These guidelines come from a detailed report released in the summer of 2020 after a two-year review of weapons used against crowds. The UN authors also advised that “the results of the monitoring should be made public” and the suggestion seems wise.
After all, you can only address a public safety threat – including the threat of costly, disproportionate, and disfiguring obstruction by police – if you understand how it spreads.
As of this month, the dozen of injuries sustained by the public from so-called “non-lethal weapons” used during protests against civilians last summer had not yet been formally compiled in Minnesota.
The first of these reports is out now, but with no help from Minneapolis or Minnesota health officials. It turns out that the guns aren’t that “non-lethal” after all.
“We saw a lot of injuries to the face and head that required surgery and caused blindness,” says Dr. David P. Darrow, neurosurgeon at M Health Fairview and Hennepin Healthcare Systems’ hospitals in Minneapolis.
“That seems pretty extreme to us, especially since many of the injured were just spectators, not even in protest.”
Darrow and his 14 co-authors have compiled a database of injuries treated in the two hospitals related to less lethal weapons such as kinetic impact projectiles and tear gas. They published this work as a letter to the New England Journal of Medicine in mid-January.
89 such injuries have been reported to the two systems, 45 from projectiles, 32 from tear gas, and 12 from both. The injuries included 41 from rubber bullets, seven from tear gas canisters, two from bean bags and seven from unknown projectiles.
The study found that 16 patients in Minneapolis suffered traumatic brain injuries that may require long-term rehabilitation and can cause permanent disability.
The ammunition struck 10 protesters in the eye in Minneapolis and left three permanently blind in one eye.
“We were surprised to see that 40 percent of impact injuries were in the head, face, and neck,” says Erika Kaske, a medical student at the University of Minnesota and co-author of the paper. “That’s pretty high when you look at guidelines that basically say that shooting in the head, neck and face may be illegal.”
The UN 2020 report addresses this potential illegality under the heading “Circumstances of Potentially Lawful Use”.
“Kinetic impact projectiles should generally only be used in direct fire to hit the lower abdomen or legs of a violent person,” it says, “and only to counter the threat of injury to a law enforcement officer or member of the public.”
Law enforcement in Minneapolis appears to have faced safer travel during the violent lifting of the protest.
Although they did not make the information public, University of Minnesota clinicians collected data on who was treated in their systems during the protest period, and while the events are commonly referred to as “riot,” the physical harm from these riots decreased almost entirely Publicity.
“In terms of the police that were injured,” Darrow said, “it was only a handful, and it really didn’t compare to the protesters.”
The authors also noted a striking disregard for safety by the Minneapolis police force when firing tear gas cans.
“We saw injuries from the tear gas canisters as projectiles,” said Darrow. “That’s what’s so worrying. Even if you say we’re only going to use tear gas, the problem is that they’re getting shot in people’s heads.”
“These things are heavy weapons. They can cause serious damage as a projectile.”
Repairing injuries caused by the global incidence of police brutality seems to fall heavily on neurosurgeons. Last June, World Neurosurgery magazine published gruesome CT scans of the heads of 10 protesters, all of whom were teenagers, killed when a tear gas canister entered their skulls from crowd control officers in Iraq.
Enough to break the skull
The U of M study is only the second attempt to systematically collect data on the health effects of non-lethal weapons used to control the crowd following protests against the death of George Floyd.
In September, clinicians at the University of Texas at Austin reported that “beanbag” ammunition, believed to cause minor blunt injuries, required seven surgical procedures, four of them because a beanbag had penetrated the body.
“I think it’s important to highlight the severity of these injuries that we’ve seen and witnessed in Minneapolis. I don’t think that’s just the case in our two cities. I think it’s across the country happens and it is an important discussion for us to have. “
– Dr. Kristofor Olson, University of Texas at Austin
In addition, four patients in Texas had beanbag brain hemorrhage and one had a fractured skull that required intubation, brain surgery, and 23 days in the hospital, followed by a discharge to a rehab facility.
“This is a serious injury,” says Dr. Kristofor Olson, surgeon at the University of Texas at Austin, trauma-on-call at the hospital during the Floyd protests and co-author of the letter.
“You hear the term ‘beanbag’ and it seems kind of cartoonish. You imagine something people would use in court games that ricochets off a person and doesn’t cause a piercing injury. These were injuries that were a lot more like one Shotgun looked like wounds. “
“They were housed in people,” he says. “One of them, the beanbag, broke up and she had kept the shot in and around her elbow. One had the beanbag through her armpit and into the tissue under her chest, right there on her chest wall.”
“Two people had beanbags that actually caused fractures and depression in their skulls. One actually had a beanbag in their forehead, not down to the brain, but it had penetrated the skull.”
Austin quickly banned beanbag ammunition – cloth bags around lead shotgun pellets – and the injuries fell off. Both sites believe that it is the job of health authorities to collect data on injuries sustained during police actions against crowds.
“I think it’s important to highlight the severity of these injuries that we saw and that the Minneapolis people witnessed,” said Olson. “I don’t think this is unique to our two cities. I think it happened across the country and it’s an important discussion for us.”
“Aside from the Austin release and ours,” says Darrow, “no other protests in the US have been rated this way in the last 10 years. There was nothing about it and that really worried us.”
Darrow says the next step is to try to get similar information from other city hospital systems over the same period. The surgeon said there had been a lack of involvement from officials from the City of Minneapolis, the Minnesota Department of Health, Governor Tim Walz’s office, or public safety.
“The bigger discussion is the relationship between public safety and public health,” he says. “There is not much dialogue right now … so that you understand what you did during these protests. There is no discussion of what the guidelines should be.”
“As far as I know, no one in any city department has spoken to us about it. We’ll go forward and try to talk to them about it.”