According to a San Diego County deputy medical examiner, there is reason to believe sheriff deputies’ use of force resulted in the death of Vanessa Facen, a 35-year-old pre-operative transsexual who was arrested last November for a residential burglary.

Following Facen’s death, Sgt. Rick Empson, a sheriff’s homicide investigator, told The Associated Press and recently restated to the Gay & Lesbian Times that there “is nothing to indicate that the use of force caused this death.” However, San Diego County Deputy Medical Examiner Christopher Swalwell, M.D., said that the deputies’ use of force did, in fact, play a role.

“I am not sure what they mean that there’s not a relationship between the restraint and the death because there certainly is a relationship in terms of the sequence of events and when the arrest occurred,” Swalwell told the Gay & Lesbian Times in response to Sgt. Empson’s statement. “There is a connection between the restraint and the death because the arrest occurred during that time, and the implication is that it did play a role in the death.”

Swalwell determined Facen’s death to be an accident, based on the County of San Diego Office of the Medical Examiner five classifications: natural causes, suicide, homicide, accident and undetermined.

“Because of the circumstances of the restraint, in my mind, that takes it out of the realm of being natural causes because there were other people involved; there was restraint,” he said. “… Whether we call it an accident, or even if we call it a homicide, it doesn’t imply necessarily any wrongdoing. I mean, there may or may not be culpability on somebody’s part. That’s a legal determination. That’s not a medical determination.”

According to the San Diego Medical Examiner’s report, deputies were dispatched to Terracina Circle in Spring Valley after Facen was reported as a prowler. Facen broke through a second story window in her neighbor’s townhouse, fell to the first floor, and was found naked and bleeding inside the home.

Due to lacerations on her arms from breaking the house window, Facen was transported via paramedics to Sharp Grossmont Hospital. Along the way, according to the report, she became violent and combative. The ambulance stopped on the side of the freeway at one point, where Facen was pepper sprayed twice and locked inside. She proceeded to kick out a window of the ambulance, the report said.

When La Mesa Police Department officers arrived, Facen was “tazed” with a tazer gun four times before she became compliant.

Facen was treated in the Grossmont emergency room for arm lacerations sustained in the burglary, and again became combative. She was sedated and restrained, and a spit sock – a protective device that prevents the transfer of spit – was placed over her head. According to the report, she later became compliant with medical staff and the spit sock was removed.

Facen was then discharged and transferred to the San Diego County Correctional Detention Facility. Her legs were secured with leg chains and her arms were secured to a waste chain. A spit sock was again placed over her head. Upon arrival at the detention facility, Facen became agitated and began to kick the cage of the patrol car while attempting to spit through the spit sock. The report also said she removed the spit sock using the cage of the vehicle.

At that point, Facen was pepper sprayed again. The deputies requested two bed sheets to put over her head to prevent being spit on. She remained aggressive and noncompliant and was struck with a baton to the thigh and bicep. She was placed in prone position face down, handcuffed behind the back and then placed onto a gurney, again in prone position. Pressure was placed on her legs, head and torso to control her movement. After a few minutes of struggling, she became unresponsive and did not have a pulse, the report said.

Swalwell, who performed Facen’s autopsy, said she died of hypoxic/ischemic encephalopathy due to cardiopulmonary arrest during prone restraint for aggressive and psychotic behavior. Her toxicology report revealed the presence of cannabinoids. Common drugs of abuse, such as cocaine or methamphetamine, were not detected.

“The hypoxic/ischemic encephalopathy refers to the damage that the brain gets when there is lack of oxygen, so it’s just the result of having his heart stop and there being a lack of oxygen to the brain for a period of time,” Swalwell said. “The second part of the cause of death, the cardiopulmonary arrest, just refers to the fact that the heart and lungs stopped at some point, and that was during the time that there was restraint, prone restraint ….”

Swalwell said the prone position could have caused an obstruction of airflow that may have lead to Facen’s death.

“Well, there is the possibility that being in [prone] position can interfere with one’s ability to breath normally, and this is actually kind of an area of controversy in the forensics field in terms of how much of an effect that can have,” he said. “There have been a number of cases similar to this where a person has been in an altercation with law enforcement, and the usual story is that they end up being handcuffed and put down prone on the ground. There may be, or there usually are, officers holding the person, maybe even putting pressure on their back or on their torso to keep them restrained in that position, and then at some point they usually become unresponsive.”

Given Facen was 35 years old, had no history of heart disease and was not under the influence of cocaine or methamphetamines, Swalwell said under normal circumstances he would not expect Facen to have a cardiac or respiratory arrest.

When asked if sheets wrapped around Facen’s head could have contributed to the hypoxic/ischemic encephalopathy, Swalwell said he could not determine if her death was caused by the cardiac arrest or a failure of the respiratory system.

“[W]e really don’t know for sure whether it’s a primary heart event or respiratory that’s the initial thing that started it,” he said. “But, obviously, once the heart stops, you’re not going to continue breathing for long, and the same thing the other way around … which is why we say cardiopulmonary because it refers to both the heart and lungs.”

Sgt. Empson said he could not comment on any specifics because the case within the Sheriff’s Department has not been finalized.