At 7:28 a.m. on May 26, a call was made by National City police to San Diego Fire-Rescue dispatch, requesting an ambulance at the county jail downtown. In a recording of that call, the caller from National City asks, "Um ... would you guys be able to start, um, an ambulance to county jail? One of our prisoners got rejected.”
The dispatcher responds, “What do you mean by that?”
The question is followed by about 10 seconds of silence, nervous laughter and then the officer's response: “Um, so I guess I don’t know why he got rejected. Um, but they just said they wanted a transport."
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The call was for Earl McNeil. National City police said he'd shown up at their headquarters at around 5:30 that morning, agitated and telling them he was high and looking for help.
McNeil was arrested on suspicion of drug use and put in restraints. His family said he was still wearing them when his heart stopped hours later. Medics resuscitated McNeil, but he died 16 days later after being pulled from life support.
A news release from the National City Police Department said they restrained him with a device called the WRAP. As seen in a YouTube video, it binds the legs and wrists together while keeping a person sitting in an upright position. Its maker, Safe Restraints, said it’s made to be a safe, nonlethal way to stop a conflict. The company said the WRAP is used by law enforcement agencies across the country, including nearly every agency in San Diego County.
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But can nonlethal force become lethal if someone is under the influence of drugs? KPBS put the question to Dr. Gary Vilke, an emergency physician at UC San Diego Medical Center Hillcrest, where medics rushed McNeil after his heart stopped.
“You add that all together, and it creates in someone who may have a pre-existing heart condition or drug-induced heart problems a risk for sudden death. That (also) happens for patients who are being restrained outside of the wrap,” Vilke said.
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Vilke has conducted studies on restraints like the WRAP and said they have little impact on one's ability to breathe. He also said the struggle to get someone into a restraint can be more harmful than the restraint itself.
“From a physiologic perspective, it really shouldn't have a significant impact. There will be questions on people who are a little bit more obese and if it impacts being able to breathe as deeply as you would standing up and probably if you measured in a lab setting you might see some changes,” Vilke said.
But not all experts agree. JJ Wohlers, a paramedic in Las Vegas, teaches other medics and law enforcement about restraint asphyxia. That's when a restraint prevents a person from breathing.
He compared a person who is agitated or under the influence to a marathon runner.
“What is your body’s compensatory mechanism to recover? Rapid breathing. That’s your body's buffer system taking over to blow off all those acids," Wohlers said. "Now if we put somebody in a wrap or in a prone position, and we prevent the body from blowing off those acids and breaking down those acids. What happens is the body becomes acidotic, and it has a cascade of effects that leads into a cardiac arrest.”
Wohlers said the research done by UCSD is flawed, and said a realistic study where someone is in respiratory distress and put in a restraint would be fatal for the test subject.
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McNeil’s case isn't the only one where the use of the WRAP restraint has been questioned. In 2014, a man in the Bay Area died inside a WRAP restraint. That led to a wrongful death suit that was settled for $1 million just last year.
Wohlers said a person suspected of drug use or mental illness should be treated as a patient first and be given immediate medical care.
“Drug abuse is a big problem. We help these people and move on. Nobody should die trying to get help,” said Wohlers.
McNeil didn’t see a medic until after he was taken to the jail, about two hours after he first contacted police.
