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Mortality associated with in-custody prone restraint: A review
Alon Steinberg1, Amanda Frugoli2
1Division of Cardiology, Department of Internal Medicine, Community Memorial Hospital, 147 N Brent St, Ventura, CA, USA.
Forensic Science International
|September 18, 2025
Summary
Prone restraint, a face-down hold used by law enforcement, is linked to a mortality rate of approximately 0.023 per 100,000 annually. This finding highlights the critical need for re-evaluation of its use due to potential lethality.
Area of Science:
- Forensic Pathology
- Public Health
- Law Enforcement Studies
Background:
- Sudden and unexpected arrest-related deaths are a significant public concern.
- Prone restraint is a controversial technique used in law enforcement.
- Debate exists regarding the safety and risks of prone restraint.
Purpose of the Study:
- To analyze the mortality rate associated with prone restraint.
- To evaluate the evidence on the safety and risks of prone restraint.
- To inform public policy and clinical guidelines regarding restraint techniques.
Main Methods:
- Review of prospective epidemiologic studies and retrospective analyses.
- Inclusion of data from investigative journalism on restraint-related fatalities.
- Estimation of mortality rates based on available evidence.
Main Results:
- Prospective studies often report no fatalities, but may underestimate risks.
- Retrospective analyses and investigative data reveal fatal outcomes linked to prone restraint.
- Estimated mortality rate for in-custody prone restraint is approximately 0.023 per 100,000 population annually.
Conclusions:
- The potential lethality of prone restraint necessitates its re-evaluation.
- There is a need for more rigorous, large-scale epidemiological studies.
- Findings underscore the importance of recognizing fatal risks and ethical responsibilities in restraint use.
