1. URGENT CONCERN: Throughout the United States, including Minnesota, bail hearings and the prosecution of Felony Domestic Abuse by Strangulation cases are occassionally presided over by judges and prosecutors who are not fully aware of the insidious nature of strangulation. In some cases, bail is set at meager amounts, and prosecution cases are resolved with plea agreements that ignore the terrifying reality of strangulation cases, leaving the victim and her family justifiably upset (and terrified.)

2. PURPOSE: This training update aims to educate the bench and bar about critically essential facts that must be considered in every Domestic Strangulation bail hearing and prosecution. An extensive list of resource materials and authorities is listed at the end of this training update.

3. 609.2247 DOMESTIC ASSAULT BY STRANGULATION

Subdivision 1. Definitions. (a) As used in this section, the following terms have the meanings given.

(b) “Family or household members” has the meaning given in section 518B.01, subd. 2

(c) “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. Unless a greater penalty is provided elsewhere, whoever assaults a family or household member by strangulation is guilty of a felony and may be sentenced to imprisonment for not more than three years or to payment of a fine of not more than $5,000 or both.

4. MECHANICS OF STRANGULATION: Strangulation is a form of asphyxia characterized by the closure of blood vessels and air passages due to external pressure on the neck. This can lead to unconsciousness within seconds and death within minutes if pressure is not released.

5. CONSIDER THESE ALARMING STATISTICS:

  • Nationally, studies show that 7-10% of all women have experienced strangulation by an intimate partner at least once in their lifetime.
  • Up to 68% of victims of domestic violence report being strangled.
  • In domestic homicide cases, prior strangulation is present in 45% of cases.
  • Strangulation is one of the top predictors of future domestic homicide. Women who have been strangled by their partner are ten times more likely to be killed by that partner.
  • In other words, strangulation is often one of the last abusive acts committed by a violent domestic partner before murder. 

KEY FACTS THAT EVERY JUDGE AND ATTORNEY SHOULD KNOW BEFORE MAKING BAIL OR PLEA AGREEMENT DECSIONS IN DOMESTIC STRANGULATON CASES:

1. The Ugly World of Strangulation – The Victim’s Reality:

  • The act of strangulation symbolizes an abuser’s power and control over the victim. The sensation of suffocating can be terrifying.
  • The victim is completely overwhelmed by the abuser; she vigorously struggles for air and is at the mercy of the abuser for her life.
  • A single traumatic experience of strangulation or the threat of it may instill such intense fear that the victim can get trapped in a pattern of control by the abuser and be made vulnerable to further abuse.

2. The “Neck” Is the Most Vulnerable Part of The Body:

  • Blood and oxygen all flow from the body to your brain through the NECK.
  • The NECK is the most unprotected and vulnerable part of the body.
  • More severe injuries occur from NECK trauma than anywhere else.

3. Medical Facts:       

  • Strangulation stops blood flow to the brain (carotid artery).
  • Lack of blood flow to the brain will cause unconsciousness in 10 seconds.
  • Lack of blood flow to the brain will cause death in 4 minutes.
  • It only takes “4 psi” to stop blood flow to the brain. For example:
    • It takes less pressure than opening a can of soda (20 psi);
    • It takes less pressure than an average handshake (80-100 psi);
    • It takes less pressure than pulling the trigger of a gun (6 psi);
    • It takes 33 psi to fracture a victim’s larynx (less than a handshake) vs “4 psi” to stop blood flow to the victim’s brain.

4. Lack Of Visible Marks on The Skin: The lack of visible injuries in strangulation cases is well-documented in medical and legal literature. Research indicates that up to 50% of strangulation victims do not have visible external injuries despite experiencing significant internal trauma. In other words, the absence of visible injuries does not mean no harm was inflicted.

5. Strangulation Can Cause Substantial Injuries (Often Delayed):

  • Physical injuries: Death, unconsciousness, fractured trachea/larynx, damage to blood vessels leading to internal bleeding (hemorrhage) and artery damage (intimal tears), dizziness, nausea, sore throat, voice changes, throat and lung injuries, swelling of the neck (edema), breathing and swallowing problems, ringing in the ears (tinnitus), vision change, miscarriage;
  • Neurological injuries: Pressure on the neck can disrupt blood flow to the brain, leading to neurological symptoms such as confusion, memory loss, stroke, facial or eyelid droop (palsies), left or right-side weakness (hemiplegia), loss of sensation, loss of memory, paralysis;
  • Psychological injuries: PTSD, depression, suicidal ideation, memory problems, nightmares, anxiety, severe stress reaction, amnesia, and psychosis;
  • Delayed Symptoms and Fatality: Death can occur days or weeks after the attack due to carotid artery dissection and respiratory complications such as pneumonia, respiratory distress syndrome (ARDS), and the risk of blood clots traveling to the brain (embolization). Some symptoms, such as swelling, voice changes, difficulty swallowing, and neurological issues, may appear hours or even days after the incident.

6. Physical Injuries Occurring Within 30 seconds:

  • Loss of Consciousness: This typically occurs within 10-15 seconds due to a lack of oxygen to the brain.
  • Neurological Damage: This can occur within 30 seconds, potentially leading to brain damage or death if not promptly relieved.
  • Internal Injuries: Damage to the larynx, trachea, blood vessels, and other structures in the neck can occur within seconds to a minute of applying pressure during strangulation.

7. Some Good News: In 2005, Minnesota was one of only six states with a statute making strangulation of a family or household member a felony-level crime. Currently, 49 states and the District of Columbia have felony strangulation laws. Ohio was the last state to pass such legislation, with its law taking effect in April 2023. This widespread legislative action underscores the recognition of strangulation as a severe and potentially lethal form of domestic violence.

  • The Training Institute on Strangulation Prevention provides a detailed chart of state statutes related to strangulation. The institute updates this information regularly to reflect current legislative changes (Training Institute on Strangulation Prevention).

Summary: It is crucial that Judges and attorneys understand that domestic strangulation is a significant predictor of future domestic homicide. Recognizing the medical impact, such as the rapid onset of unconsciousness and potential for brain damage or death, is crucial in making informed bail and prosecution decisions. Strangulation is treated as a severe felony due to the immediate and potentially fatal consequences it carries, and understanding its prevalence in domestic violence cases underscores the need for stringent legal measures.

Alan F. Pendleton, Attorney (former district court judge)  afpendleton@gmail.com; pendletonupdates.com; linkedin.com

RESOURCE PAGE

Medical-Physiological Facts

  1. Mechanics of Strangulation and Physiological Effects:
    • Source: Training Institute on Strangulation Prevention
    • Citation: “Strangulation is a significant predictor for future lethal violence. Unconsciousness may occur within seconds and death within minutes.”
    • URL: Training Institute on Strangulation Prevention
  2. Signs and Symptoms:
    • Source: Journal of Emergency Medicine
    • Citation: “Strangulation injuries can result in voice changes, difficulty breathing, and swallowing, and may present with bruising, petechiae, and other physical signs.”
    • URL: Journal of Emergency Medicine

National Overview

  • Strangulation as a Domestic Violence Crime:
    • Source: National Domestic Violence Hotline
    • Citation: “Strangulation is recognized as a severe form of domestic violence and is addressed specifically in many state statutes due to its lethality.”
    • URL: National Domestic Violence Hotline

Statistics

  • Minnesota and National Statistics:
    • Source: National Coalition Against Domestic Violence (NCADV)
    • Citation: “Up to 68% of victims of intimate partner violence report being strangled. Women who have been strangled are ten times more likely to be killed by their partner. Nationally, 7-10% of women report being strangled by an intimate partner.”
    • URL: NCADV
  • Predictor of Lethal Violence:
    • Source: American Journal of Public Health
    • Citation: “In domestic violence homicide cases, prior non-fatal strangulation is present in 45% of cases.”
    • URL: American Journal of Public Health

The lack of visible injuries in strangulation cases is a well-documented phenomenon in medical and legal literature. Here are some authoritative sources that address this issue:

  1. National Institute of Justice (NIJ)
    • Citation: “A significant portion of strangulation cases may present with no visible injuries, which can complicate the investigation and prosecution of these crimes.”
    • URL: National Institute of Justice – Strangulation
  2. Journal of Emergency Medicine
    • Citation: “Research indicates that up to 50% of strangulation victims do not have visible external injuries, despite experiencing significant internal trauma.”
    • URL: Journal of Emergency Medicine
  3. Training Institute on Strangulation Prevention
    • Citation: “Studies show that in many strangulation cases, there are no visible injuries, which means that the absence of external marks does not correlate with the severity of the assault.”
    • URL: Training Institute on Strangulation Prevention
  4. American College of Emergency Physicians (ACEP)
    • Citation: “Victims of strangulation often exhibit no visible external injuries, even though they may suffer severe internal injuries and symptoms that are not immediately apparent.”
    • URL: ACEP – Strangulation Injuries
  5. National Domestic Violence Hotline
    • Citation: “Strangulation can result in significant internal injuries without external signs, making it a particularly insidious form of domestic violence.”
    • URL: National Domestic Violence Hotline
  6. Futures Without Violence