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Investing as a Community: Analyzing Strangulation Cases & Implementing a MDT Strangulation Protocol to Reduce Domestic Violence Homicides.

Ashanti Hunter (Ashanti) was a mother, daughter, and cousin with a very bright future. Ashanti's family recalls that she was "the brain of the family, graduating high school at 16 with a perfect GPA." (1) After high school, Ashanti enlisted in the United States Air Force at age seventeen. Unfortunately, this loving mother of three would never realize her ultimate potential because her longtime boyfriend, Albee Lewis (Lewis), brutally murdered her on April 30, 2017.

Earlier that day, Ashanti and Lewis had an argument. Ashanti was trying to get away from Lewis. As she attempted to leave, Lewis strangled her. Ashanti eventually escaped from her apartment with two of her children. As Ashanti sat in the passenger seat of her cousin's car, having finally gained the strength to leave her abuser, Lewis shot her at point blank range in front of her children and family. Ashanti's two children, soaked in their mother's blood, literally watched the life leave their mother's body as she took her last breath right before their innocent eyes.

Before her murder, Ashanti and Lewis dated for five years. And although she would frequently complain of Lewis being verbally and physically abusive, she hadn't tried to leave until that fateful day of April 30, 2017. A thorough review of police reports show that Ashanti called police on multiple occasions, yet no criminal charges were ever authorized. Those reports include incidents of simple assault, harassment, and most importantly STRANGULATION, known in Texas as Impeding Breath or Circulation.

A summary of Ashanti's prior abuse allegations reports are listed below:

* Incident #1, 3/19/14 -- Lewis grabbed Ashanti by the neck and STRANGLED her and punched her in left cheek three times.

* Incident #2, 2/25/15 -- Lewis STRANGLED Ashanti until she felt like she was going to pass out and told her she would die if she left him. Ashanti reports that she starts to lose faith in system.

* Incident #3, 7/26/15 -- Lewis bends Ashanti's arm upward causing pain. Later, Lewis comes back and kicks in the door.

* Incident #4, 12/10/16 -- Lewis argued with Ashanti for money and he threw her to the ground. Ashanti was holding knife in self-defense when police arrive.

* Incident #5, 2/7/2017 -- Lewis struck Ashanti in her face. Ashanti did not want to press charges because she was in fear that Child Protection Services would be involved and didn't want him in jail.

* April 30, 2017 -- 87 days later, Lewis STRANGLES Ashanti and although she escapes to a vehicle to flee, he murders her in front of her children and family.

Sadly, the system failed Ashanti. But on May 1, 2017, determined that Harris County, Houston, TX would learn from this tragedy and improve our community's response, District Attorney Kim Ogg, who had just been sworn into office five months prior, assigned me the task of evaluating Ashanti's murder and the series of incidents mentioned above. My task was clear yet comprehensive. As the Division Chief of the Family Criminal Law Division (FCLD), I was asked to determine the systemic gaps that existed within our criminal justice system that allowed Ashanti to suffer in silence for so many years, without the intervention and support of law enforcement. Ashanti's brutal murder, as she was trying to flee her abuser, is a sobering occurrence that happens too frequently within our communities. "With distressing frequency, domestic violence ends, not in escape and reconstruction of the woman's life, but in murder or murder/suicide." (2) In the United States, three women are killed each day by their intimate partners. (1) And while strangulation is not the cause of death for all domestic violence homicides, evidence of prior [non-fatal] strangulation, like that experienced by Ashanti in the years before her death, "inhabits a category all its own in domestic violence as a marker of lethality. A kick, a punch, a slap, a bite--none of these, though terrible, portend homicide like strangulation does." (4) Accordingly, understanding dangerousness and lethality factors like strangulation are critical to developing an effective response to domestic violence and preventing domestic violence homicides.

Domestic violence is a pattern of behavior used to establish power and control over another person through fear and intimidation, often including the threat or use of violence.' Best practices suggest that all domestic violence cases should be screened for potential lethality with strangulation being one of the highest rated lethality factors. Harvard Law Professor Diane Rosenfeld notes "strangulation is not only a reliable indicator of future homicide attempts or actual homicides but also as an apt metaphor for the control abusers often exert over their victims." (6) The mere presence of strangulation in a situation of domestic abuse increases the chances of homicide sevenfold. (7) Strangulation is a clear trajectory from escalating violence to homicide, of which strangulation is the penultimate act. (8) Gael Strack, chief executive of the Training Institute on Strangulation Prevention in San Diego, CA, provides "statistically, we know that once the hands are on the neck, the very next step is homicide. They don't go backwards.'' (9) And while no police officer, prosecutor or advocate can see into the future nor guarantee that a woman (10) won't be murdered by her intimate partner, domestic violence homicides are so predictable as to be preventable. (11)

Domestic violence cases that result in murder are not a random sample of domestic violence cases. Death is far more likely when certain factors [such as strangulation and weapons are present] than when they are absent. (12) "While the number of women murdered by their intimate partners is only a small percentage of women who report being beaten and abused, these murders have enormous symbolic value. They are the background against which so much sublethal violence is committed. [Like Ashanti], many battered women do not know whether the next beating will be a fatal one." (13) Because batters wield power and control over their victims, they constantly manipulate their victims, making them acutely aware that murder is always a possibility. Harris County internal case research proves that victims who experience non-fatal strangulation by an intimate partner, are at the highest risk for escalating violence or homicide. Recognizing this, communities should prioritize domestic violence by developing coordinated community responses that include innovative prosecution strategies that consider "the level of potential dangerousness in any domestic violence case [particularly strangulation] and creates an effective response that focuses on offender containment to keep the victim safe." (14) Accordingly, this article will focus on the dynamics of strangulation, effective prosecuting strategies for non-fatal strangulation cases, and how a coordinated community response can effectively support strangulation victims, while achieving the ultimate goal of preventing domestic violence homicides.


In 2014, the U.S. Sentencing Commission recognized strangulation as a marker of dangerousness and recommended increased prison time--up to 10 years--for those convicted of it. (15) Currently, 45 states, including Texas now recognize strangulation as a felony. (16) In 2009, the Texas Legislature passed a law codifying family violence strangulation or suffocation as a third degree felony punishable from 2 to 10 years for the first offense and 2 to 20 years for subsequent convictions. Texas Penal Code Section 22.01 part, that "... the offense is committed by intentionally, knowingly, or recklessly impeding the normal breathing or circulation of the blood of the person by applying pressure to the person's throat or neck or by blocking the person's nose or mouth. (17) In a pamphlet designed to educate advocates and survivors about strangulation, the Texas Council on Family Violence explains:
"Strangulation is impeding the normal blood flow and/ or the airflow by
applying external pressure to the neck or throat. Depriving oxygen (via
the blood) to the brain causes unconsciousness in as little as 10
seconds, then permanent injury (such as difficulty in concentration and
loss of short-term memory capacity). If uninterrupted, strangulation
may lead to death in as little as two minutes. Strangulation can be
accomplished in various ways including: ligature, manual, and hanging.
Ligature is the use of an object such as a piece of rope, chain,
clothing, phone cord, or other material to strangle another person.
Manual is the use of one's body parts as weapons, such as hands or
arms, to strangle another person. Manual strangulation can also be
accomplished by placing the neck of the victim in the crook of an arm
or leg, or by placing a foot or other body part onto the victim's neck
or throat. Hanging is suspension by a cord wrapped around the neck.
Suffocation is another method of stopping the flow of air to the brain.
It involves covering the mouth and/or nose and can be done with hands
or with an object such as a plastic bag or pillow. Suffocation is just
as potentially lethal as strangulation." (18)

After the Texas strangulation law was passed, law enforcement and prosecutors were given the authority to investigate and charge offenders for this potentially lethal crime as a third-degree felony. Gone were the days were a man could strangle a woman and he'd only be arrested for a Class A Misdemeanor--Assault Family Member charge. Thus, it can be inferred that the legislature's intent was to prioritize the safety of strangulation victims, by holding their abusive family members accountable at a felony level. After all, when an abuser strangles a victim, he takes on the role of "God" demonstrating to the victim that he can take her life, at any given time, which makes terrorizing the victim that much easier. Notably, although Texas enacted a powerful statute designed to increase offender accountability and protect strangulation victims, the legislature did not provide the requisite framework for law enforcement officers and prosecutors who are charged with enforcing the law. Accordingly, nine years later, non-fatal strangulation cases aren't being investigated (because they don't know what/how to ask), aren't being filed (because prosecutors don't understand the evidence), and are getting dismissed. (19) Sadly, this means that abusers are not being held accountable and continue to wield power and control over their victims.

a. Strangulation Poses a Safety Threat to Law Enforcement Officers

The failure to establish a consistent investigative framework for strangulation cases is also concerning because studies indicate that 30-50% of perpetrators who kill police officers have a documented public record of intimate partner strangulation. See Diagram 1.

Diagram 1

2013 Treasure Valley (ID) Study

* Evaluated ten officer-involved critical incidents where officer shot a suspect or suspect shot an officer

* 80% of suspects with domestic violence history

* Non-fatal strangulation history in 30%

* Based only on public records history

* More research needed

* We all should be looking for it/tracking it

Riverside County

District Attorney's Office 2013 Study

Gerald Fineman, J.D.

* Law enforcement officers killed in the line of duty

* 1993-2013

* 50% of officers were killed by a criminal suspect with a public records act history of strangulation assault against a woman in a prior relationship.

In 2017, more officers were shot responding to domestic violence than any other type of firearm-related fatality, according to the National Law Enforcement Officers Memorial Fund. (20) This statistic is no doubt due to the fact that domestic violence offenders (including stranglers) tend to lack respect for authority. So when confronted by law enforcement, batterers often react violently and become defensive when they perceive that they are losing power and control. The propensity for stranglers to explode and harm or kill an officer is greater since strangulation is an escalating form of violence, only second to homicide.

b. Mass Shooters Have History of Intimate Partner Strangulation

Research also shows that mass shooters often have a history of intimate partner strangulation. An example of this correlation can be seen in the Sutherland Springs, Texas mass shooting in November 2017. In 2012, gunman, Devin Patrick Kelley, was convicted of domestic violence while stationed at Holloman Air Force Base in New Mexico. Notably, during the 2012 assault, Kelley also strangled his wife. In her Washington Post editorial, Rachel Snyder powerfully opines, "if the particular severity of his violence had been better understood and recognized in New Mexico, 26 people, including a 17-month-old baby named Noah, might not have been killed in Sutherland Springs, Tex., this month." While some may argue that Synder's opinion is conjecture, she substantiates my aforementioned position that many jurisdictions and keepers of justice are unfamiliar with the severity of strangulation and often miss opportunities to identify strangulation, which poses a great threat to public safety. Synder also highlights the following mass shooters who had a history of intimate partner of strangulation (21):

* Omar Marteen--On June 12, 2016, the Orlando Pulse nightclub shooter, choked both of his wives, yet was never charged or prosecuted for strangulation.

* Cedric Ford--Prior to fatally shooting three of his co-workers and injuring 14 others in Kansas on February 25, 2016, Ford was charged only with misdemeanor domestic violence for choking his ex-partner.

* Esteban Santiago--On January 6, 2017, Santiago killed five people and injured six in a shooting at the Fort Lauderdale Airport. He had been charged with a misdemeanor after strangling his ex-partner.

These case studies demonstrate that intimate partner strangulation is a characteristic of mass shooters. Yet strangulation, as a signal of dangerousness, is overlooked by most law enforcement officers. As discussed below, most strangulation injuries are not visible enough to photograph, and police often don't know to look for other non-visible signs. (22) As a result, injuries are often downplayed in police reports. In sum, Synder correctly states "it wasn't that Kelley operated under the radar; it was that authorities failed to see and then act on the clues he was leaving," and as a result, innocent lives were lost. (23) By strategically prosecuting strangulation offenders, we can deter future violence and prevent homicides, which ultimately makes our communities safer.


Domestic violence cases can be multi-dimensional and time-intensive, yet often follow a familiar pattern. Successfully evaluating high-risk felony and recanting victim cases requires specialized knowledge in law and victim/perpetrator behavior. Furthermore, a county's size and/or the complexity of the systems providing services coupled with the sheer number of victims who need access to services and safety, can create unintended barriers to communication, coordination, and collaboration to improve the systemic responses to victims of domestic violence. Thus, there is a need to centralize services and systems, improve communications across disciplines, and develop written formal protocols that seek to improve access to services and safety for victims, hold perpetrators accountable, and reduce and prevent future incidents of violence. This is particularly true with regard to strangulation cases where there is little to no evidence of obvious injury. (24)

a. Visible Injuries

A Harris County police report, pre-May 2018, may provide the following statements from a strangulation victim--"I couldn't breathe," or "My neck is sore." Those statements, alone, are not enough to prove a strangulation case beyond a reasonable doubt. And because the majority of strangulation cases will not have external injuries visible to the human eye, prosecutors are often left with insufficient evidence to meet their burden of proof. However, if strangulation victims were offered a forensic medical exam, a trained medical professional could identify signs and symptoms not easily noticed by law enforcement or an advocate. Kelsey McKay, former Travis County Asst. District Attorney and national strangulation expert explains, "a half-moon-shaped abrasion may exist on the back of the victim's neck, hidden under her hair if her hair is long. (21) Though the mark may only be a few centimeters in size, it could corroborate a victim's account that the defendant's hands wrapped around her neck and could indicate the point where the defendant's finger dug into her skin. (26) McKay also notes that defensive marks on the perpetrator are also evidence that can corroborate a victim's strangulation account. For example, photos of a bite mark on an offender may be presented by the defense to argue that the victim was actually the aggressor. McKay skillfully explains that "victims often bite their assailants in an attempt to get them to release their grip." (27) Accordingly, having a good understanding of the positions of both parties can help a prosecutor explain to a jury how the strangulation occurred and why a bite mark would be consistent with a victim's account. (28)

The presence of petechiae can also aid prosecutors in proving strangulation cases. Petechiae is a phenomenon that suggests a particularly vigorous struggle between the victim and assailant. Petechiae may present due to ruptured capillaries--the smallest blood vessels in the body--and sometimes may be found only under the eyelids (conjunctivae). (29) However, petechiae may also be found around the eyes, anywhere on the face, on the neck, and above the area of constriction. (30) Petechiae tend to be most pronounced in ligature strangulation. (31) This is significant because for petechiae to occur, some amount of pressure had to be placed on a victim's neck that occluded the jugular vein. (12) At the same time, the absence of petechiae does not mean that strangulation didn't occur. Like many other visible injuries consistent with strangulation, petechiae can often be overlooked. (33)

b. Non-visible signs & symptoms

There are many ways a batterer can strangle a victim. The level of injuries and symptoms will depend on many different factors including the method of strangulation, the age and health of the victim, whether the victim struggled to break free, the size and weight of the perpetrator, the amount of force used, etc. (34) Therefore, it is important to ask the victim to demonstrate how she was strangled and to ask follow-up questions that will elicit specific information about the signs and symptoms that can corroborate strangulation. This is helpful evidence for prosecutors to rely upon since 50-60% of domestic violence victims either recant or minimize their criminal episodes. Follow-up questions can be easily asked by a responding officer, advocate or a forensic medical provider.

In an effort to gather better evidence for the investigation and prosecution of non-fatal strangulation cases in Harris County, the Harris County Strangulation Taskforce worked with Kelsey McKay to develop the Harris County Strangulation Supplement, which is used by every law enforcement agency when responding to a strangulation crime scene. Effective May 4, 2018, the District Attorney's Office mandated the use of this supplement before intake prosecutors can accept strangulation charges against a intimate partner or family member. The strangulation supplement includes open-ended questions, checkboxes for signs, symptoms, and injuries, and a diagram of the victim's neck at different angles (35) and has drastically enhanced the investigation of our non-fatal strangulation cases. Officers are identifying the signs and symptoms of strangulation without visible injuries and are appropriately engaging local paramedics as needed. As a result, Harris County prosecutors now have sufficient evidence to prosecute stranglers and gain convictions, which work to decrease recidivism. A 2017 v. 2018YTD comparison shows that since implementing countywide strangulation training and the strangulation supplement, the District Attorney's Office is filing on average 50% more strangulation cases every month. This increase, while sobering, is proof that prior to 2017 our community was not properly recognizing strangulation nor appreciating the severity of the offense, which can be directly attributed to our incredibly high domestic violence homicide rate.

c. Utilizing Medical Forensic Testimony to Prosecute Strangulation Cases

Medical forensic examinations are an important part of any coordinated community response to interpersonal violence. Sexual Assault Nurse Examiner (SANE) programs have become the standard of care for many jurisdictions around the country. (36) Medical forensic services are proven, in literature, to be an important link between the victim and other services and entities, including law enforcement. Studies have also demonstrated an improved patient experience when specially trained forensic nurses are utilized. (37) Forensic-nurses, more commonly known as SANE nurses, typically perform sexual assault examinations. However, research shows that forensic nursing can also enhance the prosecution of strangulation cases. Forensic nurses are the missing link in many domestic violence investigations. Because nurses have been named the most trusted professionals for 16 years in a row, it stands to reason that a strangulation victim would be more comfortable sharing their criminal episode with a nurse during the course of medical treatment than with a police officer.

Post-exam, forensic nurses can provide a detailed forensic record to investigators and prosecutors, which will enhance the charging and prosecuting offenders. Forensic nurses can also provide prosecutors a consistent team of experts to interpret medical records and answer questions related to strangulation symptoms, and DNA collection etc. Establishing a supportive relationship with your community's forensic nurses will empower forensic nurses to provide expert witness testimony on strangulation cases at trial, which will improve conviction rates. Even when the victim has not obtained medical treatment, it is important to use forensic nurses or medical experts like paramedics, to educate the jury and the judge about the seriousness of strangulation. (38) Jurors and judges need to know that strangulation can cause unconsciousness within seconds (39) and death within minutes (40). They also need to know that symptoms are important evidence of strangulation and that victims can die from strangulation without a single mark. (41) Medical forensic testimony is one of the most effective tools in a prosecutor's toolbox. The victim's history, which is taken for the purpose of medical diagnosis and treatment, is admissible and can be later utilized by prosecutors, even if the patient decides not to participate in the criminal justice process. (42)


When the state intervenes effectively in a domestic situation, it can prevent violence from escalating. (43) On the other hand, the lack of a coordinated community response will leave battered women in a more dangerous situation--even worse off than if she had not sought help from the criminal justice system in the first place. (44)

a. Strangulation Taskforce

The Harris County Strangulation Taskforce is an example of how a community can design systems and protocols to maximize resources and reduce complexity to access for domestic violence survivors. Prior to the establishment of the Harris County Strangulation taskforce, approximately 47% of all strangulation cases were being dismissed or no billed for lack of evidence. Recognizing that a concise and coordinated strangulation protocol is critical to victims' survival, the taskforce is developing a strangulation protocol that encompasses a coordinated response by law enforcement, forensic nurses, EMS providers, hospitals, and the District Attorney's Office concerning strangulation cases. Criminal justice partners and community stakeholders who have identified clear gaps in service support the taskforce's work and are hopeful that the successful implementation of the strangulation protocol will lead to a decrease in the county's homicide rate.

To develop an effective coordinated community response, communities should incorporate a strangulation protocol that:

1. Develops, trains and enforces policies and service delivery standards for law enforcement and first responders who respond to strangulation crime scenes.

2. Removes barriers to access services offered by criminal justice system and community-based advocates such as obtaining protective orders, the court process, and general education about the cycle of violence and effects of domestic violence and strangulation on a victim and their family unit.

3. Supports efforts to restore the strangulation victim's well-being by decreasing the amount of time to triage the victim for services.

4. Facilitates the coordination of services such as medical forensic treatment, crisis counseling, and shelter/alternative housing placement offered by community partners and domestic violence agencies.

5. Enhanced offender accountability via aggressive and innovative prosecution strategies that include early case evaluation, expanded offender containment options, intensive supervision, and increased conviction rates.

b. Loss of Life is the Catalyst for Change: Planning to Prevent Domestic Violence Homicide

Harris County has the highest number of domestic violence homicides than any other county in Texas. In 2017, 36 citizens were killed as a result of domestic violence. In 2016, 28 women were murdered. In 2017, the Harris County District Attorney's Office filed an unprecedented 7,809 domestic violence charges. (46) Approximately 1,407 of the 7,809 cases were non-fatal strangulation cases. By utilizing research-based analysis of these cases, we also discovered that victims in specific, underserved cultural communities are less likely to seek domestic violence services due to religion, customs, or family obligation. As a result, domestic violence victims in these communities do not receive the education, training, protective order services, or outreach needed for comprehensive care and sustainable safety, which makes the need for a coordinated community response even more evident.

1. Cultural Outreach Program (COP)

Currently, the Harris County District Attorney's Office's family violence social service staff can only assist domestic violence victims if they come to our office. However, due to the overwhelming number of victims traumatized by domestic violence in Harris County and our large geographical footprint, we discovered that one centralized office to serve all domestic violence victims is not the most effective service model. Additionally, due to Hurricane Harvey, our office was relocated from the downtown courthouse complex to a location not easily accessible due to a lack of public transportation and other barriers such as finances and childcare. As a result, District Attorney Kim Ogg authorized our division to create the Cultural Outreach Program (COP), which allows the division to extend its throughout Harris County and particularly to underserved communities that arc plagued with domestic violence. Specifically, COP will provide protective order services to culturally specific immigrant and minority communities who are more vulnerable to intimate partner violence due to factors unique to their nationalities. The COP program will allow family violence social workers to co-locate in community agencies to offer protective order services, criminal justice education, crisis intervention, and safety planning.

2. Domestic Abuse Response Team (DART)

Although best practices suggest that danger assessments be conducted on all domestic violence cases, equally important, is what happens to that information once a [danger] assessment is complete. When a case screens in as high risk, there must be a team, to create a safety net around the victim and hold the offender fully accountable." (47) To that end, the Harris County District Attorney's Office is also working with law enforcement officers to support high-risk domestic violence survivors through the development of the Harris County Domestic Abuse Response Team (DART). DART is a mobile crisis response team that will engage high-risk domestic violence victims, thereby closing the gap that currently exists and often inhibits victims' access to resources to facilitate their safety. DART is modeled after the Los Angeles Police Department's response team, which has been a key component of Los Angeles' coordinated community response to domestic violence. For purposes of this pilot, DART teams will be dispatched to "high risk" crime scenes involving 1) strangulation, 2) continuous domestic abuse, and 3) non-fatal weapons-involved offenses committed against an intimate partner or family member. Each DART team will include one victim advocate and one law enforcement officer who will be specially trained in safety, crisis intervention, and the dynamics of domestic violence.

DART teams will be dispatched at the request of a DART Prosecutor or the primary responding officer at a high-risk domestic violence crime scene. If a primary responding officer requests DART assistance, a DART team will be dispatched to a secured crime scene to meet the victim and provide immediate crisis counseling, victim stabilization, and coordinate community based services. By utilizing DART teams to triage high-risk domestic violence cases, we can facilitate the sharing of information with our newly established Domestic Violence High Risk Team and other community partners who provide long-term services for domestic violence victims, thereby empowering victims to make self-care decisions that prioritize safety. It is proven that early contact with an advocate creates a positive experience for a crime victim. Abused women who apply and qualify for a 2-year protection order, irrespective of whether or not they are granted the order, report significantly lower levels of violence during the subsequent 18 months." (48) Therefore, we can infer from this research that early intervention efforts like COP and DART will greatly contribute to victim safety and will work simultaneously to reduce Harris County's domestic violence homicide rate, which is a goal all communities should strive to achieve.


Ashanti Hunter's death was the catalyst for systemic change in Harris County. Having reported strangulation at least two of the five times she called police, the signs were evident that she was a high-risk for homicide. Strangulation is often the highest predictor of future fatality as well as an indicator for lethality to law enforcement. Through a targeted, intentional approach, Harris County has developed and implemented a strangulation supplement across law enforcement jurisdictions and is designing protocols for response by medical and advocacy personnel, to achieve improved safety, a decrease in deaths, and an increase in accountability. See Diagram 3.

And while we acknowledge that the sheer magnitude of victims and a lack of resources may prohibit communities from developing a coordinated response for strangulation victims, the potential lethality of the crime and its effects on a community should be enough for stakeholders to develop relationships among responding systems and build a solid foundation to plan and implement strategies for systemic improvement. Communities should strive to bring practitioners together to promote dialogue and resolve problems, develop a shared philosophy for how strangulation cases can be processed, and ultimately work to create a system that shifts responsibility for victim safety from the victim to the system because one life lost is one life too many.

By CARVANA CLOUD, Bureau Chief--Special Victims Bureau District Attorney's Office, Harris County (TX)


(2) Diane L. Rosenfeld (2008), "CORRELIGHTS AND THE BOUNDARIES OF FREEDOM: PROTECTING THE CIVIL RIGHTS OF ENDANGERED WOMEN," 43 Harv. C.R.-C.L. L. Rev. 257, Harvard Civil Rights-Civil Liberties Law Review.

(3) Family Violence Prevention Fund, Domestic Violence is a Serious, Widespread Social Problem in America: The Facts, available at

(4) Rachel Louise Snyder, Which domestic abusers will go on to commit murder? This one act offers a clue, Washington Post, November 16, 2017.


(6) Diane Rosenfeld, The High Risk Team Model and GPS Offender Monitoring: Stopping DV in Its Tracks, Domestic Violence Report, Volume 17, No. 3, (February/March 2012), 33.

(7) Kelsey McKay, "A Closer Look at Strangulation Cases," The Texas Prosecutor, Volume 44, Number 1, January-February 2014.

(8) Rachel Louise Snyder, "Which domestic abusers will go on to commit murder? This one act offers a clue," Washington Post, November 16, 2017. Available at

(9) Id.

(10) My reference to "men" as the abuser and "women" as the victim is supported by the fact that of those persons victimized by an intimate

partner, 85% are women and 15% are men. In other words, women are 5 to 8 times more likely than men to be victimized by an intimate partner. See Lawrence A. Creenfeld et al. (1998).Violence by Intimates: Analysis of Data on Crimes by Current or Former Spouses, Boyfriends, and Cirlfriends. Bureau of Justice Statistics Factbook. Washington DC: U.S. Department of Justice. NCJ #167237. Available from National Criminal Justice Reference Service.

(11) Diane Rosenfeld, "Law Enforcement Sends Mixed Signals," Chicago Tribune. July 30, 1994, 19.

(12) Id.

(13)" Id

(14) Diane Rosenfeld (February/March 2012). "The High Risk Team Model and GPS Offender Monitoring: Stopping DV in Its Tracks." Domestic Violence Report, Volume 17, No. 3,33.

(15) Rachel Louise Snyder, "Which domestic abusers will go on to commit murder? This one act offers a clue, "Washington Post, November 16, 2017. Available at

(16) Id.

(17) Texas Penal Code Section 22.01 (b)(2)(B).


(19) Kelsey McKay, A Coordinated MDT Response for Victims of High Risk Interpersonal Violence Cases, March 1, 2018.


(21) Rachel Louise Snyder. "Which domestic abusers will go on to commit murder? This one act offers a clue." Washington Post, November 16, 2017. Available at

(22) Id.

(23) Id.

(24) San Diego Police department reported that in 50% of Strangulation cases, there were no visible injuries. In another 35%, the injuries were too minor to photograph. Thus, in only 15% of the cases, were there obvious signs of injury.

(25) Kelsey McKay, (March 2018), "A Coordinated MDT Response for Victims of High Risk Interpersonal Violence Cases," at 21.

(26) Id.

(27) Id.

(28) Id.

(29) Strack and McCIane (1999), "How to Improve Your Investigation and Prosecution of Strangulation Cases," at 5.

(30) Id.

(31) Id.

(32) Kelsey McKay, (March 2018), "A Coordinated MDT Response for Victims of High Risk Interpersonal Violence Cases," at 21.

(33) Id.

(34) Strack and McClane (1999), "How to Improve Your Investigation and Prosecution of Strangulation Cases." at 6.

(35) For inquiries regarding the use of the strangulation supplement, please contact Kelsey McKay at

(36) OVC Bulletin (April 2001),

(37) Campbell. R., Patterson, D., Adams, A.E., Diegel, R.,& Coats, S. (2008). A participatory evaluation project to measure SANE nursing practice and adult sexual assault patients' psychological well-being. Journal of Forensic Nursing, 4(1) 19-28.

(38) Strack and McClane (1999), "How to Improve Your Investigation and Prosecution of Strangulation Cases," at 11.

(39) Deaths Allegedly Caused by the Use of "Choke Holds." E. Karl Koiwai, M.D.

(40) State v. Carter, 451 S.E.2d 157 (1994), [where expert testified manual strangulation would have taken four minutes for death to occur]; State v. Bingham, 719 P.2d 109 (1986) [three to five minutes]; and People v. Rushing, case no. SCD 114890 (1986), [court transcript where Deputy District Attorney Dan Goldstein elicited the following expert testimony from Dr. Christopher Swalwell:"The minimum amount of time to strangle somebody is somewhere around a minute to two for them to die, but obviously it could be longer."]

(41) Strack and McClane (1999), "How to Improve Your Investigation and Prosecution of Strangulation Cases," at 11.

(42) In Texas, expert witness testimony is admissible if A) made for--and is reasonably pertinent to--medical diagnosis or treatment; and B) describes medical history; past or present symptoms or sensations; their inception; or their general cause. See Texas Rule of Evidence 803 (4).

(43) Diane L. Rosenfeld (2008), "CORRELATIVE RIGHTS AND THE BOUNDARIES OF FREEDOM: PROTECTING THE CIVIL RIGHTS OF ENDANGERED WOMEN," 43 Harv. CR.-CL. L. Rev. 257, Harvard Civil Rights-Civil Liberties Law Review.

(44) When the state intervenes effectively in a domestic situation, it can prevent the violence from escalating. On the other hand, weak state intervention will leave battered women in a more dangerous situation--even worse off than if she had not sought help from the criminal justice system in the first place.

(46) Statistics provided by the Harris County District Attorney's Information Technology Division.

(47) Diane Rosenfeld (February/March 2012) "The High Risk Team Model and GPS Offender Monitoring: Stopping DV in Its Tracks," Domestic Violence Report, Volume 17, No. 3,34.

(48) McFarlanc, Judith, Dr.PH; Gist, Julia, PhD; Watson, Kathy, MS; Batten, Elizabeth, BA; Hall, Iva, PhD. (2004). Protection Orders and Intimate Partner Violence: An 18-Month Study of 150 Black, Hispanic, and White Women. American Journal of Public Health, 94(4), 613-618.
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Title Annotation:multidisciplinary teams
Author:Cloud, Carvana
Publication:Prosecutor, Journal of the National District Attorneys Association
Date:Jul 1, 2019
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