Injury pattern of the Flash-Ball®, a less-lethal weapon used for law enforcement: Report of two cases and review of the literature

doi:10.1016/j.jemermed.2005.09.022

The Journal of Emergency Medicine

Volume 31, Issue 3, October 2006, Pages 325-330

https://doi.org/10.1016/j.jemermed.2005.09.022 Get rights and content

Abstract

Less-lethal weapons are used in law enforcement to neutralize combative individuals and to disperse riot crowds. Local police recently used such an impact weapon, the Flash-Ball®, in two different situations. This gun fires large rubber bullets with kinetic energies around 200 J. Although it is designed to avoid skin penetration, impacts at such energies may still create major trauma with associated severe injuries to internal organs. This is a report of 2 patients shot with the Flash-Ball® who required medical attention. One could be discharged quickly, but the other required hospitalization for heart and lung contusion. Both patients required advanced investigations including computed tomography (CT) scan. The medical literature on injuries induced by less-lethal impact weapons is reviewed. Impacts from the Flash-Ball® can cause significant injury to internal organs, even without penetration. Investigations as for other high-energy blunt traumas are called for in these cases.

Introduction

Less-lethal weapons are designed to incapacitate individuals rather than to induce fatal injuries. This property makes them interesting in law enforcement, where the use of force is often mandatory to neutralize combative individuals or to disperse riot crowds, but the risk of injury to the target, the officers and bystanders has to be kept to a minimum (1, 2). In many countries, less-lethal weapons are not subject to ownership restrictions as severe as for other weapons, thus also making them attractive for self-defense (3, 4).

Some years ago, police forces of the city of Lausanne, Switzerland, were equipped with the Flash-Ball®, a firearm designed to fire various types of ammunition at muzzle kinetic energies close to 200 J. One of the possible types is a rubber ball designed to deliver a blunt impact. The manufacturer describes this gun as a “revolutionary defence weapon,” with a “dissuasive look and detonation” that “provokes on impact the equivalent of a technical K.O.,” thus making it “an impressive and effective intelligent weapon.” This weapon was recently used by the local police force’s special operations team to neutralize threatening individuals.

We report 2 patients who required medical attention after being shot with this weapon. Medical data on injuries inflicted by similar less-lethal impact weapons available in the literature is reviewed and basic ballistics are discussed.

Section snippets

Case 1

A 22-year-old man was brought to the Emergency Department (ED) after a loss of consciousness during political demonstrations that took place on a hot and sunny day. He had no complaints upon arrival. As the clinical examination revealed several small round contusion marks on the abdomen and the thighs (Figure 1), he admitted having been hit some hours before by rubber bullets fired by anti-riot police forces. No detailed information regarding this event could be obtained from the patient. The

Case 2

A case of domestic violence was investigated by a night patrol of the police. The officers encountered a threatening young man armed with a 30-cm long knife, who showed evident signs of psychological disturbance. He barricaded himself in his apartment. This prompted the officers to call in the Special Operations team. Negotiations were fruitless and the man started to mutilate himself. He was finally neutralized with the Flash-Ball® gun and immediately transported to the ED for medical

Discussion

Less-lethal technology encompasses a wide array of weapons based on delivery of kinetic energy, chemicals or electromagnetic energy, designed to incapacitate individuals without inducing lethal injury (2, 5, 6). Although suppliers often underscore the non-lethal character of these weapons, the term less-lethal reflects more accurately the recognized potential of serious injury, even when these weapons are used in optimal conditions. The terminology “less-lethal” furthermore carries potential

Conclusion

The energy delivered by less-lethal impact weapons is high enough to cause relevant injuries in a significant number of cases. The absence of skin penetration must not mislead the emergency physician into minimizing the potential damage from this kind of weapon. The impact from such a weapon must be considered as a high-energy blunt trauma and be evaluated accordingly. Although less-lethal weapons offer interesting alternatives to law enforcement agencies to subdue combative individuals or to

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In 2018, the French “Yellow Vest” social protest movement spread with weekly demonstrations resulting in confrontations between protesters and law enforcement. Non-lethal weapons, such as defensive bullet launchers (DBL) were used, and significant injuries have been reported through media, leading to public controversy regarding their use. These injuries are not well-known to civilian emergency physicians.
The aim of this study is to describe the injuries caused by DBL among Emergency Department (ED) patients during these demonstrations and to identify the characteristics that required specialized care and hospital admission.
A multicenter retrospective study was conducted in 7 EDs of academic hospitals in Paris, France. Adult ED patients who presented with DBL injuries during “yellow vest” strikes between November 2018 and May 2019 were included. The primary outcome was the rate of DBL patients requiring hospital admission. We also compared the characteristics of the injuries and the care provided between the admitted patients and other DBL patients.
152 patients were included. 17% were admitted to hospital, with 19% of them being transferred to intensive care units. 49% of all patients had head, face, eye or neck injuries including 4 cases of intracranial hemorrhage, 1 carotide dissection, 1 laryngeal edema, 1 pneumencephalus. 11% of all patients presented with multiple wounds, and 28% had fractures (77% of admitted patients vs 18%, p < 0.001). Surgery was required for 20% of all patients (62% of admitted patients vs 10%, p < 0.001). Maxillofacial surgery was performed on 38% of admitted patients, orthopedic surgery on 25%, and neurosurgery on 13%. No death were reported.
The use of DBL during the “yellow vest” civil strikes was associated with a high rate of head, face, eye or neck injuries among injured ED patients. Hospital admission was associated with a higher rate of fractures, with most of them requiring maxillofacial, orthopedic and neurosurgeries.
Clinical spectrum and functional outcome of firearm pellet-related eye injuries: A prospective follow-up study
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To determine the prognostic significance of various clinical features and surgical techniques concerning anatomical and visual outcomes in shotgun pellet-inflicted ocular trauma.
This prospective follow-up study was done at a tertiary care institute in Kashmir, India. Six hundred sixty-four eyes of 643 patients with firearm pellet-related ocular trauma were followed up for 6 months.
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An anatomical success rate of 66.3% (n = 250) was achieved for 56.8% (377/664) eyes requiring an average of 2.8 (SD 0.5) surgeries per eye. OGI was associated with poor outcomes in 259 (57.4%) and CGI with good outcomes in 200 (93.9%) eyes. The visual outcome had a significant association with grade and zone of injury both in OGI and CGI, and with the type of injury in OGI (p < .0001 each). Ocular trauma score (OTS) had a significant association with the degree of vision impairment (p < .0001). WHO category 0 visual impairment was seen in 270 (40.7%) eyes, category 1 in 85 (12.8%), category 2 in 35 (5.3%), category 3 in 30 (4.5%), category 4 in 172 (25.9%), and category 5 in 72 (10.8%) eyes irrespective of type of injury at 6 months post-treatment.
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Law enforcement officers have adopted the use of non-lethal weapons to mitigate civilian casualties incurred by firearm use over recent years and decades. These weapons include, but are not limited to, TASER, beanbag rifles, pepper spray, tear gas, and Flash-ball guns. Nonetheless, severe injuries and even deaths do occur with use of these weapons, in rare instances. This review aims to comprehensively discuss these cases and associated injuries, as well as their according findings on imaging studies. It will also examine how often injuries occur in situations with non-lethal weapons.
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The burden of fatal police violence is an urgent public health crisis in the USA. Mounting evidence shows that deaths at the hands of the police disproportionately impact people of certain races and ethnicities, pointing to systemic racism in policing. Recent high-profile killings by police in the USA have prompted calls for more extensive and public data reporting on police violence. This study examines the presence and extent of under-reporting of police violence in US Government-run vital registration data, offers a method for correcting under-reporting in these datasets, and presents revised estimates of deaths due to police violence in the USA.
We compared data from the USA National Vital Statistics System (NVSS) to three non-governmental, open-source databases on police violence: Fatal Encounters, Mapping Police Violence, and The Counted. We extracted and standardised the age, sex, US state of death registration, year of death, and race and ethnicity (non-Hispanic White, non-Hispanic Black, non-Hispanic of other races, and Hispanic of any race) of each decedent for all data sources and used a network meta-regression to quantify the rate of under-reporting within the NVSS. Using these rates to inform correction factors, we provide adjusted estimates of deaths due to police violence for all states, ages, sexes, and racial and ethnic groups from 1980 to 2019 across the USA.
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Violence: Recognition, management and preventionInjury pattern of the Flash-Ball®, a less-lethal weapon used for law enforcement: Report of two cases and review of the literature

Abstract

Introduction

Section snippets

Case 1

Case 2

Discussion

Conclusion

Lancet

Br J Oral Surg

Lancet

Lancet

Injury

J Emerg Med

Ann Emerg Med

J Emerg Med

Future police operations and non-lethal weapons

Med Confl Surviv

Impact munitions. Data base of use and effects

Gunshot wounds caused by Fiocchi Anticrime Cartridges (plastic bullets)

Am J Forensic Med Pathol

Violence: Recognition, management and prevention
Injury pattern of the Flash-Ball®, a less-lethal weapon used for law enforcement: Report of two cases and review of the literature