Why Eric Garner Couldn’t Breathe

The chokehold is only half the story of homicidal violence.

Terry J. Allen January 15, 2015

Video stills of police killing Eric Garner on July 17, 2014. (AFB/Getty Images)

Update: On Aug. 19, 2019, the NYPD announced it had fired Daniel Pantaleo​, the police offi­cer who put Eric Gar­ner in a chokehold.

Even when used alone, extended prone restraint—placing a suspect facedown, hogtied or with hands cuffed behind—has caused untold in-custody deaths by suffocation and is therefore prohibited by many police departments, including the NYPD.

When New York City police arrest­ed and sub­dued Eric Gar­ner, he fit a pro­file: an unco­op­er­a­tive black man com­mit­ting a pet­ty crime. But the pro­file that police should have rec­og­nized — and the one that Gar­ner fit per­fect­ly — was of some­one vul­ner­a­ble to a dan­ger­ous com­bi­na­tion of banned law enforce­ment prac­tices used rou­tine­ly across the coun­try with impuni­ty, and some­times fatal results.

Con­trary to con­ven­tion­al wis­dom, it was not the choke­hold alone that killed Gar­ner. And it was not sole­ly Offi­cer Daniel Pan­ta­leo who was respon­si­ble for the homi­cide of the unarmed 43-year-old African-Amer­i­can man arrest­ed for a qual­i­ty-of-life” offense under bro­ken win­dows polic­ing” that encour­ages arrest for even the most triv­ial crimes — in Garner’s case, sell­ing loosies,” unpack­aged cig­a­rettes, on a Stat­en Island street.

The video of his death, which went viral and sparked protests, shows Pantaleo’s arm tight­ened around Garner’s neck. It also shows a clus­ter of offi­cers, includ­ing Pan­ta­leo, kneel­ing on Garner’s back and press­ing his face, mouth and nose to the pave­ment as he lay face­down, hands cuffed behind him, plead­ing— at least 11 times — I can’t breathe.”

The Office of the City Med­ical Exam­in­er ruled Garner’s death a homi­cide, cit­ing both com­pres­sion of neck (choke­hold) [and] com­pres­sion of chest and prone posi­tion­ing dur­ing phys­i­cal restraint by police.”

First, about the choke­hold: Accord­ing to his lawyer, Pan­ta­leo told the offi­cial inquiry he nev­er exert­ed any pres­sure on the windpipe.”

His denial, even if true, is large­ly irrel­e­vant. There are two main types of choke­holds, and dur­ing a strug­gle, one may eas­i­ly slide into the oth­er. Pres­sure to the wind­pipe — an air choke — direct­ly cuts off the abil­i­ty to breathe and can kill quick­ly. Pres­sure to the veins and arter­ies of the neck — a blood or carotid choke — stops blood flow­ing to and from the brain and cuts off its oxygen.

Both holds can kill, and that is why, back in 1993, the NYPD banned them. Chief John F. Tim­o­ney, then com­man­der of the department’s Office of Man­age­ment Analy­sis and Plan­ning, said: Basi­cal­ly, stay the hell away from the neck. That’s what [the pol­i­cy] says.”

And then, Garner’s sec­ond cause of death: posi­tion­al asphyx­ia caused by com­pres­sion of chest and prone posi­tion­ing.” Even when used alone, extend­ed prone restraint — plac­ing a sus­pect face­down, hogtied or with hands cuffed behind — has caused untold in-cus­tody deaths by suf­fo­ca­tion and is there­fore pro­hib­it­ed by many police depart­ments, includ­ing the NYPD. But when offi­cers also kneel or push on the restrained person’s back or neck, as they did with Gar­ner, the dan­ger of posi­tion­al asphyx­ia esca­lates. And when the sus­pect has been pep­per sprayed, is intox­i­cat­ed or has med­ical con­di­tions such as Garner’s — obe­si­ty, asth­ma and a weak heart — the dan­ger skyrockets.

Dr. Michael Baden, for­mer NYC chief med­ical exam­in­er and lat­er State Police chief foren­sic pathol­o­gist, who was hired by the Gar­ner fam­i­ly to review the autop­sy report, told the New York Times: Obese peo­ple espe­cial­ly, lying face down, prone, are unable to breathe when enough pres­sure is put on their back. The pres­sure pre­vents the diaphragm from going up and down, and he can’t inhale and exhale.’’

The cell phone video shows that even after Pan­ta­leo released the choke­hold, and Gar­ner was cuffed, hun­dreds of pounds of cop flesh pushed down on him. His strug­gle against that weight was evi­dence not of vital­i­ty and aggres­sion, but rather of des­per­a­tion to change posi­tion so that he could breathe.

The nat­ur­al reac­tion to oxy­gen defi­cien­cy occurs — the per­son strug­gles more vio­lent­ly,” a 1995 Nation­al Law Enforce­ment Tech­nol­o­gy Cen­ter bul­letin warned. The strug­gle aggra­vates the asphyx­ia by increas­ing the heart rate and caus­ing car­bon diox­ide to build up in the lungs.

Ill-trained or angry police who dou­ble down on restraint when a hand­cuffed cap­tive thrash­es are clear­ly vio­lat­ing pro­ce­dure. As soon as the sus­pect is hand­cuffed, get him off his stom­ach,” the NYPD’s Guide­lines to Pre­vent­ing Deaths in Cus­tody state. Turn him on his side or place him in a seat­ed posi­tion. If he con­tin­ues to strug­gle, do not sit on his back.”

The fact that Gar­ner had med­ical con­di­tions increas­ing his vul­ner­a­bil­i­ty to posi­tion­al asphyx­ia was not read­i­ly know­able. But that he was obese and strug­gling to breathe — even after the choke­hold that com­pro­mised him was released — was obvi­ous. That, once hand­cuffed and down, he was not imme­di­ate­ly turned over or allowed to sit up was both a vio­la­tion of long-stand­ing pol­i­cy and, ulti­mate­ly, homicidal.

And by fail­ing to act after Gar­ner became comatose, police fur­ther vio­lat­ed pol­i­cy — and pos­si­bly the law. The NYPD patrol guide warns that offi­cers are required to inter­vene if the use of force against a sub­ject clear­ly becomes exces­sive. Fail­ure to do so may result in both crim­i­nal and civ­il liability.”

The FBI issues sim­i­lar injunc­tions. To avoid in-cus­tody injury or death, offi­cers should mon­i­tor sub­jects care­ful­ly for breath­ing difficulties/​loss of con­scious­ness. Be pre­pared to admin­is­ter CPR. Obtain med­ical assis­tance immediately.”

He didn’t die because he stopped breath­ing on his own,” said his sis­ter, Ell­isha Flagg. He died because some­one took his breath away.”

And the EMTs who arrived on the scene made no effort to give it back. Faced with the limp, uncon­scious man, they were bizarrely pas­sive, fail­ing to apply an oxy­gen mask, to ensure that Garner’s air­way was clear or to assess his con­di­tion in any way beyond seek­ing a pulse.

Prone restraint and result­ing posi­tion­al asphyx­ia have been impli­cat­ed in numer­ous in-cus­tody deaths on the street and in pris­ons. And if police depart­ments are unmoved by com­pas­sion, they might con­sid­er lia­bil­i­ty. Even though offi­cers escape crim­i­nal charges, civ­il courts have levied mil­lions of dol­lars in settlements.

In 2013, Ethan Say­lor, who had Down syn­drome, refused to leave a Mary­land movie the­ater because he want­ed to see the film again. Three off-duty sheriff’s deputies forcibly removed the 294-pound dis­abled man. They placed him [face­down] on the ground,” his moth­er Pat­ti tes­ti­fied before a Sen­ate com­mit­tee, prone restraint, put hand­cuffs on, and my son died of asphyx­i­a­tion on that floor of that movie the­ater for that $10 movie ticket.”

Police used prone restraint on: Jon­ny Gam­mage, a Pitts­burgh man, at a traf­fic stop; Charles Dixon, an Altoona, Penn­syl­va­nia man, after a dis­tur­bance at a birth­day par­ty; Oral Brown, who was found wan­der­ing dis­ori­ent­ed in Fort Laud­erdale, Flori­da after his car crashed; and Tan­isha Ander­son, whom Cleve­land police were tak­ing for a men­tal-health eval­u­a­tion after her par­ents report­ed she had dis­turbed the peace. All died from posi­tion­al asphyx­ia in what amounts to insti­tu­tion­al­ly pro­tect­ed homicide.

In 1999, Bri­an Drum­mond, who was unarmed and men­tal­ly ill, end­ed up inva per­ma­nent veg­e­ta­tive state after cops sub­dued him. Although he had offered no resis­tance, Offi­cer Bri­an McEl­haney put his knees into Mr. Drummond’s back and placed the weight of his body on him. [Offi­cer Christo­pher Ned] also put his knees and placed the weight of his body on him, except that he had one knee on Mr. Drummond’s neck,” the Drum­mond v. City of Ana­heim tri­al tran­script not­ed. Drum­mond repeat­ed­ly told the offi­cers that he could not breathe and that they were chok­ing him.” One eye­wit­ness tes­ti­fied, The offi­cers were laugh­ing dur­ing the course of these events.”

The 9th Cir­cuit Court con­clud­ed in 2003: The com­pres­sion asphyx­ia that result­ed appears with unfor­tu­nate fre­quen­cy in the report­ed deci­sions of the fed­er­al courts, and pre­sum­ably occurs with even greater fre­quen­cy on the street.”

More than a decade lat­er, it seems lit­tle has changed. Acts of com­mis­sion and omis­sion by each of the many police who par­tic­i­pat­ed in or wit­nessed Garner’s arrest rep­re­sent not only indi­vid­ual cul­pa­bil­i­ty, but a sys­temic fail­ure of train­ing or compliance.

It was all the police [on the scene], not just one police offi­cer, that would have caused the obstruc­tion to breath­ing,” foren­sic expert Michael Baden told Fox News.

By blam­ing only the choke­hold, Pantaleo’s fel­low offi­cers and much of the media threw one cop under a bus that car­ries a heavy car­go of igno­rance, aggres­sion, pro­fil­ing, and need­ed reform. 

The NYPD offi­cers who petu­lant­ly turned their backs on the may­or and held work slow­downs added to the impres­sion that the force is out of con­trol, and left the pub­lic jus­ti­fi­ably wary of trust­ing police with their lives.

Ter­ry J. Allen is a vet­er­an inves­tiga­tive reporter/​editor who has cov­ered local and inter­na­tion­al pol­i­tics and health and sci­ence issues. Her work has appeared in the Guardian, Boston Globe, Times Argus, Harper’s, the Nation​.com, Salon​.com, and New Sci­en­tist . She has been an edi­tor at Amnesty Inter­na­tion­al, In These Times , and Cor​p​watch​.com. She is also a pho­tog­ra­ph­er. Her por­traits of peo­ple sit­ting in some of the 1900 cars lined up out­side a New­port, Vt., food drop can be seen on www​.flickr​.com/​p​h​o​t​o​s​/​t​e​r​r​y​a​l​l​e​n​/​a​lbums. Ter­ry can be con­tact­ed at tallen@​igc.​org or through www​.ter​ry​jallen​.com.
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