Restraint Asphyxia & Positional Asphyxia

How Restraint Kills

Restraint asphyxia occurs when the physical position of a restrained person prevents adequate breathing. This is not rare — it is a known, documented, and preventable cause of in-custody death. The medical literature has warned about prone restraint dangers for decades.

The risk is heightened when officers:

• Place a person face-down (prone) and apply weight to the back, shoulders, or neck
• Use hobble restraint or “hogtie” positions that restrict chest expansion
• Continue compression after the person stops actively resisting
• Ignore statements like “I can’t breathe” or visible signs of respiratory distress
• Fail to roll the person onto their side once handcuffed

The Constitutional Standard

Under the Fourth Amendment, force must be objectively reasonable. Continuing to apply prone compression after a suspect is handcuffed or controlled is constitutionally unreasonable when the person shows signs of breathing difficulty. For pre-trial detainees, the Fourteenth Amendment's due process clause applies under an objective standard.

What Officers Are Trained to Know

Law enforcement training programs — including those certified by Oklahoma's CLEET — include warnings about positional asphyxia. We obtain training materials to show officers knew the risks and ignored them.

• CLEET Training Records: In-service training on restraint risks and positional asphyxia awareness.
• Department Policy Manuals: Written policies on prone restraint, maximum restraint duration, and medical monitoring.
• Prior Incidents: Use-of-force reports where similar techniques were used — evidence of a pattern or custom.

Evidence We Secure

• Body camera and surveillance footage — frame-by-frame analysis of restraint positioning and duration.
• Autopsy and forensic pathology — independent review of cause and manner of death.
• Officer training records — what the officer was taught about positional asphyxia and when.
• Dispatch and communication records — timeline of when EMS was called (or not called).

Monell Liability: The Department's Responsibility

Under Monell, we pursue municipal liability by proving a policy, custom, or failure to train that caused the death.