The incident at issue involved allegations that Philadelphia police officers beat a suspect.  When their further investigation cleared him of the initial criminal allegations, they left him on the street without arresting him or transporting him for medical treatment. There were officers on the scene who did not participate in the beating, but merely stood by without intervening. The proposed plaintiff suffered bruises, contusions, abrasions and broken teeth. He took himself to the hospital, where he was treated and released. He did not have medical insurance and did not receive follow-up treatment. His injuries have resolved, other than his teeth.

On its face, these facts give rise to claims for federal constitutional violations of unreasonable force¹ under the 4th Amendment to the United States Constitution, and deliberate indifference to serious medical need, under the 4th Amendment and the 14th Amendment.²   The facts also give rise to state tort claims for assault and battery.

The vehicle for bringing these constitutional violation claims is the Federal Civil Rights Act (42 U.S.C. § 1983). There is concurrent jurisdiction in state court for federal claims under § 1983, so the federal constitutional claims could be brought in either state or federal court. Likewise, the state tort claims would be supplemental claims (formerly known as pendent claims), over which the federal court has jurisdiction, pursuant to 28 U.S.C. § 1367. However, in Philadelphia, the City Law Department routinely removes state court cases with federal claims to federal court.³ The usual question for an attorney contemplating suit, then, is whether to proceed on only state law claims against just the individual officers in state court, or to proceed in federal court on federal constitutional claims and state law claims against the officers and, if warranted, the municipality.

So, if you can bring all of your claims against all possible defendants in federal court, why does all of this matter? The answer is because of different procedural rules, differences in evidentiary rules, different claims and immunities, perceived differences in the judiciary, and differences in the jury pools. I will discuss some of those factors.

The biggest reason lawyers try to keep their cases in state court in Philadelphia involves the jury pool. In the FJD, the jury pool is drawn from the contiguous confines of the City and County of Philadelphia. Federal juries are drawn from the entirety of the Eastern District of Pennsylvania, which, in addition to Philadelphia, includes the four suburban counties, as well as Berks, Lancaster, Lehigh and Northampton counties. There are certainly fewer minority members in this pool than in Philadelphia. In addition to the lack of racial diversity, the conventional wisdom also holds that federal juries are generally more conservative, and less skeptical of law enforcement.((Although our colleague Jon Feinberg argues that federal jurors look askance at the City, generally, and that this skepticism of Philadelphia includes its police and officials, and trumps their general law enforcement deference)) Federal juries are also considered to be tighter with a buck, even when they find for a plaintiff. Our experience and observation has been that Philadelphia juries are better for police misconduct cases. Like any generalization, there are fact dependent exceptions, and there is no guarantee that any jury panel you ultimately draw, should your matter reach trial, will be more or less favorable.((Also, keep in mind that if a FJD case manager or judge determines that your damages are $50,000 or less, even a case filed in the FJD as a jury demand may be remanded to the arbitration program. Although, either side has a right to a de novo trial before a jury following an arbitration decision, cases on this track receive notably less attention and consideration.))

State court cases will also probably be on a slower track than those before most federal judges in the Eastern District. If you think the case is settleable, in federal court you would have access to U.S. Magistrate Judges for early settlement conferences. Most of the Magistrate Judges are experienced and knowledgeable when it comes to civil rights cases. But keep in mind that they see the City lawyers all the time and depend on them to come up with money to settle cases, while you may be pretty much a stranger, and certain to be a less frequent visitor.

As I said, if you file in federal court, your case can include both federal civil rights claims and supplemental state law claims. Additionally, suit in federal court could include the City of Philadelphia as a defendant under a Monell((Monell v. Department of Soc. Svcs., 436 U.S. 658 (1978).)) theory (civil rights violation resulting from a policy, pattern or practice of the municipality).

⁴ If your officer has a history of relevant misconduct, your Monell claim against the City for failure to train, investigate or discipline the individual officer (as opposed to broader policy allegations, like failure to adequately investigate or discipline officer use of force, generally), would likely result in your being able to present evidence of that officer’s prior conduct, perhaps just through an expert witness. Such evidence in support of your claim against the City would have the collateral benefit of letting the jury know that the officer is not a choir boy. Unless you can establish a specific exception under Pennsylvania Rule of Evidence 404(b) (motive, opportunity, intent, preparation, plan, knowledge, identity, absence of mistake, or lack of accident), such evidence would probably not be admissible against the officer in state court on a pure state tort case.  Also, in the fact pattern described here, there are probably no viable state law claims against the officers who stood by and watched the beating, but there would be a federal civil rights claim for failure to protect, and perhaps one for supervisory liability if any of the bystanders were of higher rank.

If you expect to be removed from state court anyway, filing fee is another reason to file your case in federal court. The federal filing fee is a one time, flat $400, no matter how many plaintiffs or defendants. The Philadelphia fee for a jury demand case with one defendant is nearly $600 ($330 for arbitration/non-jury), with a further $11 for each additional defendant, and every time you file a motion there is a further $52 fee. Of course, if you are willing to spend the extra few dollars and are feeling lucky, you might want to file your case with federal claims in state court anyway, on the very unlikely chance that someone will screw up and miss the deadline for removal of the case to federal court.

Another factor to keep in mind is the immunity provided by the Pennsylvania Tort Claims Act, 42 Pa.C.S.§ 8541, et. seq. This Act provides that City employees, may not be held liable unless their conduct constituted willful misconduct or criminal conduct. Depending on the facts of your case, there is always the possibility that a state court could find the officers liable on the intentional tort claims, but immune due to a lack of willful misconduct or criminal conduct.⁵ The further problem under the Act is that the City is not compelled to indemnify an employee if they have engaged in willful misconduct or criminal conduct. So, theoretically, you could win a verdict against the officers, but find that the City will not pay that verdict. If you have not brought and prevailed on a claim against the City, a finding of willful misconduct will leave you going after the officers’ personal resources, which may not prove adequate to pay any judgment. Having said that, however, it has been our experience that the City ordinarily represents and indemnifies its police officers. Generally, the exceptions to this rule are officers who the police department’s own internal disciplinary process have found to have engaged in misconduct, or who have been charged criminally.⁶ Again, the City will not be a named defendant in state court without federal claims, so any judgment will be against the individual officer.

Just as the jury pool may be the most compelling reason to try to keep a case in the Philadelphia courts, the availability of counsel fees may be the most important reason to bring federal civil rights claims. Exposure to fees is often a powerful inducement to the City in deciding whether to settle a case. The example described above, even after you get an estimate for dental repair, may not represent a large damages case. However, if you prevail, after taking the case through pleadings, discovery, depositions, motion practice, and trial, counsel fees and costs could easily multiply the ultimate judgment several times over.⁷ Fees, whether as a prevailing party award or factored into a settlement, benefit both the client and counsel. The decision to give them up must be informed and carefully determined.

In summary: if you decide to file in state court on state tort claims, only, keep in mind that you are giving up your federal constitutional claims and with them the availability of counsel fees from defendants if you were to prevail on civil rights claims. Also, you are giving up the City of Philadelphia as a defendant, and the opportunity to expose the jury to the officer’s prior history. Finally, when proceeding only on state claims in state court, the potential immunities may result in some or all of your claims being lost, or, even if you win, you may be unable to collect. However, in the right case the advantages of proceeding in state court instead of federal court, may outweigh the disadvantages.

Whichever way you decide to proceed – just state law claims, or federal civil rights claims and state law claims – be sure that your client is fully informed and makes the final decision. Prior to filing suit in state court, my practice is to reduce the pros and cons to writing, clearly setting forth that which the client may be risking or sacrificing by choosing to proceed on state law claims only. Then I review it with my client, answer any questions, and have him/her sign to acknowledge his/her understanding and consent to filing in state court.

Whether in state or federal court, police misconduct civil rights litigation can be complex, fraught with many tiger pits filled with stakes waiting to impale you. My recommendation is to start with a modest, uncomplicated case of direct liability against an officer, without complicated theories of liability or difficult to prove damages. If you stumble upon a significant, complex case, consider referring it, or consulting or associating with an experienced civil rights litigator. In any event, be sure to vet your case carefully and be thorough in your research and investigation. Remember, there is nothing wrong with a little healthy skepticism to help make sure you are not missing flaws in your case.

And whether a newbie or a pro to this area of the law, an indispensable tool is Police Misconduct: Law and Litigation, 3d, 2014-2015 ed., by Michael Avery, David Rudovsky, et al. My well-thumbed copy of this resource is always close at hand.  If you are defending a criminal case that might result in a civil suit, get a copy of the PBI publication, Police Misconduct: Defending Criminal Cases in Pennsylvania, 2nd Edition, 2013, by Paul Messing.

Good luck.

1. Although the term “excessive force” is often used by practitioners and courts, my friend Paul Messing is a crusader for use of the correct term, which is unreasonable force. Paul points out that not only is “unreasonable” the language of the 4th Amendment, but “excessive” suggests a higher bar for proof of the constitutional violation, which is only whether the officer’s conduct was reasonable under the circumstances. Though I continue to slip on occasion, I subscribe to Paul’s argument.
2. The law is clear that medical need claims of sentenced prisoners, which include those held on parole or probation violations, arise under the cruel and unusual punishment prohibitions of the 8th Amendment. Likewise, medical need claims of pre-trial detainees who are detained following probable cause hearings, arise under the Due Process Clause of the 14th Amendment. Medical need claims of persons who end up not being arrested, or who are under arrest, but not yet formally charged, probably arise under the reasonable seizure protections of the 4th Amendment. The gray area involves persons who have been charged and incarcerated, but have not yet had a probable cause hearing. To be safe, I advise alleging both 4th and 14th amendment violations for persons denied medical care at any point prior to a probable cause hearing. The distinction is not merely academic. Although many courts apply the same standard for 8th and 14th Amendment denials of medical care claims, there is some suggestion that the protections for a pre-trial detainee may be greater than for a sentenced prisoner. In any event, the reasonableness standard of the 4th Amendment is certainly a lower bar that the deliberate indifference standard of the 8th and 14th Amendments. Of course, all of this is without discussion of issues of qualified immunity, which would require a War and Peace length blog post all its own!
3. The one exception is that the Law Department sometimes will not remove a case with federal claims filed in state court as an arbitration matter, which are capped at $50,000. Civil rights cases are not subject to arbitration in federal court, per local rule.
4. To further complicate matters, if your defendant is a state trooper, then a Monell claim will not lie against the Commonwealth of Pennsylvania.  Will v. Michigan Dept. of State Police, 491 U.S. 58 (1989).
5. Officers can claim qualified immunity from the civil rights claims, meaning that the right in question was not clearly established, or even if clearly established, a reasonable officer would not have understood that he was violating the right. There is no such qualified immunity defense available to individual officers on state law claims, and municipalities do not have qualified immunity from federal civil rights claims
6. The City may also decline to pay the punitive damages portion of a judgment.
7. A wrinkle in the fee calculus is that the City may make you an offer of judgment under F.R.Civ.P. 68 early in the case. Even if you ultimately prevail, if the amount of the verdict, plus fees and costs accrued at the time of the offer, is not greater than the Rule 68 offer, your fees and costs will be capped as of the date of the offer. If you fall short, you will also be liable for your opponent’s costs (but not their fees) accrued after the date of the offer.

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The Super Lawyer distinction is given to only a very small percentage of Pennsylvania‘s attorneys each year.  Attorneys are only considered for inclusion in the list of top rated attorneys if they have attained a high degree of peer recognition and professional achievement across 12 indicators. Lawyers cannot buy their way onto the list. The selection process, recognized as legitimate by bar associations and courts across the United States, is multi-phased and includes independent research, peer nominations and peer evaluations. Only attorneys who can be retained by the general public are considered. Honorees are selected annually for each state and practice area

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The Board was established by the Mayor by Executive Order No. 1-15, in response to the United States Department of Justice Office of Community Oriented Policy Services (DOJ-COPS) report entitled, “Collaborative Reform Initiative:  An Assessment of Deadly Force Policy and Practice in the Philadelphia Police Department” and the Interim Report of the President’s Task Force on 21st Century Policing.

The COPS Deadly Force report provided recommendations to enhance training, improve the quality and transparency of deadly force investigations, strengthen the use of force review process, and institutionalize organizational learning processes related to deadly force incidents.

The Task Force interim report made recommendations to the President on issues affecting police-community interactions, examined long-held assumptions about the nature and methods of policing,and identified areas where research is needed to highlight examples of evidence-based policing practices.

The Board’s mission is to will develop a realistic approach for implementing the reports’ recommendations, and monitor and assess the Department’s progress.

The Board’s membership represents a wide variety of professions and Philadelphia community groups and constituencies.  Yatvin brings his expertise in representing individuals and families of persons who were the victims of unreasonable force and other police misconduct.  His experience includes litigation of numerous police shooting cases.

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Based in Alexandria, Virginia, the American Diabetes Association (ADA) is leading the fight to Stop Diabetes and its deadly consequences and fighting for those affected by diabetes. The ADA funds research to prevent, cure and manage diabetes; delivers services to hundreds of communities; provides objective and credible information; and gives voice to those denied their rights because of diabetes. Founded in 1940, the ADA’s mission is to prevent and cure diabetes and to improve the lives of all people affected by diabetes.

Alan Yatvin joined the ADA’s Legal Advocacy Subcommittee (LAS) in 2004, as a result of his litigation of a class action on behalf of persons with diabetes in police custody in Philadelphia. In 2011 Alan became LAS chair, serving through 2013. By virtue of that position, he also served on the ADA’s National Advocacy Committee. During his time on the LAS, Alan has been involved in numerous activities designed to advance the health and welfare of persons with diabetes.

Because his law practice includes civil rights litigation, criminal defense and representation of children with disabilities, Alan has concentrated his work with the ADA on the intersection of those areas with the rights and needs of persons with diabetes. These activities have included representing individual Pennsylvania students with diabetes whose schools are denying them the services and accommodations which they need to stay healthy, benefit from their educational opportunities, and be an equal member of their school community.

Alan also served on the faculty for the ADA’s three Fighting for Fairness training programs (2005, 2007, 2009), including serving as 2009 program planner. He was a member of the Writing Groups for the ADA’s 2012 Position Statement on Diabetes and Driving and the ADA’s 2014 Position Statement on Care of Young Children With Diabetes in the Child Care Setting. For the past year Alan has been the ADA’s lead negotiator on steps to implement the ADA’s Safe at Schools victory in the California Supreme Court.

Alan is particularly proud of his contribution to the strides the ADA has made in protecting the rights of persons with diabetes in schools and in police encounters. Although these groups seem polar opposites, they share the circumstance of persons with diabetes at their most vulnerable, most reliant upon others for care and most disconnected from their regular support systems. The ADA’s strategy to Educate, Negotiate, Litigate and Legislate, has increased the number of states following ADA Safe at School standards. On the police front, the ADA has strengthened existing relationships and grown new ones, as it continues to recruit police departments to the need to educate their officers on diabetes issues. A particularly exciting success has been the response of ADA volunteer networks (attorney, healthcare professional, school advocate) to Alan’s Assist Officer campaign, which has resulted in numerous law enforcement agencies adopting ADA materials and adding diabetes education to their recruit and in-service officer training.

To learn more about the ADA, go to the website:  Diabetes.org

To donate to the ADA’s fight against the deadly consequences of diabetes and fight for those affected by diabetes, click this button:

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The text of the written testimony appears below:

Testimony of Alan L. Yatvin, Esq.
Legal Advocacy Subcommittee
American Diabetes Association
Before the
Subcommittee on the Constitution, Civil Rights, and Human Rights
Committee on the Judiciary
United States Senate
“Law Enforcement Responses to Disabled Americans:
Promising Approaches for Protecting Public Safety”
Tuesday April 29, 2014 — 10:00 a.m.

Introduction

Thank you for the opportunity to submit testimony on behalf of the American Diabetes Association (Association) and on behalf of the nearly 26 million Americans who have diabetes. The Association is the largest, most prominent nongovernmental organization that deals with the treatment and impact of diabetes. It establishes and maintains the most authoritative and widely followed clinical practice recommendations, guidelines, and standards for the treatment of diabetes. This includes a medical statement on diabetes management in correctional institutions.

One of the Association’s top priorities is giving voice to those denied their rights because of diabetes. We seek to ensure people with diabetes are free from discrimination in all areas of daily life, including by working to make sure people with diabetes are treated fairly by local law enforcement agencies.

I am the immediate past chair of the Association’s Legal Advocacy Subcommittee and have worked closely with the Association to ensure law enforcement agencies have the tools necessary to fully serve and protect all people living with diabetes. I hope the Association’s experience will be useful in developing collaborative strategies to ensure fair treatment of people with diabetes and all disabilities.

In my testimony I will focus on the following areas:

1. The scope of the problem of inappropriate law enforcement response to people with diabetes, including representative incidents.
2. The medicine and science of diabetes emergencies.
3. The Association’s work with community partners, including law enforcement agencies, to provide quality diabetes training.

1. The Problem: Ignorance of Diabetes

The concern with regard to diabetes and law enforcement centers around the lack of adequate training on how to respond to diabetes emergencies. Individuals who experience severe hypoglycemia (low blood glucose) and hyperglycemia (high blood glucose) need immediate medical intervention, but too often, their medical needs are overlooked. Recent examples that have come to our attention include:

• A visibly pregnant woman with gestational diabetes had a low blood glucose emergency and local police officers, upon approaching her and seeing an insulin syringe, assumed she was a drug addict, despite her repeated explanations that she had diabetes and needed to eat her glucose tablets. She was taken from her vehicle and wrestled to the ground and then charged with resisting arrest, although charges were later dropped.

• An elderly man was found unresponsive by law enforcement officers inside his vehicle. The officers responding to the scene assumed that he was drunk and pulled him out of the vehicle and forced him to the ground. His hip was broken and a lung was bruised. He spent 21 days in the hospital as a result of how the officers responded to this medical emergency.

• A young man in police custody was denied access to insulin for more than 24 hours until he developed diabetic ketoacidosis and went into a coma. He now requires round-the-clock nursing care.

• A man with both schizophrenia and diabetes lingered in a jail cell for more than two months after a warrantless arrest. He received inadequate insulin and died.

• A man with schizoaffective disorder and diabetes was in prison on a parole violation. He was provided an injection of insulin in anticipation of an upcoming meal. However, when the meal did not come, he asked the guards for it because if insulin is given without food, severe hypoglycemia leading to seizure, unconsciousness, and death can occur. Instead of being given his meal, he was dragged from his cell and died after guards restrained him for several minutes using shock shields.

Each year, numerous individuals contact the Association alleging that they have been treated improperly by law enforcement on account of their diabetes. We believe that the reason for this mistreatment is due to ignorance rather than malice. However, as long as this ignorance continues, people with diabetes cannot be confident that they will be served and protected like other citizens, and families will fear for their loved ones.

2. The Medicine and Science of Diabetes Emergencies

In diabetes, insulin, a hormone produced by the pancreas, is either totally or partially lacking or the body cannot appropriately absorb insulin. Insulin is needed by the body to convert sugar, starches, and other food into energy needed to sustain life. Without insulin, life is not possible for long due to high glucose (hyperglycemia) and toxins that increase in the blood. On the other hand, too much insulin or some other medications causes low blood glucose (hypoglycemia) so much so that the brain and other organs cannot function.

Medical emergencies arise when individuals develop either severe hypoglycemia or hyperglycemia and immediate treatment is required. However, these conditions can be mistaken as intoxication, uncooperativeness, or belligerence. Training is required so that the law enforcement officers can distinguish between a person who is experiencing a medical emergency and a person who is choosing not to cooperate.

3. The Association’s History of Educational Outreach and Cooperation

Philadelphia Police Department

Since 2001, the Association has worked to defend the rights of people with diabetes in the law enforcement context. In that year, I was lead counsel in a class action law suit against the Philadelphia Police Department (PPD) on behalf of detainees with diabetes who were denied access to appropriate food, medication and medical care while in police custody. The lead plaintiff was a businessman arrested for a minor liquor code violation who ended up in the hospital due to lack of access to medication and proper care while in police custody. The American Diabetes Association joined in this suit. Settlement of the suit in 2003 included an agreement for the PPD and the ADA to jointly produce a training video and an informational poster, both aimed at helping police officers know how best to identify and respond to medical issues facing individuals with diabetes. These materials are geared towards when a policy officer encounters a person with diabetes in the community needing help as well as when someone is being arrested or in custody.

Treating Diabetes Emergencies: What Police Officers Need to Know is a 20 minute training video designed to show law enforcement officers how to respond to people with diabetes in a variety of situations. Intended as a companion or stand-alone piece, Diabetes is serious: It can be life threatening! is a poster designed to help police officers understand diabetes and the signs and symptoms associated with diabetes emergencies. It also includes action steps to protect the safety of detainees with diabetes.

This was not the end of the cooperation between the PPD and the ADA however. In 2012, the PPD and the ADA agreed to work together to update and revise the PPD’s key training and informational document. The result of our cooperative efforts was a much improved and updated police training tool, the 2013 diabetes Assist Officer. It has become a resource for other law enforcement agencies.

New York Police Department

In 2012, the Association began to meet with the New York Police Department in order to help it improve its officer training on diabetes. There had been several high profile incidents of individuals with diabetes being denied treatment while in NYPD custody. One incident involved the denial of insulin to an individual who subsequently experienced diabetic ketoacidosis and sustained serious brain damage requiring nursing care for the rest of his life. Through continued dialogue and cooperation, we have seen real change. The Association helped the NYPD to produce a compelling training video that is now shown to each officer. Earlier this year, one of the Association’s medical experts and I were invited to present a program to 250 of the NYPD’s training sergeants. As a result of the positive feedback, we have been invited to present annually.

Community Outreach

The work of the American Diabetes Association depends on our many volunteers in communities throughout the United States. To that end, in May 2013, we asked our volunteers to approach their local law enforcement agencies with our training materials and to offer to be resources for any agency that would like to begin a training program for their officers. Our volunteers have reached out to more than 400 local agencies in 31 states and the District of Columbia. However, even more hearteningly, law enforcement agencies have expressed their keen desire to receive training. They recognize the scope of the diabetes epidemic in their communities. Quite simply, they understand that their son, daughter, brother, sister, husband, wife, father, or mother could be in harm’s way if law enforcement does not have the tools it needs to appropriately respond to people with diabetes.

Conclusion

We join our allies in the disability rights community to ask that the federal government develop concrete proposals to ensure that law enforcement officers across the country are given the tools, training, and resources to ensure that people with all disabilities can be confident they will be protected as well as any other citizen.

Thank you again for this opportunity to provide my testimony. The Association is ready and willing to work with the Senate Judiciary Committee and other legislative and executive groups to improve the treatment of people with diabetes by law enforcement officers.

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The program started with screening of the NYPD’s Diabetes Awareness training video.  This 2013 video provides New York police officers information about diabetes, generally, and the effects of severe hypoglycemia (low blood sugar) on persons with diabetes.  The video also features Geri Spollett, MSN, ANP-CS, CDE, past ADA President, Health Care & Education, explaining and demonstrating the various diabetes devices police officers might encounter.

Then, Dr. Lorber, Endocrinologist, Certified Diabetes Educator and long-time ADA volunteer, explained in greater detail the processes that may cause a person experiencing severe hypoglycemia to appear intoxicated, under the influence of drugs, irritable, or even combative.  Dr. Lorber also reviewed some of the ways officers could recognize a person suffering a diabetes emergency, including medical alert jewelry, wallet cards, diabetes supplies and certain behaviors.

Alan Yatvin, immediate past chair of Legal Advocacy for the ADA, then spoke to the officers about some of the legal issues involved in officer interaction with persons with diabetes.  This portion of the program started with the playing of a video, with audio, recorded by a police dashboard camera following the stop of an erratic driver outside Las Vegas, in Henderson, Nevada.  The video showed Adam Greene, himself the son of a Highway Patrolman, being forcibly removed from the vehicle, restrained by six officers and kicked repeatedly while lying on the ground.  Only afterward, upon searching his pockets and finding diabetes supplies, did the police recognize that Greene had diabetes, was suffering from severe hypoglycemia and was only semi-conscious.  Yatvin was pleased to note the training sergeants’ spontaneous negative vocal reactions to the officer conduct in the video.

Yatvin then reminded the audience about the facts in Graham v. Connor, 490 U.S. 386 (1989), a landmark United States Supreme Court case.  Graham established that use of force by police officers against a free person is to be evaluated under the Fourth Amendment to the Constitution and that the reasonableness of any force used must be viewed from the perspective of an objectively reasonable police officer, under all the circumstances presented.  Although this proposition is widely relied upon by police and police trainers, few recall the facts which gave rise to the case.  Yatvin reviewed those facts for the officers:

On November 12, 1984, Graham, a diabetic, felt the onset of an insulin reaction. He asked a friend, William Berry, to drive him to a nearby convenience store so he could purchase some orange juice to counteract the reaction. Berry agreed, but when Graham entered the store, he saw a number of people ahead of him in the checkout line. Concerned about the delay, he hurried out of the store and asked Berry to drive him to a friend’s house instead. Respondent Connor, an officer of the Charlotte, North Carolina, Police Department, saw Graham hastily enter and leave the store. The officer became suspicious that something was amiss and followed Berry’s car. About one-half mile from the store, he made an investigative stop. Although Berry told Connor that Graham was simply suffering from a sugar reaction, the officer ordered Berry and Graham to wait while he found out what, if anything, had happened at the convenience store. When Officer Connor returned to his patrol car to call for backup assistance, Graham got out of the car, ran around it twice, and finally sat down on the curb, where he passed out briefly. In the ensuing confusion, a number of other Charlotte police officers arrived on the scene in response to Officer Connor’s request for backup. One of the officers rolled Graham over on the sidewalk and cuffed his hands tightly behind his back, ignoring Berry’s pleas to get him some sugar. Another officer said:    I’ve seen a lot of people with sugar diabetes that never acted like this. Ain’t nothing wrong with the M. F. but drunk. Lock the S. B. up. Several officers then lifted Graham up from behind, carried him over to Berry’s car, and placed him face down on its hood. Regaining consciousness, Graham asked the officers to check in his wallet for a diabetic decal that he carried. In response, one of the officers told him to shut up and shoved his face down against the hood of the car. Four officers grabbed Graham and threw him headfirst into the police car. A friend of Graham’s brought some orange juice to the car, but the officers refused to let him have it. Finally, Officer Connor received a report that Graham had done nothing wrong at the convenience store, and the officers drove him home and released him.  At some point during his encounter with the police, Graham sustained a broken foot, cuts on his wrists, a bruised forehead, and an injured shoulder; he also claims to have developed a loud ringing in his right ear

Following the presentation, Yatvin and Lorber made available copies of diabetes awareness materials: The ADA police poster, Diabetes is serious:  It can be life threatening!; Philadelphia Police Department Assist Officer; and the ADA Diabetes Medical Alert wallet card which appeared in the January 2014 issue of Diabetes Forecast magazine. Yatvin and Lorber then spent about 20 minutes speaking with individual sergeants, answering questions and providing information on diabetes resources.

The number of people with diabetes continues to climb.  According to the Centers for Disease Control and Prevention there are nearly 26 million Americans with diabetes.  Knowing how to respond to a potentially life threatening diabetes emergency is becoming increasingly important for law enforcement officers and other first responders.  Through his pro bono work with the American Diabetes Association, Alan Yatvin is working to bring police trainers together with medical and legal professionals to successfully collaborate on matters of importance to law enforcement and the diabetes community.

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