Training inadequate for use of restraint chair at Kitsap County Jail

KCIRT investigation finds poor training led to an inmate’s death

By Mike De Felice

Special to Kitsap Daily News

PORT ORCHARD – Kitsap County Jail corrections officers involved in a violent encounter to place an inmate into a restraint chair that led to the man’s death had not been properly trained in the use of the chair, according to Washington State Patrol investigators.

During the jail struggle on May 9, officers placed the combative Sean Michael Howell into a restraint chair, investigators stated in a report. Once he was placed in the chair, officers bent Howell forward at the waist and held him down in that position for nearly three minutes. After he was moved upright in the chair, corrections staff members noticed he was not breathing. Howell was taken to a hospital, where he died days later.

Howell, 28, was initially arrested by Bremerton police on May 8 and booked into Kitsap County Jail for first-degree murder. He had confessed to murdering his girlfriend Sabrina Olson-Smith, 23, police reported.

The multi-agency Kitsap Critical Incident Response Team (KCIRT) was activated to investigate the incident since the use of force resulted in the man’s death. The team consisted of members from the Washington State Patrol, which served as the lead agency, and detectives from the Port Orchard, Poulsbo and Shelton police departments.

Because the Bremerton Police Department had arrested Howell and corrections staff from the Kitsap County Sheriff’s Office had used force in the incident, those agencies did not take part in the investigation.

During the investigation, the corrections officers involved were interviewed, jail video recordings were reviewed and a forensic pathologist was contacted. WSP detectives also reviewed jail policies and training materials.

Fatal altercation

According to KCIRT reports obtained by the Independent through a public records request, on May 9 jail staff observed Howell climbing the side of his jail cell to tamper with a fire sprinkler on the ceiling. Five jail officers were initially called to move Howell to another cell where a sprinkler was not accessible. When officers entered the cell, Howell became combative and additional staff was summoned.

Surveillance video was used by investigators to review the incident.

Howell was standing and fighting for less than a minute before a fight ensued on the cell floor. During the altercation, Howell was tasered four times and pepper-sprayed, according to reports.

The physical altercation lasted approximately five minutes until Howell was in a controlled position face down on the floor in handcuffs and restrained.

Howell was then placed in the restraint chair and immediately bent forward in a leaned-over position while being held down by at least four corrections officers. As officers secured Howell to the restraint chair, staff members noticed he was no longer breathing.

Medical staff immediately administered first aid and CPR, the report stated. EMTs arrived on the scene and continued CPR efforts but Howell remained nonresponsive.

The inmate was transported to Harrison Bremerton Hospital where he remained in critical condition for several days. Howell was removed from life support on May 15.

After reviewing the struggle at the jail, the investigation found that Howell had stopped breathing shortly after being placed in the restraint chair.

Howell’s ability to breathe was also impacted prior to that point by him being pepper-sprayed and tasered. Another factor investigators listed was the stress of being in a physical fight, which led to Howell being put face-down on the floor with his arms pulled back and raised behind his back. “This action would have compressed his rib cage and prevented his lungs from expanding fully,” according to a State Patrol detective’s comment in the report.

Howell was then placed in the restraint chair where he was immediately bent over at the waist for 2 minutes and 46 seconds before being brought to an upright position. “Being bent forward prevented his diaphragm from expanding, in turn preventing him from breathing,” the report stated.

The Kitsap County Coroner’s Officer determined Howell’s cause of death to be restraint asphyxia and the manner of death to be a homicide.

Restraint asphyxia is caused by the action, or actions, of a person, or persons, that leads to the obstruction of airflow or interference with ventilation during restraint, pathologist Dr. Megan Quinn explained to investigators.

“With the definition of homicide, it simply means that the action of another contributed to the death,” Kitsap County Coroner Jeff Wallis had previously told the Independent.

No corrections officer displayed criminal negligence or criminal intent in their actions dealing with Howell, according to the findings.

The pathologist noted that contributing factors to Howell’s death were him being tasered, pepper-sprayed and the inmate undergoing a “psychotic episode.”

The KCIRT investigation focused on the actions of the four officers who held Howell bent at the waist once he was placed in the chair. Officers Juan Guerrero, Richard Campbell, Aaron Donahue and Gran Riley were identified as the individuals who “placed downward pressure” on Howell to prevent him from struggling and pushed him into a bent-over position. Howell continued struggling, trying to push his legs forward so they could not be restrained. There were mixed witness accounts on whether Howell was still resisting after he had been in the chair for a short time.

None of the jail staff present during the struggle attempted to intervene with the actions of the four holding Howell in the chair, according to the report.

Training inconsistencies

A restraint chair is a portable unit equipped with shoulder, lap, ankle and wrist straps. It is used to overcome the resistance of a combative inmate, according to training materials.

During the review, investigators examined the jail’s training procedures involving the use of the restraint chair.

The jail created its own training materials for how to use the chair. The state criminal justice training commission does not provide law enforcement personnel any training materials on the device, investigators stated in the report.

The most recent Kitsap County Jail training on cell extraction, which would have included restraint chair refresher training, was conducted in 2012, jail staff reported. Training materials from that session could not be located by jail personnel, according to investigators.

A diagram of the restraint chair that is the subject of the KCIRT investigation, pictured here, was included in the multi-agency report. (KCIRT report diagram)

A diagram of the restraint chair that is the subject of the KCIRT investigation, pictured here, was included in the multi-agency report. (KCIRT report diagram)

During interviews with the jail’s two restraint chair instructors, it was learned one of them, Officer Millsap, taught students to immediately bend an inmate over at the waist when placed in the chair. Millsap told investigators she had not received specialized training in restraint chair use other than what she received when she was hired 13 years ago.

No mention of the technique the four officers used on Howell was found in any of the jail’s training materials, the report stated. Investigators noted that nowhere does the manufacturer recommend bending an inmate over at the waist during the restraint process.

SureGuard, the manufacturer of the restraint chair, provides free online training on its website. It appeared to investigators that KCSO had not utilized the free training.

Areas of concern

During the Washington State Patrol investigation, several areas of concern were identified regarding the use of the restraint chair:

  • There is inconsistent training on how to use the restraint chair.
  • There is an inconsistent understanding among jail staff on how to use the restraint chair.
  • One of the primary instructors for restraint chair training received no formal training on restraint chair instruction or defensive tactics instruction.
  • The current training sergeant, as well as the training lieutenant, are under the mistaken belief that newly hired employees are provided restraint chair instruction at the Criminal Justice Training Center.
  • The current training sergeant, as well as the training lieutenant, are under the mistaken belief that the training curriculum for the restraint chair is developed with materials provided by, and in conjunction with, the training center.
  • It appears there is no formal review process for the use of the restraint chair at the jail.
  • Training material for the restraint chair has been developed ad hoc with little supervision from first-line or higher supervisors.
  • Training materials available from the restraint chair manufacturer are not utilized in training at the jail.
  • Refresher training for restraint chairs is not done on a consistent basis.
  • Supervisors at the jail do not oversee new-hire orientation training.
  • Supervisors at the jail do not oversee refresher training, except on a limited basis.

Sheriff’s plans

Kitsap County Sheriff Gary Simpson oversees correctional officers in the county jail. During the KCIRT investigation, Simpson said he was given updates by investigators and was provided a copy of the reports. He has not, however, reviewed the written material provided, saying he wants to wait until the investigation is complete before reading them.

“This investigation is not complete until the prosecutor’s office reviews it and says no more investigative work needs to be done,” he said.

Simpson said he disagrees with several of the conclusions of the investigation. He also takes issue with law enforcement personnel conducting the investigation.

“I don’t agree with a lot of their judgments or assessments they have indicated in their press releases. They are making comments about areas of jail operation [while they are] traffic investigators and investigators in general criminal law enforcement investigations. They are not aware of or are familiar with the environment of a jail. It’s a different world,” the sheriff said.

Once the dust settles, Simpson said he plans to conduct a thorough in-house review of the Howell incident, which he said will include a peer review by jail commanders from other local correctional facilities.

Simpson indicated the officers involved in the Howell incident remain on the job pending completion of the investigation. Once the review is finished, his office will do an administrative review to determine if any policy violations took place and whether disciplinary action or changes in practices are needed, he said.

The sheriff also said the restraint chair continues to be used in the jail.

“If the investigation finds that some processes [surrounding its use] need to be addressed, then they will be addressed,” Simpson said. “It is a tool that we are certainly going to audit … and determine if there is anything that needs to be done differently based on the findings,” he said.

Whether any training changes in the use of the restraint chair are needed is another issue that will be addressed once the investigation is finished, the sheriff said.

Next steps

Howell’s death has attracted the attention of the ACLU — the American Civil Liberties Union.

Hank Balson, a civil right attorney with the law firm of Budge & Heipt that handles jail death cases and is a member of the board of directors of the ACLU of Washington, provided this statement about the incident:

“Based on the State Patrol’s investigation, there appear to be serious questions about the training jail officials provided staff in the use of this potentially deadly piece of equipment. We should all be deeply troubled by that. People are brought to jail for a variety of reasons, some with very serious medical or mental health needs. Jail officials have a moral and a constitutional duty to ensure they have the policies and training in place to protect the health and safety of all people who enter the jail.”

The State Attorney General’s office is reviewing the matter to ensure the requirements of Initiative 940 were met. That measure, passed in 2018, requires that “completely independent” investigations of incidents take place when law enforcement uses deadly force resulting in death or substantial bodily harm.

Meanwhile, the Kitsap County prosecutor’s office is reviewing the Howell case to determine whether to file criminal charges against the corrections officers.