San Antonio Express-News (Sunday)
How a genetic trait in Blacks is often used to cover police abuse
When they carried the body of a 32-year-old Black man named Lamont Perry out of the woods in Wadesboro, N.C., there were no protests over his sudden death in police custody.
No reporters camped at scene. No lawyers filed suit.
Instead, the final mark in the ledger of Perry’s life was made by a state medical examiner who attributed his death in large part to sickle cell trait, a genetic characteristic that overwhelmingly occurs in Black people. The official word was that he had died by accident.
But the examiner’s determination belied certain facts about that night in October 2016, public records and interviews show. Accused of violating probation in a misdemeanor assault case, Perry was chased by parole and police officers through the dark into a stand of trees, where only they could witness what happened next.
He had swelling of the brain, and a forensic investigator reported that he had an open fracture of his right leg. He was covered in dirt, and residents of a nearby housing complex told his family that when the officers emerged from the woods, their shoes and the bottoms of their pants were spattered in blood.
Perry’s case underscores how willing some American pathologists have been to rule in-custody deaths of Black people accidents or natural occurrences caused by sickle cell trait, which is carried
the by 1 in 13 Black Americans and is almost always benign. Those with the trait have only one of the two genes required for full-blown sickle cell disease, a painful and sometimes life-threatening condition that can deform red blood cells into crescent shapes that stick together and block blood flow.
As recently as August, lawyers for Derek Chauvin, the Minneapolis police officer convicted last month of murdering George Floyd, invoked sickle cell trait in an unsuccessful motion to dismiss the case against him, saying that the condition, along with other health problems and drug use, was the reason Floyd had died.
The New York Times has found at least 46 other instances over the past 25 years in which medical examiners, law enforcement officials or defenders of accused officers pointed to the trait as a cause or major factor in deaths of Black people in custody. Fifteen such deaths have occurred since 2015.
In roughly two-thirds of the cases, the person who died had been forcefully restrained by authorities, pepper-sprayed or shocked with stun guns. The determinations on sickle cell trait often created enough doubt for officers to avert criminal or civil penalties, the Times found.
In three cases, deaths linked to sickle cell trait that were deemed natural or of indeterminate cause were later ruled homicides — as occurred when Martin Lee Anderson, 14, died at the hands of his jailers at a northwest Florida juvenile detention camp in January 2006.
“You can’t put the blame on sickle cell trait when there is a knee on the neck or when there is a chokehold or the person is hogtied,” said Dr. Roger Mitchell Jr., the former chief medical examiner for the District of Columbia and now chair of pathology at the Howard University College of Medicine. “You can’t say, ‘Well, he’s fragile.’ No, that becomes a homicide.”
Not every death that is tied to the condition is inherently questionable. Medical experts say sickle cell trait has caused deaths in rare cases of extreme overexertion, especially among military trainees and college athletes. Three of the in-custody deaths identified by the Times involved people who were exercising vigorously in jail yards or running hard before they collapsed — and law enforcement officers said that at most they put handcuffs on them.
In none of the deaths examined by the Times did the person have actual sickle cell disease.
In interviews, Mitchell and other medical experts agreed that the trait warranted mention in autopsies but said any natural or accidental death attributed to it, even in part, should be scrutinized if the person died during or after a struggle with law enforcement.
Many said they suspected some sickle cell determinations might reflect a pattern of bias or conflicts of interest among medical examiners and police officials.
Forensic pathologists, the doctors who conduct autopsies for coroners and medical examiners, were singled out in a hotly disputed study published in a scientific journal in February suggesting that racial bias could influence their rulings, though it did not address sickle cell trait.
And coroners and medical examiners have entrenched relationships with law enforcement in many areas, functioning as part of police departments or working closely with them.
In Perry’s case, agents with the North Carolina State Bureau of Investigation sealed his body in a bag before a forensic investigator inspected it. Officers at the scene could not say for sure how he had suffered his injuries but said it appeared he had tripped and fallen into a ravine. The officers said he had been talkative when they found and handcuffed him, but then he lost consciousness. No efforts were made to revive him with lifesaving equipment when paramedics arrived, records and interviews show, and the “open fracture” documented by the forensic investigator was described in the autopsy as a “laceration.”
Perry had alcohol and a small amount of cocaine in his bloodstream when he died, and the medical examiner ruled that he had succumbed to “cocaine toxicity in the setting of sickle cell trait,” effectively ending any deeper inquiry. The local district attorney declined to bring charges.
For Perry’s relatives, who could not afford a lawyer to challenge the ruling, all that was left was a series of unanswered questions. What had happened in the woods? Why would the investigators not let them view the body before the autopsy?
“The only people who know what happened are that probation officer and the officers who ran out there,” said Perry’s halfbrother, Mario Robinson. “I don’t believe what they said.”