nurse, Nurse –ABC’s and Oxygenation and • YOU? Perfusion – You have to be an expert so that you can interpret the evidence, prepare the approach and –Talk to your expert and shape your guide the testimony! questions
Using Expert in Trial Using Expert in Trial • Qualifications (base on anatomy, not DV • Blunt force trauma (like hit with a bad in knee with soft Strangulation) tissue or bone damage) vs Strangulation (obstruction of blood /oxygen to brain and organs) • Definitions: Asphyxiation. Choking vs. • Strangulation and Death (can cause, can have no Strangulation, Methods of Strangulation external VI, autopsy) • Misconceptions and Expectations (pressure, • Delayed Death by Strangulation visible injury, missed and misunderstood) • Pain without visible injury (funny bone example) • Relevant neck anatomy and functions (offer • Explain how each sign/symptom relates to diagram into evidence) strangulation and how • Pressure (psi) and Injury (soft tissue, blood • Connect each s/s to the elements of impeding blood flow) flow/air flow • Relevant factors • Specific issues in case: scream/talk but not breathe
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Double the Pleasure • Biggest challenge was finding someone to play and having the money to pay them to testify! • Jury wants a medical person talking to them: unbiased, down to earth, they are worth their weight in gold. • If you train your medical responders (EMS, SANE, ER staff) you get the benefit of: – Better documentation (don’t assume they are) – Easier access to an expert at trial – Hearsay exceptions
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