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Ten years ago, a police officer drove his knee into the back of a 28-year-old Black man already in handcuffs during a confrontation at a Minneapolis YMCA. The man, David Smith, died and the Minneapolis Police Department paid his family $3 million.

, the department agreed to include additional training on how to avoid positional asphyxiation, which is the inability to breathe and death as a result of body position. But in the wake of the death of George Floyd, Smith’s family is investigating whether the department ever implemented it.

Newly released Minneapolis police training records shared with and reviewed by MPR News are giving critics more reason to question whether officers were adequately trained on the dangers of improper restraints.

A review of the documents, which span the past seven years, shows only a brief mention of “compression asphyxia” and plenty of references to a controversial cause of death known as “

.” It’s often used by law enforcement officials to explain deaths of people in police custody who have been using drugs or who have serious mental illness.

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The records concern members of the Minneapolis Police Conduct Oversight Commission, which is now embarking on a research project to understand the department’s training history on positional asphyxiation.

Abigail Cerra, a Minneapolis attorney who serves on the commission, said the records she has seen so far miss the mark on training officers to recognize the dangers of prone restraints. 

“The one PowerPoint training document that was disclosed to me was about excited delirium. A focus was not on positional asphyxiation, and in fact, the term ‘positional asphyxiation’ is nowhere in that entire PowerPoint,” she said. “It doesn’t say ‘when you kneel on someone’s back, they can’t take a full breath.’”

Cerra was referencing a 2013 presentation, titled “Arrest Related Deaths,”  that was included in a batch of documents as a response to her data request for positional asphyxiation training material. Although it defined a police-custody death as a person “under physical restraint or custody,” it also said that deaths don’t necessarily have to be related to police actions or negligence. Instead, they can be caused by intoxication, suicide, illness or natural causes, the slides stated.

George Kirkham, a criminologist and a professor emeritus at the College of Criminology and Criminal Justice at Florida State University, said neck restraints are dangerous and should only be used in situations where deadly force is warranted, noting that Miami and Chicago consider it lethal force.

“You’re playing around with fire,” he said. “This guy may as well have screwed a gun into George Floyd’s ear and pulled the trigger.”

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Aside from the presentation decks and notes, it’s not clear what the training covered or didn’t cover. A Minneapolis police spokesperson declined repeated requests for interviews and would not comment on whether there is a gap between how officers are trained and the Smith settlement requirements. 

Last month, however, Police Chief Medaria Arradondo said the Police Department went above and beyond the training requirements spelled out in the Smith settlement. 

All officers in 2014 were given training on turning arrestees from a prone position into a recovery position, meaning on their side, to help them breathe, Arradondo said at the time.

Derek Chauvin, who knelt on Floyd’s neck for more than eight minutes, and fellow officer Tou Thao, received the training, according to Arradondo’s statement.

“Mr. George Floyd’s tragic death was not due to a lack of training — the training was there,” Arradondo said. 

Some of the records provided in response to the data request corroborate Arrodondo’s claims. 

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A policy dated June 13, 2014, requires officers who use maximal restraint to subdue someone — defined as a technique used to secure feet to waist to prevent movement of legs to prevent injury — to monitor the person's medical condition and turn them on their side to reduce the pressure on their chest.

Another document provided as part of the data request is a set of notes titled “Defensive Tactics Street In-service Training 2014.” Of the nine defensive tactics listed, one discussed neck restraints. The notes discuss the need to protect the trachea and reposition the person if they’ve lost consciousness. 

But Jeff Storms, the Smiths’ lawyer, who’s also representing Floyd’s family, said he’s investigating whether the department actually complied with the 2013 settlement agreement.

“It’s one thing to say you’re going to provide training on positional asphyxiation,” he said. “It’s another thing to identify the concept of positional asphyxiation, but the Minneapolis Police Department is telling people, ‘Hey, this concept of positional asphyxiation exists, but internally we all really believe it’s not an asphyxiation issue, this is all really just excited delirium.’”

The 2013 presentation about the deaths of people in police custody cited “excited delirium” as the main culprit for in-custody deaths. It says the condition manifests as a combination of delirium, speech disturbances, anxiety, hallucinations and “superhuman strength,” among other things.

One of the former officers charged in George Floyd’s death cited excited delirium as a concern for whether they should continue pinning Floyd down. Thomas Lane told the officer who knelt on Floyd’s neck, Derek Chauvin, “I’m worried about excited delirium or whatever,” and asked whether they should turn Floyd on his side.

As part of the case, Lane’s attorney Earl Gray filed training records that covered the topic of prone restraint and side recovery more extensively than the data request provided by the city. Records also identified neck restraint as a “nondeadly force option” defined as compressing someone’s neck with an arm or leg “without applying direct pressure to the trachea or airway.” 

Gray filed the records as he argued that the charges of aiding and abetting second-degree murder against Lane should be dismissed, noting that Lane was the one who suggested to turn Floyd over on his side, while Chauvin, his field training officer, insisted on keeping him on his stomach until the ambulance came.

“Lane was thinking of excited delirium,” according to the court filing. “Lane listened to FTO (field training officer) Chauvin and thought it made sense because there are times when a person who is OD’ing or passed out one minute but then comes back really aggressive.” 

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Excited delirium is a phrase police officers are familiar with. While the associations representing emergency doctors and medical examiners say excited delirium is real, the American Medical Association and the American Psychological Association do not recognize it.

Critics say officers using the diagnosis to justify the deaths of people in police custody is troubling. 

Mary Moriarty, Hennepin County’s chief public defender, said it comes up often in cases that her office works on.

“The problem here is when you train somebody that excited delirium is a legitimate medical diagnosis and then they act on that belief, it’s, I would imagine, a little difficult to discipline,” she said. “I think we need to ask why are police officers being trained on something that isn’t viewed as a legitimate medical diagnosis by most in the field.”

Smith was having a mental health crisis and acting erratically at the downtown Minneapolis YMCA in 2010 when police responded to a call from employees. Two police officers responded, struggled with Smith and handcuffed him behind his back. One of the officers continually drove his knee into Smith’s back, which made it hard for him to breathe. Smith was revived but died a week later without ever gaining consciousness.

In that wrongful death lawsuit, former Minneapolis Police Chief Tim Dolan testified that he believed officers didn’t know that Smith was in distress, that they didn’t recognize his struggle to breathe because not everyone has seen that on the job. 

Dolan also said that a prone restraint “is not a serious, dangerous position for most people, but it is dangerous for some people.”

When asked whether it’s a dangerous position for people after they’ve had a ground fight, Dolan answered: “It's a dangerous position for people that are suffering from what we in our profession would call excited delirium, which seems to be the case here.”

Smith’s sister, Angela Smith, told the Minneapolis Police Conduct Oversight Commission last month that the family went back and forth with the city during the lawsuit to make sure the department included additional training on positional asphyxiation. But after seeing Floyd die on camera, she’s not confident the department ever complied with the settlement. 

“Now my family is reliving this horrible trauma all over again because all our efforts were in vain,” Smith told the commission in June. “We had some sense of peace thinking that we really did something by this clause being in the settlement. Nobody else will have to die like my brother did. But now I watch George Floyd cry out for his mom, and people stood by, and he died.”

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Newly released Minneapolis police training records are giving critics more reason to question whether officers were adequately trained on the dangers of improper restraints. A review of the documents, which span the past seven years, shows training focused heavily on excited delirium, a controversial cause of death of people in police custody.

MPD records suggest scarce training on dangers of improper restraints

Person wearing a law enforcement uniform speaks at a podium. 

Christine T. Nguyen | MPR News

A photo collage of a young man with some of his family members.

Illustration by KARE 11 from Smith family photo

A presentation slide shows discussions on arrest related deaths.

MPD records suggest scarce training on dangers of improper restraints

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