D de Brito1, K R Challoner, A Sehgal, W Mallon. 1. Department of Emergency Medicine, Los Angeles County & University of Southern California Medical Center, Los Angeles, CA, USA. debrito2@earthlink.net
Abstract
STUDY OBJECTIVE: This case series describes the injury pattern of the police bean bag, a new weapon adopted by US law enforcement agencies. METHODS: Retrospective chart review between 1996 and 2000 identified bean bag injuries. Autopsy data were gathered for 1 fatality. Circumstances of the shootings, toxicology results, and psychiatric diagnoses, if any, were recorded. RESULTS: Thirty-nine men and 1 woman between the ages of 16 and 77 years were shot by officers of either the Los Angeles Police Department or the Los Angeles Sheriff's Department. The fatality was caused by massive hemothorax after thoracic penetration. The locations of serious penetrating injuries included the thoracic cavity, eye, abdomen, arm, and leg. Blunt injuries included splenic rupture, pneumothorax, compartment syndrome, testicular fracture, subcapsular liver hematoma, and cardiac contusion. Complications included hemothorax, pneumopericardium, wound infection, compartment syndrome, and osteomyelitis. Psychiatric consultation was requested for 27 (69.2%) of 39 surviving patients. The Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) Axis I was used for diagnosis in all 27 patients. Psychosis was diagnosed in 16 (59.3%), suicidal ideation in 15 (55.6%), and major depression in 6 (22.2%) of the 27 cases. Schizophrenia had previously been diagnosed in 7 (25.9%) of the 27 cases. All but 1 of the patients had toxicology screenings performed, and the results of 29 (74.4%) of 39 were positive. Of these 29 positive results, 15 (51.7%) were positive for alcohol and 8 (27.6%) were positive for cocaine. CONCLUSION: Awareness of the broad scope of potential injuries mandates a thorough evaluation of both blunt and penetrating trauma in patients shot with police bean bags. The scope of these injuries raises significant public health considerations because use of this weapon has been adopted by law enforcement agencies in all 50 states and at least 10 countries.
STUDY OBJECTIVE: This case series describes the injury pattern of the police bean bag, a new weapon adopted by US law enforcement agencies. METHODS: Retrospective chart review between 1996 and 2000 identified bean bag injuries. Autopsy data were gathered for 1 fatality. Circumstances of the shootings, toxicology results, and psychiatric diagnoses, if any, were recorded. RESULTS: Thirty-nine men and 1 woman between the ages of 16 and 77 years were shot by officers of either the Los Angeles Police Department or the Los Angeles Sheriff's Department. The fatality was caused by massive hemothorax after thoracic penetration. The locations of serious penetrating injuries included the thoracic cavity, eye, abdomen, arm, and leg. Blunt injuries included splenic rupture, pneumothorax, compartment syndrome, testicular fracture, subcapsular liver hematoma, and cardiac contusion. Complications included hemothorax, pneumopericardium, wound infection, compartment syndrome, and osteomyelitis. Psychiatric consultation was requested for 27 (69.2%) of 39 surviving patients. The Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) Axis I was used for diagnosis in all 27 patients. Psychosis was diagnosed in 16 (59.3%), suicidal ideation in 15 (55.6%), and major depression in 6 (22.2%) of the 27 cases. Schizophrenia had previously been diagnosed in 7 (25.9%) of the 27 cases. All but 1 of the patients had toxicology screenings performed, and the results of 29 (74.4%) of 39 were positive. Of these 29 positive results, 15 (51.7%) were positive for alcohol and 8 (27.6%) were positive for cocaine. CONCLUSION: Awareness of the broad scope of potential injuries mandates a thorough evaluation of both blunt and penetrating trauma in patients shot with police bean bags. The scope of these injuries raises significant public health considerations because use of this weapon has been adopted by law enforcement agencies in all 50 states and at least 10 countries.