A Training on Domestic Violence Strangulation Cases Detecting Strangulation Cases – Investigation through Prosecution “Never Let a Victim Die in Vain” Presented by David R. Thomas M.S. Johns Hopkins University and the Maryland Network Against Domestic Violence StrangulationTHIS LESSON PLAN Training IS BASED Institute ON THE WORK OF: Project of the Family • Casey Gwinn, San Diego City JusticeAttorney Center Alliance • Gael B. Strack, San Diego Assistant City Attorney Launched October • Dr. George E. McClane, Emergency Physician 2011 • Dr. Dean A. Hawley, Forensic Pathologist Sponsored by the Office on the Violence Against Women To Provide Training and Technical Assistance National Strangulation Training Institute – A Project of the Family Justice Center Alliance © www.strangulationtraininginstitute.org IN MEMORY OF CASONDRA STEWART & TAMARA SMITH SHEDDING LIGHT • Two teenagers died in 1995. Casondra Steward 17 and Tamara Smith 16. • We wanted to learn from their tragic deaths. • The common denominator in their cases was strangulation. • We asked ourselves, what do we really know about detecting, documenting and prosecuting attempted strangulation cases? • We discovered, we didn’t know much at the time. But now…. WHAT’S REALLY GOING ON? A study in San Diego, CA revealed: • 300 strangulation cases studied • Victims were all women • 99% suspects were men • 89% of cases had domestic violence history • All reported being choked by their male partners with bare hands, arms or objects • In 50% of the cases children were present STUDY FINDINGS 7 National Strangulation Training Institute – A Project of the Family Justice Center Alliance © 56 www.strangulationtraininginstitute.org STUDY FINDINGS National Strangulation Training Institute – A Project of the Family Justice Center Alliance © 57 8 www.strangulationtraininginstitute.org STUDY FINDINGS 9 STUDY FINDINGS 10 SIGNS & SYMPTOMS DOCUMENTED IN SAN DIEGO POLICE REPORTS • Redness to neck • Pain to neck/throat • Scratch marks • Coughing • Rope burns • Raspy voice • Thumb print bruising • Nausea or vomiting • Red eyes • Unconsciousness • Spasm • Ears ringing • Urination & • Head rush defecation • Miscarriage 11 NEXT STEPS • Recognition of indicators. • Therefore, investigating officers should understand that strangulation cases may not always have visible signs or symptoms. • Officers need to understand how to determine and investigate strangulation cases. THE DV CONNECTION •Strangulation is more likely to occur in domestic situations than in non- domestic situations. STUDY FINDINGS • Focusing on symptoms, police reports showed police often neglected to clearly document what, if any, symptoms victims experienced. • This lead to conclusion that either officers failed to ask and/or victims failed to report symptoms. • Reported symptoms included pain to throat, hoarseness, nausea, loss of consciousness, hyperventilation, defecation, uncontrollable shaking, or loss of memory. STRANGULATION & SEXUAL ASSAULT • At least 50% of all DV cases include sexual assault. • At least 25% of all DV cases include strangulation. • At least 25% of all sexual assault cases include strangulation. • It’s difficult for victims to talk about sexual assault and it’s difficult for professionals to ask. 15 SAN DIEGO STRANGULATION STUDY GAEL STRACK AND DR. GEORGE MCCLANE In 50% of the Strangulation Cases……. Children were present 17 THE CHANCES OF BECOMING A VIOLENT OFFENDER LATER IN LIFE. Young boys who are Young boys physically who wit.DV in abused are the home are 6X more likely 3 X more likely Kalmuss, D. (1984). National Strangulation Training Institute – A Project of the Family Justice Center Alliance © www.strangulationtraininginstitute.org LISA TAPE • What type of violence do you think was going on? 19 STRANGULATION AND PREGNANCY • 34% of abused pregnant women reported being choked (Bullock 2006) • In 2010, a 10-year Kentucky Study of 102 strangulation victims showed 9% of victims were strangled at the time of pregnancy. (Shields) • In 1995 San Diego City Attorney Study of 300 cases, 10 cases involved pregnant victims being strangled. (Strack, McClane, Hawley, JEM 2001) STRANGULATION POTENTIALLY LETHAL SYMPTOMS Ask victim if she is pregnant. Oxygen deprivation can affect the pregnancy. 240,000 pregnant women are subjected to domestic violence each year. 40% of assaults begin during the first pregnancy and pregnant women are at twice the risk of battery than non-pregnant women. 2000- 2004 data. www.Americanpregnancy.org/main/statistics/html Treat Strangulation Cases Seriously “When a victim is strangled, she is at the edge of a homicide” •Surviving Victims 700% more likely to experience subsequent attempted homicide by their partner; & •800% more likely to be killed by that same partner. SIGNIFICANT FINDINGS: • Lack of injuries caused us to minimize the seriousness of strangulation. • Suspects were not being held accountable for the crimes they committed. • An attempted strangulation should be prosecuted as a felony. • When prosecuted as a misdemeanor, we must treat it as one of the most serious misdemeanor case our office handles. 24 UNDERSTANDING LETHALITY 25 What does it mean to us when the victim says her boyfriend choked her? 26 CONTINUUM OF VIOLENCE STRANGULATION? 27 STRANGULATION IS A RED FLAG… • When battered women were asked what made them believe they were in danger or not -- the majority of women perceiving a great amount of danger in both a shelter & a hospital study mentioned “choking” as a tactic used against them that made them believe their partner might kill them. • Stuart & Campbell, 1989 28 “CHOKING” VS. “STRANGULATION” 29 TEMPORARY OBSTRUCTION OF THE CAROTID ARTERIES, OR THE JUGULAR VEINS (STRANGULATION), OR THE AIRWAY (SUFFOCATION) WILL PRODUCE ASPHYXIATION -- AN INTERRUPTION OF OXYGENATION. THE CHOKING GAME IT IS ESTIMATED 1,000 YOUNG PEOPLE DIE EACH YEAR AS A RESULT OF THE CHOKING GAME BUT NO ONE IS TALKING ABOUT IT! 31 32 SIGNS OF THE CHOKING GAME • Unexplained marks on the neck. • Bloodshot eyes. • Ropes, scarves or belts tied to bedroom furniture or doorknobs. • Bent closet rods. • Out of place leashes or bungee cords. • Bleeding under the skin on the face, especially the eyelids. • Talking about the choking game. • Disorientation, especially after being alone • Severe Headaches 33 MEDICAL SIGNIFICANCE • Dr. George McClane, Speacialist on Emergency Room Medicine • Dr. Dean Hawley, Forensic Pathologist Start by making it an agency policy to use the word “strangle” as opposed to the word “choke”. “To Strangle” is an intentional act which seriously or fatally obstructs the normal breathing of a person “To Choke” is an accidental blockage of the windpipe entirely or partly by some foreign object like food USE OF FORCE CONTINUUM Officer Presence Uniformed Officer Verbal Commands Provision of verbal directives Empty Open Hands Wrist locks, pressure point compliance, neck restraints Protective Implements Batons, pepper spray, taser Deadly Force Firearms, deadly strikes and or manuvers LATERAL VASCULAR NECK RESTRAINT NECESSARY FORCE 1.Location of 2. Quantity Force of Force 3. Duration of 4. Surface Force Area LATERAL VASCULAR NECK RESTRAINT Neck Restraint vs. Choke Hold Step by step instruction Emphasis on arm placement Sides of neck vs. Across windpipe 7 seconds Face down & cuff Seated position Consciousness 15 – 30 seconds 3 strikes to the back Contact EMS start CPR CAROTID RESTRAINT: PROHIBITED OR RESTRICTED BY MANY POLICE DEPARTMENTS NATIONWIDE • Many police agencies do not allow officers to use carotid restraint. • SDPD: No more than 30 seconds (7/92) • POST: First aid protocol. • “... subject should be checked by medical personnel” 43 STRANGULATION • Can be a quick and lethal assault method • The victim can lose consciousness in seconds and death can occur in mere minutes if the strangulation persists. MINIMIZATION BY VICTIMS • Victims may not understand the danger and maybe reluctant to seek medical attention. “He didn’t really choke me, he just had me in a headlock and I couldn’t breathe”. Plattsburgh, NY • Santa Clara County policy to roll out the paramedics on each case MINIMIZATION BY PROFESSIONALS • Positive Aspects • Negative Aspects 7-47 MINIMIZATION BY DEFENDANTS • San Diego, California case: • Why are you arresting me? All I did was choke her. • Portland, Oregon case: • “Officer, I swear I didn’t hit her. All I did was choke the living shit out of her once or twice. I swear I didn’t hit her.” • Thank you Officer Pam Moen (5/99) 48 MINIMIZATION BY POLICE & PROSECUTORS • The cases submitted for misdemeanor prosecution were shocking. • The cases we didn’t issue were heart breaking • The dispositions of some of the cases were embarrassing 49 MINIMIZATION AT COURT • Don’t expect your judges or jurors to understand the seriousness of strangulation • Without an expert, jurors are likely to think it didn’t happen because the injuries were too minor (San Diego Jury) • With an expert, jurors wanted to know why the case was only prosecuted as a misdemeanor (Orange County Jury) 50 DOCTORS MAY NOT RECOGNIZE THE SIGNS OR SYMPTOMS • Escondido, CA Case: • Victim sought medical attention for dramatically red eyes caused by strangulation • Doctor told her she had “pink eye.” • Later victim disclosed to nurse and police were called. INCIDENCE • 10% of violent deaths • 12% of femicides • Experts suggest 20% of all femicides • Male assailants are often intoxicated FORMS OF STRANGULATION • Ligature • Manual INJURY DURING STRANGULATION ASSAULT • External signs of strangulation