January 13, 2025
From: Karen Koehler
To: The Seattle City Council
Re: Opposition to the SPD’s use of blast balls in crowd control management.
Warning: graphic content
Dear Members of the Seattle City Council.
In 2024, following four years of litigation, the City paid $10 Million to settle the claims of 51 peaceful BLM protesters for unconstitutional physical assaults perpetuated upon them by the SPD during the George Floyd/BLM protests of 2020.
As the lead plaintiff attorney in that lawsuit, I ask that you honor the City’s pledge to our citizenry to do much better in the future, by permanently prohibiting the use of blast balls during crowd control.
A defining moment in that lawsuit occurred during the deposition of Professor Clifford Stott PhD, the world’s foremost expert in crowd control. Dr. Stott was hired and paid by the City to evaluate crowd control following the protests. And later was hired to train high level members of SPD in better techniques.
Dr. Stott’s opinions included the SPD’s overly speedy use of force and indiscriminate use of force which impacted peaceful protesters and this statement:
“ I’ve never seen that level of intensity of use of munitions in as confined a geographical location in any other democratic state.”
Dr. Stott’s deposition transcript and video is here. 1
As part of the BLM peaceful protesters settlement, the City was required to provide an explanation of 1 Black Lives Matter Injured Protesters Lawsuit - Stritmatter Kessler Koehler Moore
all of the changes and improvements it had made to crowd management since the 2020 BLM protests. In that attached letter 2 , the City laid out changes that if implemented would not include the SPD to firing munitions at people during protests or other public gatherings.
Our clients included protesters, legal observers, journalists, and medical personnel attempting to render aid to the injured. Some were of advanced age, disabled, or young children.
A. “NON LETHALS”
A non-lethal weapon is still one capable of producing severe bodily injury or death.
Last month, physicians from the University of Washington and Seattle Children’s Hospital published an article on protest related injuries related to CHOP. 3 At the outset they noted it was well known that “less lethal weapons are sometimes large causes of burden and disability at protests.”
2 Exhibit 1: Feb. 26, 2024 post-mediation letter from City explaining all of the changes to crowd management.
3 Exhibit 2: Medical article by University of Washington and Seattle Children’s Hospital on injuries during CHOP published Dec. 2024.
The purpose of the weapons and their dangers are best described by the SPD’s own PowerPoint slides used in blast ball training of its officers.
The problem with using blast balls during crowd control is that it is usually not possible to avoid hitting someone even if the officer doesn’t have specific intent to cause bodily harm. The known dangers of projectiles are that they can inflict severe bodily harm. Again, see the SPD’s PowerPoint slide.
Blast ball photos from the East Precinct taken during the lawsuit’’
During the BLM protests, SPD suspended accountability for tracking and using less lethals. The munitions were pulled by the bag full out of the storage room, loaded into police trunks and truck beds and completely used up against the protesters. As noted in deposition of the City:
Q: Was SPD able to account for the use of every blast ball in its supply during the 2020 protests?
A: I don’t know that.
Here is a more detailed account by one of the officers:
We viewed the actual blast ball check out notebooks at East Precinct and the records were either not kept or grossly incomplete.
B. INJURIES FROM “NON LETHALS”
The 51 peaceful protest Plaintiffs did not engage in criminal behavior. They did not strike nor attempt to strike any person including law enforcement either with their person or any sort of item or weapon. They did not commit any looting. They did not threaten any person or law enforcement officer with bodily harm.
Many of them were struck by shrapnel, others were directly hit. Here are 23 short, illustrated stories. Please note it was often difficult to discern the precise weapon being used since they were all projectiles that exploded.
1. Blast ball injury to Ms. C.
On July 25, 2020, Ms. C was with two other friends. Officers had begun to advance. She had turned to flee. But felt something brush her leg. She looked down and saw a bright flash of an explosion.
Her ears were ringing from the explosion. The impact stunned her, rendering her unable to move or speak. The explosion ripped a piece of flesh from her leg.
Ms. C went to an emergency room where doctors expressed concern about the depth of her wound and the amount of swelling in her leg. Stitches were not an option because the gash was too deep, so medical staff irrigated her wound, stuffed it with gauze until it soaked through, and replaced the gauze. She had limited range of motion in her knee and was on crutches for roughly two and a half weeks. Her wound took a month to heal, and visible scarring remains. She missed five weeks of work and was forced to take an Incomplete for one of her last classes in her PhD coursework. She was diagnosed with PTSD To this date, loud noises such as fireworks or gunshots will re-trigger her anxiety.
1. Blast ball injury to Mr. Fa.
Mr. Fa was a practicing psychologist and amateur photographer covering the protests in his neighborhood. He was taking photos, about 50 feet from the nearest policeman, when an officer launched a blast ball at him. The device exploded at Mr. Fa’s feet, knocking him to the ground where he lost consciousness.
At Harborview, Mr. Fa was diagnosed with a concussion, cardiac issues, and temporary loss of hearing After five days, his hearing returned. As a result of his injuries, Mr. Fa missed several days of work. He suffered chronic headaches, had difficulty sleeping, and was physically and emotionally exhausted. He suffered from anxiety, depression, fear, and irritability. Fireworks and helicopters are triggering. He’s had to soundproof his home so that he does not hear helicopters fly above him. He has panic attacks when he sees groups of police.
2. Blast ball injury to Mr. Fo.
On June 7th, Mr. Fo was twenty yards away from the western barricade near 12th Avenue and Olive Way when he saw an arc of OC spray originating from an area near the generators powering the police light poles. Mr. Fo began to back away from the barricade near the corner of 11th Avenue and Pine Street when a blast ball struck him in his left shoulder. It bounced upward and exploded near his neck and face. Shrapnel struck him directly in the neck.
Photo of protesters dragging Mr. Fa away after he was knocked unconscious by a blast ball
After being struck, Mr. Forghani fell to the ground. His ears were ringing, and he could not hear. He felt pain in his neck. He felt dizzy and lightheaded. When Mr. Fo arrived home, he realized his neck was bleeding and there was a golf ball-size lump on his neck underneath is left ear. He called in sick from work the next day and was instructed by his doctor’s office to go to an emergency room.
Mr. Fo was evaluated by an audiologist who confirmed that his hearing was damaged in the 3k Hz frequency band – a noticeable deficit. He was also suffering from tinnitus.
3. Projectiles to Mr. G.
Mr. G, a schoolteacher, was wearing a sandwich board to protect other protesters. He was walking away when an officer fired rubber bullets at him. He was struck in the hip, in the right leg breaking the skin, and in the right forearm.
.
Mr. G was treated at Swedish. He was diagnosed with an open ulnar fracture and underwent surgery to put three pieces of bone back into place.
He has permanent scarring.
4. Projectiles to Ms. H.
On July 25, 2020, in the early afternoon Ms. H and her housemate went to Capitol Hill to protest near the East Precinct at 12th Ave and East Pine Street. As the group of protesters approached the precinct, the police broke the march into two smaller groups separating them with tear gas and flash bangs.
An officer shot Ms. H from approximately ten feet away with rubber bullets that tore through her pants, injuring her knee. Moments later a flashbang/blast ball detonated near her right foot and shrapnel hit her right toe. Ms. H could not walk on her injured foot so her friends had to carry her to a car so she could leave.
On June 7, 2020, Ms. H, a healthcare worker, was at 11th Avenue and East Pine Street. She was about 100 feet from the police line when officers began launching explosives including tear gas and blast balls into the crowds. Ms. H attempted to back away, when one of the blast balls struck her on the pelvic region and exploded – melting the jeans she was wearing and causing flesh wounds and heavy bruising.
On May 30, 2020, 17-year-old MH went to downtown Seattle with two family members. They arrived at Westlake Center around 1pm, where they listened to speakers and marched around downtown. Later that afternoon, they were stopped by a police blockade. Mx. MH and the group knelt, with their hands up, chanting “hands up, don’t shoot.” Tear gas was deployed and as Mx. Howe, attempted to flee the area, they became separated from their family members. They were anxious, fearful, and began to panic.
An officer threw an explosive device (either a blast ball or flashbang), striking Mx. MH in the hand. Mx. Howe felt immediate pain but could not stop to see what happened until later.
5. Blast ball to Ms. Ha
6. Projectile to Mx. MH.
Doctors at Swedish determined that the explosion partially amputated Mx. MH’s thumb and damaged their forefinger, shattering bones.
7. Publicly reported blast ball case of Aubreanna Inda
On June 7, 2020, Ms. Inda and a few other protesters stood in the intersection of 11th Avenue and Pine street a fair distance from the SPD officers. One of those protesters held flowers, while another knelt on the ground. As Ms. Inda began to kneel and put her arms in the air, an SPD officer launched a blast ball that exploded on her chest with a burst of flames, while another exploded at her feet.
Ms. Inda was instantly immobilized and fell to the ground. She hyperventilated and lost consciousness. Not a single SPD officer rendered aid. Protesters and volunteer medics rushed Ms. Inda to the hospital, where she went into cardiac arrest three times over the course of the night.
OPA determined that the deployment of the blast ball violated SPD policy and training.
8. Projectile to Mr. BK
On July 25, 2020, Mr. BK was walking over to attend a protest on Pine Street with his fiancée and brother They had just arrived and joined a group of protesters when SPD officers began advancing on the group and ordering everyone to move back. The three complied with SPD’s orders and moved back. As they were doing so, the officers deployed pepper spray and explosive devices. One of the devices exploded near Ben, hitting him with shrapnel in the back of the leg.
Blast ball thrown and striking Ms. India in the torso
9. Blast ball and other projectiles to Mr. SK
On July 25, 2020, Mr. SK, a UW grad student, was participating in a protest on Capital when SPD began deploying projectiles. Several exploded near his head, causing him first-degree burns, hearing damage, and a concussion. Shrapnel from one device penetrated his left leg.
Another projectile struck him on the thigh.
A third projectile hit the back of his left hand, causing burns even through a glove.
On June 1, 2020, DL, a legislative assistant was at 11th Avenue and East Pine Street. He was in the process of moving back from the advancing line of police, when a blast ball struck his left hip and exploded, leaving an 8-inch bruise on his hip.
10. Blast ball to Mr. DL
On September 25, 2020, during a Breonna Taylor protest on Capitol Hill, he was hit with a flashbang explosion that caused lacerations and bruising to his knee.
On July 25, 2020, Mr. JM, a practicing Buddhist and group leader of Soka Gakkai International, arrived in the Capitol Hill area in the early afternoon. In his backpack he carried among other things a copy of the Constitution – “To show what you’re out there defending!”
Mr. JM was struck by a blast ball to his left ankle. This caused an abrasion and some bruising, despite the protection of his sturdy steel-toe work boots.
11. Blast ball to Mr. JM.
ER doctors cleaned his wounds, took x-rays, and identified another shrapnel injury on his shin that he had not previously noticed. He also suffered from hearing loss and tinnitus of the left ear.
On July 25, 2020, at 4:30 pm Ms. CM, a law student, was at a protest that ended at the East Precinct. Ms. CM was pepper sprayed in the face. She could not see anything. Her brother and another protester grabbed her arms and led her out of the crowd. At the same time, a blast ball was thrown at her feet and exploded on her ankle.
She was diagnosed with a bone bruise and chemical burn under her skin from the chemical released by the blast ball. She wore a walking boot for over a month
12. Blast ball to Ms. CM
On July 25, 2020, Mr. ML went with his partner to protest in a march that ended at the East Precinct. He was in the process of trying to retreat when a blast ball hit his right shoe, bounced up and exploded on the back of his left calf. Logan was knocked back a little by the impact of the explosion.
His leg was so swollen, and the swelling went down to his ankle, making it hard to walk. He was diagnosed with a traumatic hematoma.
13. Blast ball to Mr. LM
14. Blast balls and other projectiles to Ms. AM
On July 25, 2020, Ms. AM was protesting near the East Precinct. She had already retreated and was at a bus shelter on Pine Street and Broadway, when she was hit by numerous explosive devices including blast balls and flash bangs
On July 25, 2020, Mr. MD was at the East Precinct. He was hit five times in the legs by blast balls.
15. Blast balls to Mr. MD
On June 7, 2020, Mr. JP, a journalist for The Daily, went to the protests wearing identifying clothing.
About 10 minutes after he arrived the police deployed weapons, and a blast ball exploded next to his foot with shrapnel striking his leg
16. Blast Balls to Mr. JP
17. Blast ball and other devices to Mx. JR
On September 7, 2020, Mx. JR had just arrived at the East Precinct, when police came out from behind the building and began discharging flashbangs, blast balls, and tear gas. They were walking backwards when they felt the shockwave of a blast ball or flash band grenade explode near their head. It hit their right hand and exploded.
A fellow protester saw Mx. JR’s hand and called for a medic. Police would not allow them to stop to bandage the injury, so Mx. JR had to keep moving while medics assisted them. Upon arrival at Harborview, they were so weak from blood loss they could barely get out of the truck. The blast ball had nicked an artery and Mx. JR was hospitalized for several days because the doctors could not stop the bleeding. Mx. JR lost half an inch of nerve in their right hand. On September 18, 2020, they had nerve graft surgery. They still cannot feel parts of their hand.
18. Projectile to Mx. RR
On July 25, 2020, Mx. RR, a professional cook, had marched to 11th and Pine in Capitol Hill around 3:00 p.m. at the same time SPD officers were coming out with gas masks, shields, and padding.
A projectile hit their knee. Mx. RR described the impact as “a very intense and acute pressure at the site of impact … and a second or two later like the actual pain set it.” This forced them to the ground and blood began to seep down their leg. Mx. RR could not stand up on their own. Protesters nearby pulled them from the scene toward volunteer medics and drove them to the emergency room at Harborview Medical Center, where doctors determined they needed arthroscopic surgery on their knee and treatment
for a deep laceration on their leg.
They were in the hospital for two days for their injury, and prescribed oxycodone for pain. They required physical therapy and used a cane to walk for several weeks post-surgery. They had to inject themselves with blood thinners multiple times per day to prevent surgical complications.
19. Flashbang or blast ball to Mr. MS
On July 25, 2020, Mr. MS, a professional musician and teacher, was on the corner of Broadway and Pine with members of the media. Police began to shout, “Move back!” He complied with the order and moved back into the roadway with the media to get a better view of the events but was hit in his right arm and foot by shrapnel from a flashbang or blast ball
20. Projectiles to Mr. BT
Mr. BT is an independent photographer specializing in documentary photography of arts, culture, music, theater, and travel.
On June 7, 2020, Mr. BT was in Capitol Hill at the intersection of 11th Avenue and Pine Street, taking photographs as he moved back and forth along the space between the protesters and the line of SPD officers.
As SPD officers began to fire explosive projectiles at the protesters, Mr. BT repeatedly identified himself as “press,” but SPD officers ignored him. One SPD officer replied, “I don’t care who you are.” Mr. BT was struck by multiple projectiles fired by the police in short succession. A projectile hit Mr. BT’s camera bag. A second exploded at his feet. And a third struck his buttock.
On June 6, 2020 at 7:30 pm, Ms. AV, a UW student, was in a crowd of protesters on Capitol Hill when SPD officers directed them to move back. Ms. AV ran away from the police lines and hid behind a utility box. But an SPD officer launched a projectile that exploded in on the right side of Ms. V’s torso. The force of the explosion ripped holes in Ms. V’s jacket, blasted off and abraded her skin, and inflicted a
21. Projectile to Ms. AV
large wound on her upper torso.
22. Blast balls and projectiles to Mr. JW
Mr. JW live streamed the protests as a documentarian and attended most events on Capitol Hill.
On June 7, 2020, police began firing numerous projectiles including tear gas and blast balls into the crowd, some of which exploded near his arms, head, and feet. He suffered temporary hearing loss and later woke up with blood in his ear canal.
He suffered many other injuries from projectiles.
23. Projectile to Ms. GW
On June 7, 2020, Ms. GW, a carpenter who also teaches trade school students, was at 11th and Pine near the police line. Ms. GW was standing on the sidewalk, trying to get her bearing, looking for the best way to leave the area. Before she could find a path out, multiple munitions exploded near her feet. Most severely, Ms. Williams was hit directly on her forearm with a projectile roughly two inches wide.
The next day, she went to the hospital where she was diagnosed with a bone contusion, nerve and muscle damage.
“Less Lethal” Munitions
Rubber bullets, plastic bullets, baton rounds, bean bag rounds, and shot pellets, are kinetic impact projectiles used as an alternative to normal ammunition. While they are less lethal than normal bullets, they are hardly safe.
The City failed to follow its own manual provisions (SPD Manual Section 8.300) on the use of these weapons and munitions during the BLM protests. There is no reason to think the City will do any better the next time.
The SPD is fully aware of the risks of less lethal weapons, having used them in the past, and having been warned of their risks and potential lethality by multiple sources, including the CPC, the OPA, their own expert Mr. Ijames, and their training videos from at least as far back as 2015.
The main difference between a blast ball and a flash bang is shape. A blast ball is round and made of rubber, while a flash bang is metal and cylindrical. 4
SPD Manual, Section 8.300 regarding blast balls, states:
• Officers may use blast balls only when such forces is objectively reasonable, necessary, and proportional to the threat or resistance of a subject.
• When feasible, officers shall avoid deploying blast balls in the proximity of people who are not posing a risk to public safety or property.
• When feasible, officers will not deploy blast balls until a dispersal order has been issued to the crowd, the crowd has been given a reasonable amount of time to comply, and a supervisor
4 United States v. City of Seattle, 2:12-cv-01282-JLR, Doc. 637-1, Review of the SPD Crowd Dispersal Policy and Less Lethal Weapons (August 14, 2020).
has authorized the deployment. The only exception to this is that officers may reasonably deploy blast balls to address an imminent risk of harm to a person or significant property damage.
• Officers must justify each separate blast ball deployment. After the initial blast ball deployment, each subsequent deployment must be reasonable and the officer should reevaluate the situation accordingly.
SPD Manual, Section 14.090 regarding crowd management states:
• Officers may only make individual decisions to deploy blast balls when its use is consistent with Title 8 – Use-of-Force.
• Only the Incident Commander has the authority to direct the use of blast balls to disperse a crowd, after a determination that there are acts or conduct within a group of four or more persons that create a substantial risk of causing injury to any person or substantial harm to property.
o Before ordering that the crowd be dispersed, the Incident Commander must consider whether less restrictive means of crowd management are available.
o Upon determining that dispersal is appropriate, the Incident Commander shall ensure that there is an avenue of egress sufficient to allow the crowd to depart.
o The Incident Commander or designee must issue the order to disperse prior to instructing officers to disperse the crowd, if feasible.
• A lieutenant may authorize the use of blast balls to disperse a crowd, but only if an immediate life safety emergency exists that requires this action be taken and there is insufficient time to obtain incident command approval.
In response to the BLM/George Floyd Protests, the SPD discarded its lessons from the previous twenty years, its own policies and practices, the mandates of the federal Consent Decree, and the federal and State constitutions.
Observations by the Seattle Office of Police Accountability (OPA):
On August 15, 2020, OPA issued a response to the City Council’s Crowd Control Weapons Ordinance Ban: 5
• The OPA expressed concern regarding “the sheer amount of force used by SPD over the last two months, which appears to represent a significant departure from previous demonstrations.”
• “…officers were sent to confront crowds with no clear strategy or plan behind the deployment,” which led to a pattern of using force to temporarily remove crowds from certain areas, only for demonstrators to return and for the pattern to repeat itself. “Front-line officers and supervisors sometimes appeared to be improvising their responses to the crowd in the apparent absence of clear directions from an incident commander...”
• “…at times, SPD deployed large groups of officers for reasons that are unclear. Not only does this create the risk of unnecessary escalation, it also forces officers into a situation where they become targets for anyone in the crowd who seeks to engage or harm them.”
• “OPA has received numerous complaints from community members who contend that they or others were subjected to the use of less-lethal weapons despite having done nothing wrong. Although these incidents are still under investigation, they highlight the secondary effects that the use of less-lethal tools can have on peaceful demonstrators and on public trust in SPD.”
5 United States v. City of Seattle, 2:12-cv-01282-JLR, Doc. 636-1, Response to City Council Crowd Control Weapons Ordinance Ban (August 14, 2020).
On January 15, 2020, OPA publicly released multiple reports on completed investigations, which included sustained findings of improper, out-of-policy use, as well as recommendations for systemic changes.
In three cases, SPD officers deployed tear gas canisters or blast balls overhand without being fully aware of their surroundings and hitting people who were not posing a risk to public safety or property. The OPA found that the methods used to deploy these munitions were inconsistent with policy and training. It recommended not only sustained allegations of improper use, but also systemic policy changes to prohibit officers from deploying blast balls overhand and/or directing blast balls at a person unless purposed to prevent imminent serious bodily harm. 6
In the first case, non-SWAT SPD officers, who were largely assigned to patrol, received an “abbreviated,” “impromptu” training on the deployment of CS gas canisters by hand. The training lasted for approximately 30 minutes. One of the officers who received this “impromptu” training threw a CS gas canister that struck a reporter standing in Cal Anderson Park. At the time, while the adjacent street was crowded with people, the park was relatively empty. Most of the people in the park were recording what was happening on their phones. There was no evidence of any individuals in that vicinity of the park throwing projectiles at officers. The officer threw the CS gas canister over the park fence. The OPA found this deployment “simply inconsistent with the expectations and training surround the use of such less-lethal tools.” 7
In the second case, an SPD officer threw a blast ball overhand, striking a person lying on the ground with his face covered in Cal Anderson Park. The blast ball appeared to strike him directly in the vicinity of his face and chest. The officer claimed he deployed the blast ball to “disperse an assaultive crowd,” that striking the man lying on the ground was “unintentional,” and asserted that “his throw was inaccurate and was due to fatigue, the chaotic situation, the amount of gear he was wearing at the time, and his lack of athleticism.” The OPA found that this incident occurred because the officer “engaged in a risky overhand deployment without complete knowledge of where he threw the blast ball,” and that the officer acted “contrary to policy.” 8
In the third case (which reviews the incident involving Plaintiff Aubreanna Inda, see infra, an SPD officer deployed a blast ball overhand towards a person – Ms. Inda. At the time, Ms. Inda was unarmed and was not throwing projectiles at officers, and neither were the other individuals in her immediate vicinity. The officer threw a blast ball, striking Ms. Inda in the chest. The officer claimed he did not intend to hit Ms. Inda and did not even know he had done so until he became aware of the FIT and OPA investigations. The OPA found this a problem in and of itself, as it was the officer’s “responsibility to be aware of where he was throwing a blast ball, particularly when deployed overhand and in the vicinity of a person. Indeed, [the officer] was trained to do exactly this by the SPD. His failure to comply with his training, as well as his engaging in actions that resulted in injury to [Ms. Inda], constituted a violation of policy.” 9
6 https://www.seattle.gov/Documents/Departments/OPA/PressReleases/01-15-21_OPA-Press-Release-DashboardUpdate.pdf (January 15, 2021).
7 http://www.seattle.gov/Documents/Departments/OPA/ClosedCaseSummaries/2020OPA-0333ccs122820.pdf (issued December 10, 2020, released January 15, 2021).
8 http://www.seattle.gov/Documents/Departments/OPA/ClosedCaseSummaries/2020OPA-0335ccs121020.pdf (issued December 10, 2020, released January 15, 2021).
9 http://www.seattle.gov/Documents/Departments/OPA/ClosedCaseSummaries/2020OPA-0344ccs122820_pt1.pdf (issued December 28, 2020, released January 15, 2021).
The OPA further found that, regarding the use of blast balls, CS gas, and OC spray on June 1 – a widely publicized incident where the SPD used chemical weapons to disperse a crowd after an officer ripped a pink umbrella from the hands of a protester 10 – the reasons to disperse the crowd were not proportional to the risk of injury/damage that dispersal would cause. “As a result, the decision to disperse the crowd violated [SPD] policy.” 11 Specifically, the OPA found that “while evidence suggested that individuals within the crowd did seek out conflict with officers, the weight of the evidence shows that the large majority of the crowd was not acting violently at the time the officers deployed OC and, shortly after, blast balls and CS gas.” Moreover, as to SPD’s claim that umbrella use by protesters was “evidence of ‘coordinated conduct,’” and a “‘go-to tactic’ of individuals seeking confrontation,” the OPA found that “the presence of umbrellas on the front line [is not] conclusive evidence that this segment of the crowd had a settled plan to confront officers or attempt to breach the line. Rather, OPA finds it equally plausible that demonstrators – some of whom had been exposed to OC on prior days – used umbrellas as an improvised protection tool ” And as to the SPD’s claimed “intelligence” that individuals or groups wanted to burn the East Precinct down, “OPA has not located, and the Department has not produced any tangible documentation of such a threat or of the intelligence relied upon that would have warranted the force used.” 12
Observations by the Seattle Office of Inspector General (OIG): 13
• “Although the SPD crowd dispersal policy is clear as to the conditions under which crowds can be dispersed and less lethal force can be used, the general nature of the policy reduces crowd status to two conditions: lawful, and unlawful. In a very general sense, protestors are allowed to assemble, until they are not. The transition from managing a lawful demonstration to dispersing an unlawful assembly has the potential to be abrupt and confusing to non-violent participants in the crowd who are unaware of violence elsewhere in the crowd, and who then may become understandably angry when subjected to unexpected force.”
• “OIG identified that there are limited opportunities for officers to gain proficiency and experience with practice in using [blast balls and the 40mm occurring launcher]. Practice munitions are not available to officers for the 40mm launcher outside of annual qualification requirements, and officers may not have an opportunity to deploy live blast balls during annual re-training, depending on supply.”
• The events at the East Precinct demonstrated the particular ineffectiveness of the SPD’s deescalation approaches. “Time did not appear to work, perhaps as SPD itself was the focus of the crowd’s agitation.”
• “…briefings did not always occur,” and “some briefings were not detailed enough to properly
10 https://www.thestranger.com/slog/2020/06/02/43818002/slog-am-police-pepper-spray-protesters-over-pink-umbrellaescalating-fourth-day-of-police-brutality-protests (June 2, 2020).
11 https://www.seattle.gov/Documents/Departments/OPA/PressReleases/01-15-21_OPA-Press-Release-DashboardUpdate.pdf (January 15, 2021).
12 https://www.seattle.gov/Documents/Departments/OPA/ClosedCaseSummaries/2020OPA-0334ccs010821.pdf (issued December 28, 2020, released January 15, 2021).
13 United States v. City of Seattle, 2:12-cv-01282-JLR, Doc. 637-1, Review of the SPD Crowd Dispersal Policy and Less Lethal Weapons (August 14, 2020).
inform officers as to new objectives and situational changes.”
• “Personnel stated it could be very difficult to hear instructions over the radio using existing equipment, particularly when wearing gas masks. If personnel cannot hear instructions clearly, they may misunderstand instructions and take action which unnecessarily or improperly escalates the situation.”
• “…the public does not understand why SPD undertook many of its actions during the recent demonstrations and are horrified by the scenes of violence and perceived indiscriminate use of force. These actions have eroded public trust in the department.”
Systemic bias among law enforcement is not limited to SPD. A WSP Trooper was videotaped “motivating” his team by saying “Don’t kill them but hit them hard.” 14
The disparate treatment of the BLM/George Floyd protests by the SPD has been specifically recognized by multiple oversight organizations:
• CPC:
“During discussions with SPD, the Department stated that Seattle boasts an average of 300+ demonstrations each year, with approximately 80 of those mentioned being monitored by police. Presuming purported numbers are correct, 26% of demonstrations are monitored by SPD annually. However, in recent months, the Department has attended a majority of demonstrations that are specifically rallying against police violence and brutality. Moreover, SPD’s presence during protests was perceived by community as an intimidation tactic with a looming sense of threatening force, which was actualized.
The unsettling nature of SPD’s presence during recent demonstrations is underlined by the way in which officers attended and presented – in riot gear, by the hundreds. It is unclear what intelligence was gathered by the Department to warrant such a response to planned peaceful protests, largely led by young people.” 15
• OPA:
“The recent protests in Seattle have been about police misconduct not, for example, women’s rights or the environment which has posed a unique challenge for SPD. During protests, the police are generally responsible for protecting the public, preserving property, and mitigating traffic impacts. But when the protests are police-focused, they must also avoid escalating existing tensions with demonstrators unnecessarily.
It appears to OPA that, at times, SPD deployed large groups of officers for reasons that are unclear. Not only does this create the risk of unnecessary escalation, it also forces officers into a situation where they become targets for anyone in the crowd who seeks to engage or harm them. If police presence at a demonstration would not serve any apparent purpose, it
14 https://www.seattletimes.com/seattle-news/washington-state-patrol-apologizes-after-officer-tells-his-team-dont-killthem-but-hit-them-hard-in-reference-to-seattle-protesters/ (June3, 2020).
15 United States v. City of Seattle, 2:12-cv-01282-JLR, Doc. 639-1, CPC Recommendations on Seattle’s Crowd Control Weapons Ban Ordinance 126102 (August 19, 2020).
may be more appropriate for officers to monitor it from a distance.” 16
After August 2020, Merrick Bobb resigned after seven years as the court-appointed monitor of the Justice Department-mandated reforms of the Consent Decree. In a letter authored on the eve of this resignation, Mr. Bobb expressed disappointment in the direction the SPD has taken:
“Let me then first speak soberly about the recent demonstrations and protests. SPD’s performance left many observers disappointed and crestfallen, if not disturbed profoundly by what looked like multiple instances of excessive force, as if lessons learned and techniques trained under the consent decree were lost, or, at least, set aside.” 17
Mr. Bobb described the SPD as currently being “at its nadir”:
“Its performance during the recent demonstrations and protests betrayed a lack of adequate preparation and training, an apparent absence of an overall strategic plan or foreknowledge how to deal with violent interlopers without cutting off legitimate First Amendment activity by peaceful protesters, even if loud and challenging; inadequate subtlety and sophistication about the use of powerful and injurious nonlethal weaponry; a seeming lack at times of sensitivity to the First Amendment role of journalists and the moral and ethical role of medics; a willingness to call something a riot when it might have met some technical definition but was a far cry from a rebellion or stampede or even a melee merely so the SPD could use tear gas, a chemical agent banned for use in warfare after World War I.” 18
On September 21, 2020, Mr. Bobb issued a formal report to Mayor Durkan and others about the SPD’s use of crowd-control weapons. 19 The report concluded that “SPD’s crowd management tactics during the recent demonstrations and protests were deficient” for a number of reasons, including:
• “There was an apparent absence of an overall strategic plan to deal with violent individuals without significant prejudice to legitimate First Amendment activity by peaceful protesters. The SPD, like police departments across America, lacked seasoned and well-trained commanders to respond to the novel circumstances of the George Floyd and BLM protests. There also was a seeming lack at times of sensitivity to the First Amendment rights of journalists and the moral and ethical role of medics.”
• “In the absence of the strategic plan and well-trained commanders, there was a lack of adequate preparation and training of rank-and-file police officers and their supervisors.
16 United States v. City of Seattle, 2:12-cv-01282-JLR, Doc. 636-1, Response to City Council Crowd Control Weapons Ordinance Ban (August 14, 2020).
17 https://www.seattletimes.com/seattle-news/federal-judge-appoints-new-monitor-for-seattle-police-harvard-professorreplaces-merrick-bobb-who-resigned/ (September 9, 2020); https://www.documentcloud.org/documents/7204069-CleanFinal-Version-Bobb.html
18 Id.
19 https://www.documentcloud.org/documents/7215952-The-Facts-of-the-Protests-002.html (September 21, 2020); https://www.seattletimes.com/seattle-news/report-seattle-police-department-should-ban-tear-gas-remind-officers-to-protectprotesters-rights/ (September 23, 2020).
Seasoned and well-trained commanders should have been taking the actions of the crowd into consideration and making judgment calls based on the crowd size, actions, environment, and the law enforcement resources available to the commanders to manage the crowd. This is with the understanding that utmost care should be given to supporting constitutional rights.”
• “There was a tendency to call something a riot when it might have met some technical definition but was not a rebellion or melee and did not constitute an overall imminent threat of death or serious physical injury. As a result of using the label of “riot,” there followed indiscriminate and poorly controlled use of less- lethal tools, particularly tear gas and blast balls as described later in this memorandum.”
C. Conclusion
History teaches lessons. The lessons from the BLM 2020 protests have not even been fully taught and absorbed by the SPD To pay $10 Million for constitutionally abusing our citizenry one minute. Then turning around and applauding the use of blast balls and other incendiary and chemical-based projectiles for crowd control the next; would be to ignore what happened just four short years ago.
These weapons don’t differentiate between peaceful protesters and others whom the police say they want to specifically target. They create mass chaos and injury.
Blast balls and flashbangs have no place in crowd control.
Very truly yours,
STRITMATTER KESSLER KOEHLER MOORE
Karen Koehler
KK/km
Enclosures:
Exhibit 1: Letter from City of Seattle to protester plaintiffs as part of the $10 M settlement. Exhibit 2: Medical article by University of Washington and Seattle Children’s Hospital on injuries during CHOP published Dec. 2024.
EXHIBIT 1
February 26, 2024
Mark Filipini
By E-mail Only
Karen K. Koehler
Shannon Kilpatrick
Debora Silberman
Melanie Nguyen
Furhad Sultani
Stritmatter Kessler Koehler Moore 3600 15th Ave W. #300 Seattle, WA 98119
Re: Zoe Adberg, et al. v. City of Seattle and King Co., No. 20-2-14351-1 SEA
Dear Counsel:
Pursuant to your request at mediation, attached is a list of changes made by the Seattle Police Department with respect to Crowd Management following the protests in Seattle in 2020.
Sincerely, /s/ Mark S. Filipini
Mark S. Filipini
Enclosure
Changes Made by the Seattle Police Department with respect to Crowd Management following the Protests in Seattle in 2020:
• In 2020 and 2021, SPD made fundamental changes to its crowd management policies and practices. As part of the Consent Decree process, these changes were presented to Judge Robart and approved.
o SPD’s current Crowd Management Policy (Interim Manual Section 14.090, building off previously approved revisions in 2021) and its 2023 Crowd Management training are rooted in the following principles:
More robust emphasis on crowd intervention tactics that focus on isolating and arresting law violators within an otherwise peaceable assembly;
Reducing the SPD visible footprint around these events in order to avoid escalation that may result from an SPD presence;
Emphasizing de-escalation and force modulation responsive to changes in crowd behavior following an order to disperse;
A more robust statement of purpose that embraces Seattle’s approach to facilitating public assembly, over and beyond what would be required under a strict First Amendment analysis;
Emphasis on de-escalation and acknowledging the potential for escalating tension through officer appearance;
Emphasis on crowd intervention strategies where safe and feasible;
Use social media to communicate expectations and dispersal orders;
Revising the dispersal order/requirements for announcement to better inform of conditions and reflect expectations;
Providing consistency in required warnings around the use of less-lethal tools; and
Additional documentation around pre-event planning and tactical considerations (incorporated in revisions to 14.100, incorporated by reference in 14.090).
• In 2021, SPD conducted a major effort to update crowd management training and implemented a mandatory, full-day Crowd Management, Intervention, and Control training for sworn personnel. Half of the day is in the classroom; it covers lessons learned from the 2020 protests and revisions to SPD’s Crowd Management policies and practices. The rest of the day is practical training during which officers are given the opportunity to perform crowd management drills and scenarios utilizing the new tactics and policies.
o The new training places a heightened emphasis on de-escalation principles in the crowd management context. Similar to individualized de-escalation tactics, crowd management can support positive outcomes by emphasizing time, distance, and communication.
o The updated training also includes the following topics:
Meeting with event organizers ahead of a protest;
Maintaining a low-profile (less visible police presence) when feasible;
Using social media to communicate information to protestors in real time;
Tactics to address individuals who are taking unlawful actions in otherwise lawful crowds; and
Dispersal orders, including giving detailed and clear instructions about why SPD is issuing a dispersal order and how and what direction people should go to leave the area.
• In 2022, SPD launched a training course for new officers called “Before the Badge.” Before SPD’s new recruits receive state-mandated training at the Basic Law Enforcement Academy, they report to SPD for a five-week pre-academy course. A foundational goal is that SPD recruits gain a more comprehensive and intimate understanding of the people they will eventually swear to serve and protect.
o Among other topics, the curriculum explores the policing profession’s history with communities of color, gender responsiveness, and the science of relationship-based policing.
o In addition, police recruits and Community Service Officers meet with and are expected to have honest, open dialogues with the public about the history of policing in their communities, their expectations of how officers should interact with people in those communities, and the public safety challenges those communities face.
o Trainees hear and learn directly from communities most impacted by policing, including currently and formerly incarcerated persons, persons who have experienced violence, immigrant and refugee communities, local business communities, and students.
o The coursework also covers brain development and the impact of childhood trauma, poverty, addiction, and other societal stressors on many with whom officers will come into contact.
o More information about this program, which is now routinely studied for replication by departments around the country, can be found on SPD’s website at https://www.seattle.gov/police/communitypolicing/before-the-badge.
• In 2022, SPD implemented the Outward Mindset program, which is focused on community engagement.
o All members of Command Staff participated in the Outward Mindset program in 2022 with a senior facilitator from the Arbinger Institute in anticipation of a broader implementation.
o Five SPD employees became certified to facilitate the Outward Mindset program.
o The Outward Mindset program was incorporated into the core of the new Before-theBadge program for all new recruits prior to attending the academy.
o All Community Service Officers (CSOs) went through the Outward Mindset program to enhance teamwork and improve their ability to help community members with their unique needs.
o All civilian and sworn supervisors, including sergeants, lieutenants, and captains, have now completed the program.
o All OPA supervisors including the director have participated in the Outward Mindset program.
o Starting in the fall of 2023, 50 SPD leaders (including Command Staff) will participate in a one-year intensive Outward Mindset Leadership program which includes the application of the Outward Mindset concepts throughout the department as well as small cohorts for discussion and individual coaching for support.
• Establishment of the Police Outreach and Engagement Team (POET):
o Serving in khakis and polo shirts, rather than regular uniform, unit members serve as liaisons between crowd organizers, members, and operational commanders, checking on crowd members’ well-being, and offering aid and guidance as requested.
EXHIBIT 2
1Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
2Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, Washington, USA
3Internal Medicine, University of Washington School of Medicine, Seattle, Washington, USA
4Emergency Medicine, University of Washington School of Medicine, Seattle, Washington, USA
Correspondence to Dr Anthony L Bui; anthony.bui@ seattlechildrens.org
Received 6 June 2024
Accepted 19 December 2024
Protest-related injuries during the Capitol Hill Autonomous Zone protest in Seattle, Washington, USA in 2020
Anthony L Bui , 1,2 Georgia A Sleeth,3 Jessica E McDade,1 Herbert C Duber,4 Frederick P Rivara1,2
ABSTRACT
Introduction George Floyd’s death in 2020 galvanised large protests around the country, including the emergence of the Capitol Hill Autonomous Zone (CHAZ) in Seattle, Washington, a non-policed, organised protest region that may have differing injury risks than other regions. We sought to quantitatively describe characteristics of injuries related to protests documented at visits to two nearby major emergency departments, including the only Level 1 trauma centre in the state.
Methods Using the International Classification of Diseases, 10th Revision code inclusion criteria, we identified 1938 unique patient visits across the two emergency departments from 29 May 2020 and 1 July 2020. We reviewed provider notes to identify keywords to determine if the visit was related to the CHAZ protest. We quantitatively described demographics and injury characteristics.
Results We identified 48 injury visits related to the protest, with 25 from assault, 11 from crowd-control weapons and 8 from ground-level falls. Crowd-control weapons consisted of five visits from pepper spray, five from tear gas and a smaller number from flash-bang grenades, rubber bullets or other projectiles or a baton. In terms of body region injuries, 23 involved the head, 13 involved the knee and lower leg and 11 involved the thorax. Five patients required transfer to the operating room for surgery and admission and two died.
Discussion The demonstrations during the CHAZ in Seattle in 2020 resulted in several violent injuries. Given the high proportion of assault and head injuries, these injury patterns can help prepare healthcare workers and first responders to plan care needs during protests.
INTRODUCTION
© Author(s) (or their employer(s)) 2025. No commercial re-use. See rights and permissions. Published by BMJ Group.
To cite: Bui AL, Sleeth GA, McDade JE, et al Inj Prev Epub ahead of print: [please include Day Month Year].
doi:10.1136/ip-2024-045396
The death of George Floyd on 25 May 2020 galvanised protests across the USA. Bolstered by the deaths of Floyd and other black individuals, the ‘Black Lives Matter’ movement protested racialised police violence in America.1 Peaceful protests, as an expression of free speech, are core to advocacy for many issues, including racial equity.2 Still, there were observations of increasing incidents of violence and injuries during protests.3 Some studies have documented violence and both accidental and intentional injuries, studying ‘less lethal weapons’ frequently employed during these protests as mechanisms of crowd control.4–7
Shortly after Floyd’s death, individuals in Seattle, Washington, created a non-policed organised
WHAT IS ALREADY KNOWN ON THIS TOPIC
⇒ Less lethal weapons, including crowd-control weapons, are sometimes large causes of burden and disability at protests
⇒ The Capitol Hill Autonomous Zone (CHAZ) in Seattle, Washington, in 2020, represents a large urban 1-month protest with media reporting injury, yet no study has systematically attempted to understand patterns of injury that occurred.
WHAT THIS STUDY ADDS
⇒ We sought to describe injuries related to protests at the CHAZ across two major emergency departments in the city.
⇒ We identified that most injuries presented to these emergency departments are due to assault, followed by those from crowd-control weapons and ground-level falls.
HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY
⇒ Healthcare workers, first responders and public health leaders should recognise potential injury patterns that arise from protests and civil unrest to facilitate injury preparedness efforts and policy interventions.
protest region.8 9 From 29 May 2020 to 1 July 2020, the Capitol Hill Autonomous Zone (CHAZ), also known as the Capitol Hill Occupation Protest, emerged as a six-block region of organised protest in the Capitol Hill neighbourhood of Seattle.9 Although there were several protests occurring during this period throughout America, much attention was focused on the CHAZ. Because its autonomous, non-policed nature may provide unique risks and injury patterns, we sought to build a case series and quantitatively characterise the injuries related to the protests documented at visits to the emergency departments of two major hospitals located within 3 miles of the CHAZ, including the only Level 1 trauma centre in Washington. As other emergency facilities nearby are not designated trauma centres, the two in our study therefore cover the majority of trauma-related care in the city. Previous reports studying crowd-control weapons lacked comprehensive analyses of non-crowd-control injuries at protests. The current study sought to fill this gap to inform both injury preparedness and policy interventions to prevent injury.
METHODS
Data sources and search strategy
We conducted a retrospective chart review at two major academic emergency departments in Seattle, Washington. We extracted patient data on emergency department visits between 29 May 2020 and 1 July 2020, coinciding with the first protest after George Floyd’s death and through the duration of the CHAZ.8 Patients were included in the study if they entered the emergency department for treatment of conditions that had injury-related International Classification of Diseases, 10th Revision (ICD-10) codes: S00–S99, T01–T32, T35, T52–57, T59, X92–X99, Y00–Y09, W20–W46, Y21–Y33 and Y35. We purposefully excluded codes related to poisoning, alcohol use and carbon monoxide, as they were less likely to be associated with protest involvement. We collected data on race, gender, language, injury and disposition from the emergency department (discharge, procedural or surgical intervention or death). We obtained data on selfreported race to examine how discrimination may have influenced injuries from protests. A senior medical student trained in case review analysed provider notes. Complex cases were reviewed together with the principal investigator.
Defining protest involvement
We reviewed the emergency department visit provider notes for the following phrases to indicate if the visit was associated with a protest. Using a review of media sources during this time period, we included the following words to identify a visit as being involved with a protest: ‘pepper spray’,10 ‘tear gas’,10 ‘taser’, ‘rubber bullets’,11 ‘projectiles’ (including ‘blast balls’ and ‘flashbang grenades’),10 11 ‘batons’,10 ‘protest’, ‘riot’, ‘Black Lives Matter’, ‘BLM’, ‘Capitol Hill Autonomous Zone’, ‘CHAZ’, ‘Capitol Hill Organised Protest’ or ‘CHOP’.
Defining crowd-control weapons
We also categorised visits as being associated with crowd-control weapons, which included the words ‘pepper spray’,10 ‘tear gas’,10 ‘taser’, ‘rubber bullets’,11 ‘projectiles’,10 11 ‘blast balls’,10 11 ‘flashbang grenades’10 11 and ‘batons’.10
Injury description and data analysis
Injury descriptions were obtained by reviewing ICD-10 codes for external mechanisms of injury (describing the vector that transferred energy to the body or intent of injury), nature of injury (referring to the body region and primary characteristics of the disabling condition) and our review of crowd-control weapons. Data analysis was performed on Microsoft Excel to generate descriptive characteristics. This study was approved by the University of Washington Institutional Review Board.
RESULTS
Demographic characteristics
A total of 1938 unique patient visits to the two emergency departments occurred during the study period and met inclusion by ICD-10 code. Among these, 48 visits were screened to involve protesting. The mean age of the 48 unique patients was 33 years, with a range of 16–68 years. Gender and race are listed in table 1. Nearly all patients spoke English.
Mechanism and nature of injuries
A review of the mechanism of the 48 injuries included 25 from assault, 11 from crowd-control weapons and 8 from groundlevel falls. The determination of assault was made by the ICD-10 code, which includes injuries inflicted by another individual with
Table 1 Protest-related injuries during the Capitol Hill Autonomous Zone (CHAZ) in Seattle, Washington, USA, in 2020
*Other racial and ethnic groups include Hispanic White, Alaska Native or American Indian, Asian or unknown race and ethnicity group.
†External mechanisms of injury refer to the vector that transfers energy to the body or the intent of the injury. The nature of the injury refers to the body region or primary characteristics of the disabling condition. External causes were determined by the International Classification of Diseases, 10th revision code and by description review for protest-related injuries in provider notes. Totals may be larger than 48, as some individuals may have multiple injuries.
‡Assault by other means includes assault by blunt object, firearm, sharp object, other specified means or unspecified assault.
§Legal intervention may involve blunt objects, explosives, gas or other specified means.
¶Other external mechanisms of injury that are suppressed due to having a sample size of n<5 include baton; car ramming; caught and crushed in between a moving and stationary object; contact with a knife, sword, dagger, nonpowered hand tool or sharp glass; discharge of a firework; firearm; flash-bang grenade; projectiles, rubber bullets, stabbing, striking or unknown.
**Other natures of injury that are suppressed due to having a sample size of n<5 include injuries to the elbow and forearm; wrists, hand and fingers; ankle and foot; unspecified body regions; burns and corrosions; and toxic effects of substances.
††Other procedures included wound care, irrigation and foreign body exploration, open reduction and internal fixations and abdominal repair.
intent to injure or kill, usually excluding legal intervention or war. Injuries from crowd-control weapons included five from pepper spray, five from tear gas and a smaller number from flashbang grenades, rubber bullets or other projectiles, and batons. A small number of patients suffered gunshot wounds. Some patients experienced multiple external mechanisms of injury (table 1). In terms of the nature of injuries, 23 involved the head, 13 involved the knee and lower leg and 11 involved the thorax.
Care needed and disposition
Five patients were required to be transferred from the emergency department to the operating room for a surgical procedure and admission, and an additional 11 patients were required to perform procedures that occurred in the emergency department, most commonly laceration repair (10 patients). Most patients were discharged from the emergency department, while a smaller number went to the operating room, discharged against medical advice or died.
DISCUSSION
Across two major emergency departments within 3 miles of the CHAZ, we identified a total of 48 protest-related visits. The most common causes of injury were from assault, crowd-control weapons (eg, pepper spray, tear gas and flash-bang grenades) and ground-level falls. Almost half of these involved head injuries. We identified a small number of serious injuries that required surgical operation and a few deaths. Most of these cases did not involve crowd-control weapons.
A review of provider notes showed that some victims of assault reported injury by other protesters or by police, though this study was unable to further quantify these. Although six cases were associated with an ICD-10 code that classifies legal intervention (ie, police involvement), it is likely that these codes are underutilised and therefore underestimate police involvement. During these protests, general news media reported police-related injuries with crowd-control weapons.11 Although nearly one-quarter of the injuries in this study were reported to involve crowd-control weapons, a tactic that was used by police, most serious injuries did not involve these mechanisms. In 2021, the Seattle City Council passed legislation to ban blast balls and limit the use of chemical irritants like tear gas and pepper spray only ‘to narrow circumstances (such as) during a violent public disturbance’.12 As of 2023, there have been rollbacks to this legislation, overturning the requirement to receive authorisation from the highest elected official in the jurisdiction where tear gas would be employed prior to using it.13 Since tear gas and pepper spray were responsible for some injuries in 2020, they may be a source of injuries in future protests.
These findings demonstrate the injury burden due to assault, crowd-control weapons and accidental falls during a 1-month protest period. Despite existing city policies to minimise harm during protests, these findings highlight challenges in limiting injuries during times of civil unrest. With America’s long history of protests around a myriad of issues, understanding the mechanisms of protest-related injuries is necessary to reduce the risk in current and future events.
Limitations
This study has several limitations. First, it does not capture the individuals who may have experienced minor injuries and did not present to emergency care but instead presented to urgent or primary care or no care at all. There are also two other emergency departments in the area in which individuals may have sought out care after an injury. However, neither are designated trauma centres, and therefore, they are less likely to care for violent injuries. A case report in Oregon demonstrated that just over half of individuals exposed to tear gas at a protest presented for medical care.5 This suggests that our study likely underestimates the burden of injury care during this protest period.
Second, analysis to categorise crowd-control weapons was performed by reviewing patients’ medical records and, therefore, may be limited by self-reporting bias, recall bias and inadequate
data in the electronic medical record system. According to police department data, over 500 instances of use of force by the Seattle Police Department occurred during this protest.14 Other individuals were either unlikely to seek emergency care or were not captured in our analysis across the two emergency departments. Lastly, this study was unable to determine what percentage of individuals in the CHAZ suffered injuries and was not designed to evaluate a police-free zone’s injury rate relative to other protests in other cities.
CONCLUSION
Despite advocates’ efforts to promote non-violent assembly, the protests occurring during the CHAZ in Seattle in 2020 resulted in several violent injuries, including assault, ground-level falls and use of crowd-control weapons, which represented roughly one-quarter of injuries. Healthcare workers, first responders and public health leaders can use these data to be aware of injury patterns and anticipate needed care during these protests.
Contributors Conceptualisation and planning: ALB, JEM, HCD and FPR. Methodology: ALB, GS, JEM, HCD and FPR. Data collection: ALB, GS and JEM. Statistical analysis: ALB and GS. Interpretation of data: ALB, GS, JEM, HCD and FPR. Writing the original draft preparation: ALB and GS. Writing the review and editing: ALB, GS, JEM, HCD and FPR. Study supervision: HCD and FPR. Guarantor: ALB.
Competing interests None declared.
Patient consent for publication Not applicable
Ethics approval This study was approved by the University of Washington Institutional Review Board (STUDY00013514). It qualified for expedited review (minimal risk).
Provenance and peer review Not commissioned; externally peer reviewed.
ORCID iD
Anthony L Bui http://orcid.org/0000-0003-3481-7855
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