Visuals from the last two weeks of protests for racial justice have laid bare an irrefutable truth (which many communities throughout the United States were already all too aware): Police, though sworn to protect and to serve, are too often the cause of physical harm with brutal use of force.
While 1,004 people were shot and killed by police in America in 2019, the “non-lethal” methods employed by officers to control suspects can also be deadly—George Floyd’s death is proof. And even if fatality is relatively rare from things like tear gas and Tasers, social media has been flooded since protests began with anecdotes of significant injuries sustained when police employed such methods of crowd control.
Labeling these tactics as “non-lethal,” then, is not only inaccurate but also misleading. As Carl Richard Chudnofsky, MD, chair of clinical emergency medicine at University of Southern California’s Keck School of Medicine points out, they’re not considered non-violent and so labeling them as “non-lethal” does not mean they are safe. Below, Dr. Chudnofsky and Columbia University Medical Center emergency physician Steven McDonald, MD, outline the physical risks of each tactic.
Rubber Bullets
Rubber bullets are projectiles with an external rubber covering intended to make them less lethal, even as they travel at about the same speed as a metallic bullet, according to Dr. McDonald. They are sometimes also covered in plastic or hardened foam and can be more comprehensively referred to as “kinetic impact projectiles.” Their use is intended to produce contusions (bruises), abrasions (scrapes), and hematomas (swelling). “Rubber bullets are supposed to cause pain to temporarily stop a person from engaging in whatever they were doing,” says Dr. Chudnofsky.
They are not, however, as innocuous as their (intentionally innocuous-sounding) name implies. If you’ve been riveted by social media lately, you’ve likely encountered more than one graphic post depicting a rubber bullet injury. “[Rubber bulletts] can cause severe injury: fractures, internal trauma, death,” says Dr. McDonald.
In fact, a 2017 review in the British Medical Journal found that 15 percent of patients treated for injuries from “non-lethal” projectiles suffered permanent damage and 3 percent died.
Just how severely injured you may be by a rubber bullet depends on where you get hit. According to Dr. Chudnofsky, they can cause permanent eye injuries for those hit in the eye, permanent brain trauma for those hit in the head, and permanent respiratory injury for those hit in the neck. Less commonly, rubber bullets may cause fractures or lacerations on various parts of the body. In rare cases, injuries to internal organs is possible, too. “They’re more dangerous than law enforcement cares to admit, so we’ve got to be careful with them,” he says.
The closer the shooter is to their target, the more pronounced the injury, but distance can cause unintended consequences from ricochet, increasing the chance of injury to more delicate parts of the body such as the eyes.
Tear Gas
Tear gas has been used on protestors throughout the United States in recent weeks, most notably to disperse crowds in Washington, D.C., just before President Trump walked to a church near the White House for a photo op. Tear gas is considered to be a chemical weapon, one which was formally banned in warfare based on the Geneva Protocol of 1925, but it is still legal for use in non-combat situations. “It’s meant to disable, especially in large crowds,” says Dr. Chudnofsky.
Tear gas mainly causes intense eye and respiratory pain and can irritate the skin. “Usually, patients do fine after you irrigate the eyes out and clear out the chemical from the tear gas,” says Dr. Chudnofsky, .
If, however, a patient has underlying respiratory issues like asthma, chronic obstructive pulmonary disease, or other lung diseases, the negative effects are often compounded. Plus, sometimes, canisters can also detonate and cause burns of varying severity.
Dr. Chudnofsky says he’s only heard of a few cases of death, though he offers a caveat: “If you research the literature, you’ll probably find more because it’s been used for a long time.” And while reports have surfaced within the past week that a 22-year-old Ohio woman named Sarah Grossman died after being sprayed with tear gas at a protest—it is rumored that she had asthma—it’s too early to know the truth. “It is unclear if the tear gas was the cause of death in this case,” says Dr. McDonald. “It is likely she had an underlying pathology or perhaps had an allergic reaction to the tear gas.” Autopsy results are expected to take eight weeks.
As for whether the effects of tear gas could be more severe for those wearing contact lenses when sprayed, Dr. Chudnofsky says he’s seen no research to support this; however, he notes that the contacts would obviously have to be removed and discarded once they’ve absorbed the chemicals.
Pepper spray
Pepper spray, says Dr. Chudnofsky, is made of either extracts from actual peppers or is chemically created. “It’s meant to do the same thing as tear gas—in a more concentrated stream,” he says. “If you spray it in the face, it burns the skin and irritates the eyes to stop someone [from doing whatever they’re doing] because they can’t see.”
Anecdotally, he says he’s seen few permanent issues from pepper spray. “We would put some numbing medicine in the eye, a little bit of topical anesthetic, and then we irrigate it with a pH-balanced saline solution,” he says. “Generally, after you get get it irrigated for a while, the symptoms will ease up—but it is very, very uncomfortable and can cause some fairly significant distress.”
Some research shows, however, that there’s a 1 in 15 chance for more serious complications described as “tissue injury” that persists beyond temporary irritation.
Knee-to-neck restraint
As you likely know, ex-officer Derek Chauvin knelt on George Floyd’s neck for nearly 9 minutes before he died. Dr. Chudnofsky tells me that this method falls under a category of choke-type holds that many police departments have banned over the years due to risk of asphyxiation (oxygen deprivation leading to injury or death). “This maneuver compresses the windpipe, or trachea, and so causes asphyxiation,” says Dr. McDonald. “Other risks would be cervical spine fracture which can result in paralysis.” It can also put pressure on both carotid arteries in the neck and stop blood flow to the brain, which can be deadly.
Two autopsies have been performed on Floyd: a report produced by the Hennepin County medical examiner and another produced by an examiner hired by Floyd’s family. Dr. Chudnofsky notes that if you take someone with underlying cardiac problems and deprive them of oxygen, it can lead to a cardiac arrhythmia and death. In Floyd’s case, pressure to both his neck and back would have restricted his ability to breathe, the doctor says.
To that end, these types of holds are more dangerous for people with underlying medical problems like cardiac or respiratory disease than they are for the general population, though injury and death are possible for anyone.
Chokeholds
Chokeholds, or strangleholds, offer the same risks as a knee-on-neck hold. “When someone wraps their arm around a person’s neck and squeezes the trachea closed, that can cause significant asphyxiant death,” says Dr. Chudnofsky, who notes that the blood flow to the brain can also be cut off. The danger depends, he says, on which hold is used and how tightly someone is squeezed. “Most police departments have banned the use of these holds because they can lead to death or permanent disability,” he says.
Batons
Batons can be made out of a number of materials, but the most prevalent in America today are expandable metal batons. Dr. Chudnofsky likens getting hit by one to being hit by a club, and says that your injuries will depend on where you’re hit, and how hard. Most often, batons are used to temporarily disable someone, but he says that if you hit someone hard enough and in the right place, you can cause permanent damage or death. “These are designed to be non-lethal but absolutely can be [lethal],” says Dr. McDonald.
Blows to the extremities can cause lacerations or broken bones. “In medicine, certain common fractures carry nick names. A ‘nightstick fracture’ is a fracture of one of the forearm bones (the ulna) when the defender holds up their forearm to stop a strike and the strike produces a force great enough to fracture the bone,” says Dr. McDonald.
If a blow is strong enough to break a forearm bone, Dr. McDonald says to imagine how fatal it can be when applied to the skull. “Getting hit in the head can cause lacerations, eye injuries, and internal bleeding into the brain if you get hit hard enough,” says Dr. Chudnofsky. Getting hit very hard in the abdomen has the potential to cause rare but serious internal injuries such as a ruptured spleen or lacerated liver.
Disorientation devices
Disorientation devices, also known as stun grenades, create loud explosions and bright flashes of light in order to, well, disorient people. According to Physicians for Human Rights (PHR), such devices can cause temporary blindness, temporary loss of hearing, temporary loss of balance, and panic. They can also cause internal damage, especially to delicate areas such as the eardrums, injury due to fragmentation of the device, and injury due to crowd chaos.
Tasers
Tasers are hand-held electrical shock devices used by law enforcement since the mid-1970s that are, again, meant to temporary disable someone. Generally, Tasers cause people to collapse due to widespread muscle contraction which can result in temporary paralysis, explains Dr. Chudnofsky.
Studies have shown that exposure to a taser for 15 seconds or less causes minimal if not zero exposure to fatal complications, says Dr. McDonald. “The barb, or dart which punctures and remains in the skin, itself is painful, but it’s not terrible and they’re relatively easy to remove,” says Dr. Chudnofsky. “Patients often experience some post-injury soreness because all the muscles vigorously contracted.”
Substantial injury is common most often when Tasers are used inappropriately. They can also occur when someone falls as a result of being tased. “Burns, lacerations, muscle breakdown, testicular torsion, eye injury, and miscarriage for example,” says Dr. McDonald.
Longer exposure to a Taser can also result in cardiac arrest, especially if there are underlying cardiac problems. “The risk of that is higher if the victim is intoxicated with certain stimulants,” says Dr. McDonald.
Zip ties and handcuffs
Dr. Chudnofsky says he’s never seen a shoulder injury from handcuffing, but that you can see mild injuries from handcuffs or zip ties that are too tight. “Because zip ties have a plastic edge, they can cause abrasions and dig into the skin,” he says.
Acoustic weapons
Acoustic weapons are devices that deliver extremely loud sound over long distances. According to PHR, not enough research has been done on their effects; however, anecdotal cases of hearing loss and prolonged pain or ringing have been recorded.
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