1. Investigating and Prosecuting Strangulation Cases
Bridget Healy Ryan
Violence Against Women Policy Advisor
Cook County State’s Attorney’s Office
Stalking and Strangulation

2. ACKNOWLEDGEMENTS The great and fabulous Mark Wynn
Gael Straeck (San Diego, Family Justice Center)
Dr. George McClain (San Diego)
Dr. Dean Hawley (Indianapolis)
Federal Law Enforcement Training Center (Glynco, GA.)
National Sheriff’s Association (Alexandria, VA.)
Stalking and Strangulation

3. The Lethality of Strangulation
“The use of an object in strangulation increases the likelihood of lethality. Similarly, if the victim blacks out, she/he is in great danger of not regaining consciousness or sustaining brain damage from lack of oxygen.”
— George McClain, MD, San Diego Emergency Department
Stalking and Strangulation

4. Strangulation Study: San Diego, CA
Studied 200 strangulation cases over a five year period.
62% of victims had no visible injury.
22% of victims had minor visible injuries.
16% had significant visible marks.
199 of the strangulation suspects were male and the average age was in the mid-twenties.
Stalking and Strangulation

5. Strangulation vs. Choking
Many victims will report they have been “choked” when in technical terms they were the victims of strangulation.
Choking = an internal obstruction of the airway.
Strangulation = a form of asphyxia characterized by closure of the blood vessels and air passages of the neck as a result of external pressures on the neck.
Stalking and Strangulation

6. Types of Strangulation
Hanging
Ligature
Manual
Stalking and Strangulation

7. Stalking and Strangulation

8. Obstruction of Carotid Artery
Most common cause of strangulation
Results in unconsciousness
8 pounds of pressure cuts off oxygen flow to brain (less pressure than used to pull trigger of handgun)
Oxygen flow cut off for only 8 seconds can cause critical injury
Stalking and Strangulation

9. Vessel Occlusion UNCONSCIOUSNESS Carotid artery
occlusion – 11 pounds of pressure for 10 seconds
Jugular vein
occlusion – 4.4 pounds of pressure for 10 seconds
UNCONSCIOUSNESS
Stalking and Strangulation

10. Obstruction of Trachea
33 pounds of pressure completely obstructs
Can cause tracheal fracture, death
Brain death results if strangulation persists for 4-5 minutes
Stalking and Strangulation

11. Stalking and Strangulation

12. Stalking and Strangulation

13. No Visible Injuries
Officers should always call EMS due to potential internal injuries, that can be fatal, and might not be apparent.
Because of underlying brain damage by lack of oxygen during strangling, victims have died up to several weeks later.
Stalking and Strangulation

14. Signs and Symptoms Sore throat Hoarse, raspy voice Loss of voice
Difficulty swallowing
Fainting, unconsciousness
Nausea, vomiting
Loss of bodily function
Miscarriage
Lung damage
Scrapes, scratches, claw marks, chin abrasions
Thumbprint bruises
Bruises behind ears
Red, linear marks (often 3)
Petechieae (red dots on eye)
Rope, cord burns
Behavioral changes
Stalking and Strangulation

15. Actual Strangulation Clip
8 lbs. of pressure for 8 seconds.
Victim told police “nothing happened.”
Offender ultimately convicted of Assault 2nd Degree.
Stalking and Strangulation

16. Stalking and Strangulation

17. Stalking and Strangulation

18. Stalking and Strangulation

19. Stalking and Strangulation

20. Stalking and Strangulation

21. Dangers of Minimization
Professionals
Victims
Stalking and Strangulation

22. Proving Strangulation Cases without an Autopsy
“Never Let A Victim Die in Vain”
Dean Hawley, MD, Forensic Pathologist
George McClane, MD, Emergency Physician
Gael Strack, JD, Director, SD Family Justice Center
Thoughts of a dying woman. Death Penalty.
Gone in 60 seconds
Last breath.
Gasping for air.
Hail Mary.
Stalking and Strangulation

23. The Law
Stalking and Strangulation

24. Strangulation Demands a Felony Arrest & Law Supports It.
Assault with force likely to produce great bodily injury. (PC245)
People v. Covino (1980) 100 Cal.App.3d 600 (force of defendant’s assault by choking was likely to produce a serious injury although victim only had redness to neck and pain to throat).
Attempted spousal abuse (PC273.5) does not require injury.
People v. Kinsey (1995) 40 Cal.App.4th 1621
Stalking and Strangulation

25. Missouri, Chapter 565, Offenses Against the Person, Section 565
Missouri, Chapter 565, Offenses Against the Person, Section August 28, 2003
Domestic Assault, second degree
(1) Attempts to cause or knowingly causes physical injury to such family or household member by any means, including but not limited to, by use of a deadly weapon or dangerous instrument or by choking or strangulation; or
Domestic Assault in the second degree is a class C felony.
Stalking and Strangulation

26. Minnesota, HF 963, Effective August 1, 2005
Domestic Assault by Strangulation.
Subd. 1. Definitions. Defines the terms "family or household members" and "strangulation."
"Family or household member" includes spouses, former spouses, parents, children, blood relatives, persons with a child in common, persons residing together, persons who formerly resided together, and persons who are or have been involved in a significant romantic relationship.
"Strangulation" means "intentionally impeding normal breathing or circulation of the blood by applying pressure on the throat or neck or by blocking the nose or mouth of another person."
Subd. 2. Crime. Provides that domestic assault by strangulation is punishable by five years imprisonment and/or a $10,000 fine. ("Domestic assault" is an intentional act to cause fear of immediate bodily harm or death or an intentional act to inflict or attempt to inflict bodily harm upon a family or household member.)
Stalking and Strangulation

27. Idaho Code Section
ATTEMPTED STRANGULATION. (1) Any person who willfully and unlawfully chokes or attempts to strangle a household member, or a person with whom he or she has or had a dating relationship, is guilty of a felony punishable by incarceration for up to fifteen (15) years in the state prison.
(2) No injuries are required to prove attempted strangulation.
(3) The prosecution is not required to show that the defendant intended to kill or injure the victim. The only intent required is the intent to choke or attempt to strangle.
(4) "Household member" assumes the same definition as set forth in section (1)(a), Idaho Code. 20
(5) "Dating relationship" assumes the same definition as set forth in 21 section (2), Idaho Code.
Stalking and Strangulation

28. New Laws Missouri Pending Oklahoma Washington Idaho Minnesota
North Carolina
Alaska
Hawaii
Florida
Connecticut
Louisiana
Oregon
Pending
California
Stalking and Strangulation

29. Premeditation
Commonwealth v. Serino, Supreme Judicial Court, Docket No. SJC-07310, March 28, 2002
Evidence that the defendant manually strangled the victim to death was sufficient for jury to find deliberately premeditated murder.
The defendant murdered his girlfriend by strangling her. In describing the incident to the police, the defendant admitted that he put both hands around the victim's throat and choked her for "about a minute".
At trial, the medical examiner testified that death by strangulation would result only after choking for five to eight minutes.
The testimony regarding the length of time it takes to cause death by strangulation allowed the jury to infer that death was not instantaneous but rather the result of sustained pressure applied to the victim's throat for several minutes, thereby allowing the defendant time to reflect on his decision to kill.
Stalking and Strangulation

30. Likely Defenses in a Strangulation Case
Stalking and Strangulation

31. Potential Defenses Self-inflicted injuries Autoerotica
she is trying to set me up. Ask why?
Autoerotica
Evidence of a ligature mark or a hanging
Look for evidence at the scene
Consent – Applied or monitored by sexual partner
she likes sex that way
Bondage
“choke holding” during anal intercourse
Accidental Sexual strangulation – 1986 American Journal of Forensic Medicine and Pathology 7(1): 74-75, Michalodimitrakis, Frangoulis and Koustelinis
Stalking and Strangulation

32. Trial
Stalking and Strangulation

33. Trial Preparation Notice to Defense Attorney Copy of Expert’s CV
Meeting with expert
The Facts of Case
Questions to Ask
Charts
Pre-trial motion with Judge
Information is Relevant
Expert is Qualified
Stalking and Strangulation

34. PURPOSE OF THE DIRECT EXAMINATION
Persuasively tell the story
Establish the elements
Leave the jury with a clear understanding
of how the crime occurred and why the defendant is guilty
Stalking and Strangulation

35. THE PRE-TRIAL INTERVIEW: Part I
Prepping for the interview
Read and review all reports and evidence
Prepare a timeline
Identify the strengths and weaknesses of each witness
Stalking and Strangulation

36. THE PRE-TRIAL INTERVIEW: Part II
Prepping the witness
Put your witness at ease (demonstration)
Give witness the big picture
Remind the witness that the jury is a blank slate – the witness needs to fill in all blanks
Stress the importance of telling the truth – even when they would rather not!
Make sure to show the witness all exhibits
Don’t forget the basics
Stalking and Strangulation

37. ANTICIPATE THE CROSS Address the weaknesses
Explain the inconsistencies
It’s okay to say “I don’t know” to stupid questions
Treat the defense attorney with respect (even when they don’t deserve it)
Stalking and Strangulation

38. ORGANIZING THE DIRECT Introduce the witness Humanize the witness
Front the baggage
Set the scene
Stalking and Strangulation

39. ORGANIZING THE DIRECT, cont’d
Lights, Camera, Action
Lead the witness without asking a leading question
Identify the defendant as early as possible
Make a ten second crime ten minutes
Keep the questions short
Never forget your witness is the star
End strong
Stalking and Strangulation

40. TRIPLE DIRECT Take the witness through the story from start to finish
Tell the story again using exhibits
Diagram of scene
Weapon
Photograph
Clothing
Stalking and Strangulation

41. TRIPLE DIRECT, CONT’D
Have victim tell story for the third time through her sensory perception
OBJECTION!!!! Asked and answered???
Stalking and Strangulation

42. ORDER OF WITNESSES Think outside the box Start strong
Bury the weaker witnesses
End strong
Stalking and Strangulation

43. DON’T DO THE DON’TS DON’T use weak words
DON’T redirect (unless you absolutely, positively have to)
DON’T end on a sustained objection
NEVER ask a question that you don‘t intend to argue
Stalking and Strangulation

44. DIRECT OF VICTIM Remember these cases are usually he said, she said
Take direct slowly – corroboration is in the details
Deal with “challenging” facts up front
Should ask many of the same questions that responding or follow up officers asked
Stalking and Strangulation

45. Developing your Local Expert
Emergency room physician - Specialist
Medical Examiner
Certified Forensic Pathologist
Forensic/SANE nurse
Paramedic
DV Detectives
Anyone else?
Stalking and Strangulation

46. Direct Examination of Expert
Stalking and Strangulation

47. Foundation of Expert Current position and duties Prior work experience
Education
Training
Licenses & certificates
Teaching experience
Published writings
Affiliation to professional Organizations
Stalking and Strangulation

48. Attempted Strangulation Questions
Received training specific to strangulation?
Examined patients who have reported being strangled?
Applied your training to the examination of those patients?
How many patients have you examined who reported being strangled?
Previously testified as an expert?
How many times?
Stalking and Strangulation

49. Use suggested questions & customize to your case
Stalking and Strangulation

50. Use Charts
Stalking and Strangulation

51. Vessels: arteries & veins
HYOID BONE
CAROTID ARTERY
THYROID CARTILAGE (with fracture shown)
JUGULAR VEIN
TRACHEAL RINGS
Stalking and Strangulation

52. Exact Anatomic Location of Quantity of Applied Force Applied Force
Surface Area Of
Applied Force
Duration of
Applied Force
Stalking and Strangulation

53. Stalking and Strangulation

54. Make a long list of potential defense questions
Stalking and Strangulation

55. Friendly Fire Questions – Preemptive Strike & Set up for the Spike?
Come on doc, aren’t we just talking about pink eye?
Isn’t that bruise to her neck, just a hickey?
Isn’t true, she could have a sore voice from yelling at the defendant?
Isn’t it true a person can hold their breath for several minutes and die?
Do you know if the victim was intubated?
But if she were intubated, could the treatment obliterate your findings?
Stalking and Strangulation

56. Ask defense questions first:
How much are you getting paid?
Do you consider yourself a professional witness?
Testified only for the prosecution?
You haven’t qualified in a felony case, have you?
You haven’t qualified in a death penalty case, have you?
Stalking and Strangulation

57. CROSS OF DEFENDANT
Concessions first (def will usually tell the truth all the way up to the point where he gets in trouble)
Pose questions in terms of HIS behavior not HERS!
Work your theme in – he’ll give you something!
You didn’t stop when she lost consciousness…
Stalking and Strangulation

58. OPENING AND CLOSING
Opening: Tell a story – your first chance to begin to recreate the victims reality of that day
Closing: Homerun time. Take your whole offender focused prosecution and leave the jury no choice but to despise him!
Stalking and Strangulation

59. Life after Crawford v. Washington 124 S. Ct. 1354 (March 8, 2004
Stalking and Strangulation

60. Forfeiture by wrongdoing
Defendant forfeits the right to object that the victim is unavailable and he did not have the opportunity to cross examine her if:
Victim is unavailable because of his actions, threats, intimidation, harassment.
Happens in every case but how to prove it?
Stalking and Strangulation

61. Stalking and Strangulation