When police and National Guard troops mobilized during protests that broke out across the nation this spring following the death of George Floyd, they often resorted to the use of so-called "beanbag" rounds of ammunition when confronting crowds.
Beanbag rounds -- a small cloth bag filled with lead shot and fired from a standard shotgun -- are thought to be strong enough to cause pain but not serious harm.
However, a new study by emergency physicians in Austin, Texas, suggests otherwise.
They report a number cases of severe, maiming injuries -- including skull fractures, brain hemorrhages and broken jaws -- all in young protesters hit by beanbag rounds.
Although they are "purported to be 'less lethal' munitions that should not cause penetrating injuries," beanbag rounds "can cause serious harm and are not appropriate for use in crowd control," concluded a team led by Drs. Kristofor Olson and Laura Haselden, of the University of Texas at Austin Dell Medical School.
Writing in the Aug. 14 issue of the New England Journal of Medicine, the doctors noted there's been "scarce" literature to support or refute the notion that beanbag munitions don't cause serious harm.
Hoping to rectify that, the Austin team catalogued a list of 19 patients, most in their teens or 20s. All received emergency treatment at an Austin hospital located blocks from where protests broke out this spring.
Eight of the patients had injuries so severe they required admission to the hospital, and seven required emergency surgeries.
Four of the patients had remnants of beanbag rounds lodged within their bodies, the doctors noted. Four patients sustained "intracranial hemorrhages" after being hit by beanbag rounds, and fractures to the skull, face and jaw were common.
A list of a few of the worst injuries included:
According to the Austin team of physicians, all of this runs counter to the scant prior research on beanbag round injuries -- which typically reported only "minor blunt-injury patterns."
However, following the protests and reports of serious injuries, "beanbag rounds have since been abandoned by our local law enforcement in this context," the researchers noted.
Dr. Robert Glatter is an emergency medicine physician practicing at Lenox Hill Hospital in New York City. Reading over the report, he said "the bottom line is that 'less lethal' does not necessarily mean without harm or serious bodily injury."
Simply put, Glatter said, "bean bag rounds can be deadly and result in injuries which are permanently disabling. This includes not only blunt but penetrating types of injuries."
And while police typically have guidelines in place regarding the use of beanbag munitions, they are too often ignored.
"Law enforcement is taught to aim such munitions at the lower extremities, to avoid traumatic injuries to the head, chest and abdomen," Glatter noted. "But the reality is that these rounds often don't end up where they are initially aimed at from a shotgun -- potentially leading to skull fractures, bleeding in the brain, along with serious eye injuries and facial fractures."
His conclusion: "Law enforcement should seek alternative approaches for de-escalation and crowd control, especially when confronting peaceful protesters."
Find out more about emergency care at the American College of Emergency Physicians.