Positional Asphyxia
Cruz v. Laramie, 239 F.3d 1183 (10th Cir. 2001)

By Jack Ryan

Another aspect of pepper-spray that leads to litigation is deaths resulting from positional asphyxia. Positional asphyxia involves the improper placement of individuals who have violently resisted causing physical exertion and sometimes exacerbated by the effects of pepper-spray which inhibits breathing. Many of these cases also involve the presence of narcotics that increases a suspect’s heart rate as well as other physiological changes that bear on the ultimate outcome of death. In dealing with positional asphyxia cases, sometimes referred to as “sudden custody death syndrome” one must recognize that most of these cases result more from positioning than from other aspects of the arrest.

Cruz v. Laramie, provides a typical set of facts seen in these cases. The Laramie, Wyoming Police Department received a call that a man, later identified as Cruz, was running around naked near an apartment complex. The first officer on scene found Cruz on a stairwell landing on the exterior of the apartment complex. Cruz was “jumping up and down, yelling and kicking his legs in the air.” A second officer arrived and upon seeing Cruz, immediately called for an ambulance. The officers on scene, along with a third who had arrived, tried to calm Cruz and persuade him to come down the stairs. Cruz initially refused but at some point started toward the officers who were at the bottom of the landing with batons at the ready position.

As Cruz attempted to pass the officers, the three wrestled him to the ground and placed him face down. They were able to handcuff Cruz; however, he continued kicking and flailing about. A fourth officer who had arrived at the scene decided after assessing the situation to shackle Cruz’ ankles using a nylon flex-cuff and then attach the flex cuff to the handcuffs with a metal clip. The evidence presented by the parties in this case did not agree as to the distance between Cruz’ hands and ankles as a result of this hog-tie (or maybe hobble-tie) restraint. The court indicated that if the distance was less than 12” then the restraint would be a “hog tie” if the distance was more than 12” then the restraint would be a “hobble tie.” The officers noted that Cruz calmed markedly following the use of this restraint. In fact, just prior to the arrival of the ambulance, one of the officers noticed that Cruz had “blanched.” CPR was immediately begun; however, Cruz was pronounced dead upon his arrival at the hospital. Autopsy results indicated that Cruz had a large amount of cocaine in his system at the time of his death. As in many cases, two experts disagreed: one indicating that Cruz died from positional asphyxia, the second indicating that Cruz died from the cocaine.

In ruling on the constitutionality of hog tie restraints, the United States Court of Appeals for the 10th Circuit asserted:

The conduct at issue involves the tying of the decedent’s arms behind his back, binding his ankles together, securing his ankles to his wrists, and then placing him face down on the ground. We note that while sister circuits may characterize the hog-tie restraint somewhat differently; we understand such to involve the binding of the ankles to the wrists, behind the back, with 12 inches or less of separation. We have not heretofore ruled on the validity of this type of restraint. We do not reach the question whether all hog tie restraints constitute a constitutional violation per se, but hold that officers may not apply this technique when an individual’s diminished capacity is apparent. The diminished capacity might result from severe intoxication, the influence of controlled substances, a discernible mental condition, or any other condition apparent to the officers at the time, which would make the application of a hog tie restraint likely to result in any significant risk to the individual’s health or well-being. In such situations, an individual’s condition mandates the use of less restrictive means for physical restraint.

The court then looked at the facts of this particular case and determined that the officers had clear notice of Cruz’ diminished capacity. The court pointed out that one of the officers on scene called for an ambulance prior to Cruz’ restraint based upon observations of his condition. After concluding that a constitutional violation had occurred, the court granted qualified immunity to the officers since prior to this decision, the law on hog tying of persons with diminished capacities had not been clearly established.