Biometrics Monitoring:
A Law Enforcement Tool to Assess Custodies' Health & Safety
John DeFalco, Ian Osteyee, and David Sanders
In-custody deaths are an increasingly important topic among law enforcement professionals and the public. As described by Heide and Chan (2018), “Deaths in police custody often attract a huge amount of public interest and are frequently associated with controversy related to causation” (p. 109).
Beginning with the Death in Custody Act of 2000, a growing body of data has been collected about in-custody deaths. Recent high-profile deaths such as George Floyd and Freddie Grey have reinvigorated public attention across our nation. While some in-custody deaths could be attributed to the use of force, it is vital to highlight that other contributing factors, including alcohol, drugs, mental health, and poor health, contribute to a substantial number of in-custody deaths (Houston, 2016). In consideration of this information, this article will delve into the background and current trends associated with in-custody deaths, outline how biometrics monitoring could help, and display a framework for implementing biometrics monitoring.
Background and Current Trends
It is possible to discover new and effective ways to confront the in-custody death problem by delving into historical data. First, it is essential to examine the different causes and contributing factors regarding in-custody deaths. Deaths in custody have several reasons, including illness, trauma, drug use, and alcohol intoxication. Additionally, it could be a combination of these factors accompanying the stress of being arrested or incarcerated. Therefore, it is noteworthy to highlight that not all deaths are preventable; however, it is possible to prevent several through the arrest, transport, and detention process through the use of new technology.
Before exploring the issue more deeply, it is critical to define an in-custody death. For this article, an in-custody death will be defined as the death of someone who is in the custody of law enforcement and will be broken down into the following categories: arrest-related, transport-related, and detention-related.
Arrest and Transport-Related Deaths
As the Bureau of Justice Statistics does not differentiate between arrest-related and transport-related in-custody deaths, the statistics demonstrated will reflect the combination of the two categories. The majority of deaths were labeled homicide by law enforcement, followed by death by intoxication at 11 percent and death by suicide at 11 percent from data collected between 2003 and 2009 (Houston, 2016). In conjunction, it is essential to understand that an escalation of force is much higher in the initial arrest phase, likely contributing to many homicides by law enforcement as denoted. Additionally, these statistics do not illuminate different levels of use of force that could have caused injuries such as chokeholds, head trauma, or positional asphyxia combined with ongoing poor health issues in the arrestees that lost their lives. Even in these cases, better health monitoring tools might have enabled offices to call for assistance more quickly. These manners of death are drastically different from those in detention facilities.
Detention-Related Deaths
In prisons and jails, contributing factors to incarcerated deaths involve drugs, alcohol, and suicides, with suicides as a leading cause by far. Based on data collected from 2001 to 2019, “the number of suicides increased 85 percent in state prisons, 61 percent in federal prisons, and 13 percent in local jails” (Bureau of Justice Statistics, 2021). Furthermore, it is significant to highlight that approximately 90 percent of suicides in local jails involved asphyxiation, and roughly 12 percent occurred within the first 24 hours from 2015 to 2019. These statistics are vital to understand and shed light on areas where solutions must be implemented. Moreover, these numbers will be instrumental in explaining the implementation framework of biometrics monitoring.
With the amalgamation of public attention, numbers of in-custody deaths, and increasing rates of suicide in correctional facilities, law enforcement departments have begun trying to overcome the problem with tools and policies. After visiting numerous law enforcement agencies and consulting with law enforcement professionals, it was possible to ascertain the most commonly used devices and approaches. A list is below.
Current Tools to Monitor the Health and Safety of those in Custody
• Body-Worn Cameras—These have become increasingly popular in recent years and are excellent tools for capturing information that can be used for accountability purposes.
• Detention Surveillance Systems—In correctional facilities, these cameras and integrated systems are instrumental in enabling easy visual monitoring of detainees. However, it is still impossible to see everything occurring, and there are several examples of when visual monitoring alone has failed to prevent suicide.
• Health and Wellness Checks—It is common to conduct routine checks at approximately 15-minute intervals in most prisons and jails. While helpful, there is a gap in coverage between checks.
• High-Risk Detention Areas—Once a prisoner is identified to fit into a high-risk category such as suicide risk or someone having withdrawals, they are typically moved into one of these areas for a mandatory watch.
• Intake Assessment Forms—These forms are based on the observing officer and self-reporting issues from the person being taken into custody.
While many of these efforts and devices are beneficial and have no doubt prevented in-custody deaths, we can do more. As an illustration, stationary cameras are excellent tools for monitoring people, but they cannot tell you what is going on internally or physically with someone. An individual could have been arrested for intoxication, and it might appear that they are sleeping, but in reality, they might have gotten nervous and swallowed their stash before arrest. Subsequently, what might appear as sleeping could have transitioned to an overdose. That gap in health monitoring is where biometrics monitoring could make a difference and save lives.
Biometrics Monitoring Overview and Role
Biometrics monitoring is a new tool for assessing the health and safety of people in custody. Biosensors about the size of a quarter are placed on individuals at the time of the arrest. These biosensors continuously monitor heart rate trends combined with motion and use artificial intelligence to detect risks to health and safety. When the first sign of a health problem is detected, the officers, supervisors, and control centers are instantly notified. By detecting danger early and alerting responders, it is possible to save lives. Accordingly, it is crucial to delve more deeply into how biometrics monitoring alerts to signs of drug overdoses, suicide, and positional asphyxiation, which, as discussed previously, are common causes of in-custody deaths.
Opioids—With a few exceptions, an opioid overdose typically comprises respiratory depression, miosis, and central nervous system depression (CNS) (Compton et al., 2019). These elements of an overdose are significant because it is possible to monitor for these symptoms through heart rate, the number of respirations per minute, and oxygen levels. Furthermore, it is crucial to illuminate bradycardia (abnormally slow heart rate) as a symptom of intoxication and tachycardia (abnormally rapid heart rate) as a symptom of opioid withdrawal (Williams and Erickson, 2000). Tachycardia and bradycardia are particularly noteworthy symptoms and biometrics monitoring can alert to the changes in heart rate or the inability of individuals heart rate to recover appropriately, providing insight to their health situation.
Amphetamines—In contrast to opioids, amphetamines usually cause an increased heart rate and, in overdose situations, tachycardia. Furthermore, methamphetamines place considerable stress on the cardiovascular system, and patients often present with palpitations, chest pains, tachycardia, and hypertension (Darke, 2008). Even though these symptoms are less straightforward than the triad of symptoms discussed regarding opioid overdoses, it is possible to identify an impending health crisis or overdose through heart rate and heart rate recovery trends.
For example, if an individual has been in a foot chase with officers, and once taken into custody, that individual’s heart rate should begin to decline. However, if an individual’s heart rate remains elevated or continues to climb, there is likely an impending health crisis. Through biometrics monitoring, it is possible to alert accordingly in this type of scenario.
Suicide—Based on data collected by the Centers for Disease Control from 2003 to 2014 in 18 states, asphyxia was overwhelmingly the leading cause of death for suicides at approximately 90 percent (Dixon et al., 2020). Even though it is possible to watch those in custody physically, prisoners are more likely to be monitored via video surveillance or during wellness checks every 15 minutes. One of the critical markers of asphyxiation is a rapid decline in heart rate (Duen et al., 2015). With biometrics monitoring, it is possible to identify a suicide attempt even if there is no visual surveillance by identifying the rapid decline in heart rate, giving officers time to intervene.
Positional Asphyxia—Many of the same characteristics described about suicide apply to positional asphyxia, specifically the rapid decline in heart rate. However, it is worth differentiating between the two because they can occur in different settings when related to in-custody deaths. For example, positional asphyxia is common during the initial arrest, and the contributing factors could include “intoxication due to alcohol, drug use, obesity, psychiatric illnesses, and physical injury” (Heiskell, 2015, para. 2). Even though it is possible to change positions and help alleviate the stress on the respiratory and cardiovascular system, it often occurs after a struggle, where compliance and a health crisis could go hand-in-hand. Biometrics monitoring could alert officers to this health crisis and allow them to take appropriate actions.
Alcohol—Regarding in-custody deaths, the primary risks with alcohol fall into two categories: alcohol poisoning and withdrawal. In the case of alcohol poisoning, symptoms include nausea, vomiting, seizures, low body temperature, coordination problems, slurred speech, rapid involuntary eye movement, and a very slow heart rate (Ward et al., 2019). With some of these symptoms, it might be difficult to differentiate between alcohol poisoning and intoxication; however, one of the key differentiating markers is the heart rate. If the individual’s heart rate begins to slow, biometric monitoring tools will alert an impending health crisis. In concert with alcohol poisoning, alcohol withdrawal is dangerous as well.
In the event of alcohol withdrawal, appearance, sweatiness, pupil size, blood pressure, and elevated heart rate are a few symptoms (Farrell et al., 2015). Furthermore, there are different withdrawal levels, and in severe cases, mortality can be as high as 40 percent. In combination with the physical presentation of symptoms, it is significant to highlight that tachycardia is an indicator. Signs of tachycardia can be found using biometrics monitoring, allowing for medical treatment to occur sooner.
Implementation of Biometrics Monitoring within Departments
Based on data discussed earlier in this paper, combined with an in-depth understanding of how biometrics monitoring software can alert regarding common health crises experienced by those in custody, it is possible to illustrate a recommended implementation framework. The framework will demonstrate how law enforcement could use biometrics monitoring tools to overcome in-custody deaths during the initial arrest, transport, and detention phases.
Arrest
During the arrest phase, most causes of death were related to the use of force, intoxication of some sort, and suicide. With that information at the forefront, biometrics monitoring would be most beneficial if the arresting officer suspected the detainee was intoxicated, potentially swallowed a stash, or was involved in a high-impact arrest (escalation of force, head trauma, struggle that went to the ground or simply a foot chase with someone in poor health). Figure 1 depicts how to use the sensors and software in a patrol setting and when to use biometrics monitoring.
As portrayed in Figure 1, the individual officer would have biometrics monitoring software on their department-issued phone or smart device, and the officer would have a sensor, plastic tamper resistant cup, and zip tie for attaching to the arrestee. After the subject is in cuffs, the officer would use the zip tie to attach the sensor to the subject’s wrist and then monitor the custody’s health on their device.
Transport
Biometrics monitoring during transport allows you to evaluate the health and safety of those in your custody, whether it is a short movement or a cross-country movement. The sensor and software will alert you at the first sign of a health crisis. In conjunction with alerts at the local level, biometrics monitoring software can be integrated into dispatch, providing redundant coverage of health monitoring. Additionally, upon arrival at the correctional facility, it is possible to continue monitoring and transfer the custodies to booking or intake.
Figure 1: diagram displaying biometrics monitoring software on the officer's department-issued phone.
Figure 2: diagram displaying how biometrics monitoring would work during transport.
Detention
The integration of biometrics monitoring in detention targets two primary problem areas: suicide and drug overdoses. Subsequently, if it is not feasible to use the product throughout the correctional facility, it is recommended that biometrics monitoring is used in intake, high-risk areas, and medical areas. Based on data, these are the areas where biometrics monitoring could have the greatest positive impact, and an example monitoring zone is illustrated above.
There are many examples from the field where biometrics monitoring might have saved lives, which is the primary goal. Yet, there are several other direct and indirect positive consequences.
A more inclusive list of benefits is as follows.
Expected Benefits
Enhanced ability to identify health crises—Presently, identifying health crises relies predominantly on visual monitoring. While this is critical, visual monitoring does not provide the full picture of an individual’s health. By monitoring certain heart rate trends in combination with motion, it is possible to get a more complete picture of an individual’s health.
Improved decision-making—If integrated into the department’s standard operating procedures, the policy can make it easier for all officers to make the best decision regarding medical treatment. For example, if it is built into the department’s policy that if a “red alert” is received, EMS is immediately called.
Reduction in the number of in-custody deaths—While it will not be possible to prevent all in-custody deaths, reducing medical response times will have a positive impact on some cases, preventing deaths.
Decreased monetary burden on the community—Although it is discussed much less often than other facets of in-custody deaths, such as causation, the financial impact is another substantial component that accompanies these unfortunate events. For example, Minneapolis paid out a $27 million settlement following the death of George Floyd, and civil unrest spurred by this incident is estimated to have cost up to $2 billion across the country (La Jeunesse, 2020; Shapiro and Lloyd, 2021). There were also costly settlements and civil unrest associated with several other in-custody death cases in the past few years. Ultimately, there is a financial burden on the taxpayer, municipalities, and insurance companies. Moreover, there are numerous societal effects, including reducing law enforcement budgets to cover costs, in some of these scenarios (La Jeunesse, 2020).
Improved transparency and accountability—As underscored by protests and news coverage following several in-custody deaths, there is a consistent desire for transparency. By having data to display, it will bolster transparency and demonstrate that officers acted according to policy and were accountable.
Conclusion
Based on the data collected regarding in-custody deaths at the national level, we believe biometric monitoring can help prevent in-custody deaths related to drug overdoses, suicides, asphyxiation, and use of force injuries. While we realize that it might not be possible for every police officer in every department to use biometric monitoring tools, we believe that it should be employed in critical areas of each phase, including arrest, transport, and detention. Not only do we think that using biometric monitoring devices will save lives, but we also believe that it is another instrument that officers could use in conjunction with body-cam footage to demonstrate that officers did everything within their power to save a life. By saving lives and having the ability to show actions that were taken using new technology, it is also possible to decrease the monetary burden on municipalities. Furthermore, there is the potential to boost transparency and strengthen trust with communities. Lastly, through the help and participation of departments that adopt biometrics monitoring, we can build on and improve our knowledge of how best to prevent in-custody deaths.
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John DeFalco is the CEO and co-founder of 4Sight Labs. After spending over two decades in Silicon Valley building enterprise software, John turned his focus to Public Safety. Now, John builds solutions to prevent in-custody deaths using wearable sensors and AI. John lives in San Francisco, and is originally from Boston.Contact email:John@4sightlabs.com
Ian Osteyee is the President and co-founder of 4Sight Labs. Prior to founding 4Sight Labs, Ian served as a Reconnaissance Marine. He has a degree in Middle Eastern Studies from the State University of New York, Plattsburgh. After 9/11, Ian served as a member of the Intelligence Community and subsequently trained DOD Special Operations personnel and members of the Intelligence community. Ian also has extensive experience in product design. He has developed cutting-edge equipment for both recreational and government applications. Contact Email: Ian@4sightlabs.com
David Sanders currently serves as the Vice President of Business Development at 4Sight Labs. Before joining the team at 4Sight Labs, David spent over a decade in the Army Special Forces, where he deployed to numerous countries in the Middle East. Additionally, he has a bachelor of science in organizational leadership and a master of science in strategic leadership. Contact email: Sanders@4sightlabs.com