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What Happened to James Chasse: Chasse death spurs police to change policy

Tuesday, February 20, 2007

Chasse death spurs police to change policy

from The Oregonian, by Maxine Bernstein

In response to the death of James P. Chasse Jr. in police custody, the Portland Police Bureau has adopted a new policy that restricts when officers can put a sick or injured person in their patrol car and outlines what information police must share with paramedics and jail nurses, such as how much force was used during an arrest.

The Chasse case last fall spurred the bureau to meet with county health officials, jail medical staff and ambulance paramedics to find better ways to share information and coordinate how they handle people who may require medical care, Assistant Chief Lynnae Berg said.

"It was a great collaborative effort among all involved --something both officers and emergency medical staff were hungry for," Berg said.

Multnomah County Sheriff Bernie Giusto agreed. "I think there was some fairly obvious changes that we needed to make," he said.

Chasse's death revealed gaps in police and county procedures because no one recognized the significant injuries he had suffered until it was too late.

Chasse, 42, who suffered from schizophrenia, sustained multiple rib fractures, some of which punctured his left lung, early in an encounter with police on Sept. 17. Ambulance paramedics who responded to the scene said his vital signs were normal and had a Portland police officer sign for him, declining emergency transport to a hospital.

Police drove Chasse to the Multnomah County Detention Center. He appeared to suffer a seizure in a holding cell and went unconscious. A jail nurse looked through the cell door window and told police the jail would not book Chasse. There was no discussion as to whether Chasse should be taken to a hospital by ambulance or by the police. Portland officers placed him in a patrol car. He died on the way to a hospital. The cause of death was broad-based blunt force trauma to his chest, the medical examiner ruled.

Under the new policy that took effect Jan. 30, officers will no longer give rides to people who have been engaged in a prolonged physical struggle, or are seriously injured, unconscious, suffering a seizure or extremely drunk, unless a paramedic on the scene approves it.

The policy says this will include people who appear to be suffering from what police call "excited delirium," a state of severe agitation, overstimulation, paranoia, involuntary twitching of muscles and hallucinations; anyone who is having respiratory or breathing problems, such as shortness of breath or wheezing; any head trauma before or during police contact; or anyone who appears to be extremely intoxicated or under the influence of drugs.

Officers will be required to tell emergency medical staff about any force that was used against the person, something that was not fully communicated in the Chasse case.

Further, if paramedics decide a person doesn't need additional medical care and give officers the OK to take the person to jail in a patrol car, then they will provide the officer with a document detailing the medical treatment received that will be dropped off with medical staff at the jail.

If jail nurses refuse to admit someone for medical reasons, the staff will document why on a "Pre-booking Emergency Response Record," and the medical staff in the jail will determine whether the person should be taken to a hospital by ambulance or police.

"The fact of the matter is, unless it's very clearly not a risk to life or detriment to somebody's health, officers do not belong transporting people," Giusto said.

If the jail staff makes the call to summon an ambulance to transport a person in custody, then the bill for the ambulance ride, in the $500 to $600 range, will be shouldered by the county. "This will not be a free proposition," Giusto said. "But I'm not sure we can argue about money after the Chasse situation."

If the jail medical staff determines police can take someone to a hospital, the officer must inform a sergeant before transport and record the name of the medical staff member who cleared the person for police transport.

The sheriff's office is clarifying what medical assessments must be done once someone comes through the jail's door for booking. Giusto said medical staff should be doing medical screens on all people booked to make sure their vital signs are normal.

Chasse's family early this month filed a federal civil-rights lawsuit against the city, county and American Medical Response Inc., demanding wide-ranging policy changes designed to reduce excessive force by officers and provide people in custody with appropriate medical care.

The new policy will be discussed at today's Chief's Forum, which meets at 9 a.m. on the 14th floor of the Portland Police Bureau.

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