Megan Matthews thought she was dying.
"I thought my head was blown off," said Matthews, 22, who was hit in the eye with a sponge-tipped projectile fired by law enforcement at a May 29 protest in Denver. "Everything was dark. I couldn't see."
Matthews, a soft-spoken art major who lives with her mother, had gone to the demonstration against police brutality carrying bandages, water bottles and milk so she could provide first aid to protesters.
"I couldn't really grasp how bad my injury was," said Matthews, who sustained injuries including a broken nose, fractured facial bones and multiple lacerations on her face. "So much blood was pouring out. I was wearing a mask, and the whole mask was filling up with blood. I was trying to breathe through it. I kept telling myself, 'Don't stop breathing.'"
Three weeks later, Matthew is struggling with her vision and her doctor says she may never completely heal. Others fared far worse.
In a joint investigation into law enforcement actions at protests across the country after George Floyd's death in police custody, KHN and USA TODAY found that some officers appear to have violated their department's own rules when they fired "less lethal" projectiles at protesters who were for the most part peacefully assembled.
Critics have assailed those tactics as civil rights and First Amendment violations, and three federal judges have ordered temporary restrictions on their use.
At least 56 protesters sustained serious head injuries, including a broken jaw, traumatic brain injuries and blindness, based on news reports, interviews with victims and witnesses and a list compiled by Scott Reynhout, a Los Angeles researcher.
Photos and videos posted on social media show protesters with large bruises or deep gashes on the throat, hands, arms, legs, chest, rib cage and stomach, all caused by what law enforcement calls "kinetic impact projectiles" and bystanders call "rubber bullets."
At least 20 people have suffered severe eye injuries, including seven people who lost an eye, according to the American Academy of Ophthalmology.
Photographer Linda Tirado, 37, lost an eye after being hit by a foam projectile in Minneapolis. Brandon Saenz, 26, lost an eye and several teeth after being hit with a "sponge round" in Dallas. Leslie Furcron, 59, was placed in a medically induced coma after she was shot between the eyes with a "bean bag" round in La Mesa, California.
Twenty-seven-year-old Derrick Sanderlin helped defuse a confrontation at a protest in San Jose, California, on May 29. While he was trying to protect a young woman from police, he was hit with a projectile that ruptured a testicle and, his doctor said, may leave him infertile.
With terms like "foam," "sponge" and "bean bag," the projectiles may sound harmless. They're not.
"On day one of training, they tell you, 'Don't shoot anywhere near the head or neck,'" said Charlie Mesloh, a certified instructor on the use of police projectiles and a professor at Northern Michigan University. "That's considered deadly force."
Floyd's death sparked the nation's most widespread street protests in decades, drawing a massive response from police dressed in riot gear. Although many large metropolitan police departments own these projectiles, they had never before been used on a national scale, Mesloh said.
Witnesses say law enforcement in several major cities used less-lethal projectiles against nonviolent protesters, shot into crowds, aimed at faces and fired at close range — each of which can run counter to policies.
Police have said they fired these weapons to protect themselves and property in chaotic, dangerous scenes.
These projectiles, intended to incapacitate violent aggressors without killing them, have evolved from the rubber bullets developed in the 1970s by the British military to quell uprisings in Northern Ireland. They are designed to travel more slowly than bullets, with blunt tips meant to cause pain but not intended to penetrate the body.
They come in many forms, including cylindrical wooden blocks, bullet-shaped plastic missiles tipped with stiff sponge or foam, fabric sacks filled with metal birdshot, and pepper-spray balls, which are about the size of a paintball and contain the active chemical in pepper spray.
Some are fired by special launchers with muzzles the diameter of a cardboard toilet-paper roll; others can be fired from shotguns.
They can cause devastating injuries. A study published in 2017 in the medical journal BMJ Open found that 3% of people hit by projectiles worldwide died. Fifteen percent of the 1,984 people studied were permanently injured.
"Given the inherent inaccuracy" of the projectiles and the risk of serious injury, death and misuse, the authors concluded they "do not appear to be an appropriate means of force in crowd-control settings."
Yet manufacturers continue to market them on their websites for that purpose. Defense Technology says its "eXact iMpact" sponge projectile is "used for crowd control, patrol and tactical applications." PepperBall says the uses for its projectiles include "anti-riot" and "crowd control."
Security Devices International describes its "blunt impact projectiles" like weapons of war, saying they're "designed for military, peacekeeping, homeland security, law enforcement, correctional services and private sector security." It adds, "they are ideal for crowd control."
The companies did not respond to requests for comment.
There are no national standards for police use of less-lethal projectiles and no comprehensive data on their use, said Brian Higgins, an adjunct professor at the John Jay College of Criminal Justice in New York.
So the nation's more than 18,000 law enforcement agencies establish their own rules for when they should be used, who's allowed to fire them and how to hold their officers accountable.
Many police departments don't require officers to document their use of projectiles, Higgins said, making it difficult to know how often they're used.
Denver's policy says officers should use projectiles only on a "combative or physically resistive person whose conduct rises at least to the level of active aggression," to prevent others from being harmed, or to "incapacitate a suicidal person who cannot be safely controlled with other force."
Denver also forbids officers from targeting the "head, eyes, throat, neck, breasts of a female, genitalia or spinal column" of a suspect "unless deadly force is warranted."
Matthews said she was standing 5 feet from other peaceful protesters at the Denver demonstration and nowhere near anyone rowdy. She suspects her shooting was no accident.
"Either they targeted her face or they fired indiscriminately at the crowd," said Ross Ziev, Matthews' lawyer. "Either way, that poses a tremendous safety hazard."
A federal lawsuit accuses Denver police of "targeting protesters, press, and medics" and aiming projectiles "at the heads and groins of individuals, in a clear tactic to inflict maximum damage, pain and distress."
The Denver Police Department "takes complaints of inappropriate use of force seriously and has initiated Internal Affairs investigations into officers' actions during demonstrations that may be violations of policy," a department spokesman said.
A federal judge in Denver issued a temporary order limiting the use of projectiles and tear gas. Police may use them only with the approval of a supervisor — and only to respond to "specific acts of violence or destruction of property that the command officer has personally witnessed."
In his ruling, U.S. District Judge R. Brooke Jackson found a "strong likelihood" that Denver police violated protesters' constitutional rights "in the form of physical injury and the suppression of speech."
The Denver Police Department "has failed in its duty to police its own," Jackson wrote.
Judges in Seattle and Dallas have issued similar injunctions, and cities such as San Jose, Atlanta and Austin have moved to curb their use.
'We've opened the floodgates'
As of 2013, 37% of police departments in the U.S. authorized the use of "soft projectiles," according to the most recent survey released by the U.S. Department of Justice. That included the largest police departments in the country and more than half of those serving 10,000 or more citizens.
Law enforcement used the projectiles widely during the 2014 protests in Ferguson, Missouri, sparked by the death of black teenager Michael Brown.
But in day-to-day policing in the United States, kinetic impact projectiles are rarely used, according to a study published in 2018. Fewer than 1% of police use-of-force incidents involved such weapons, researchers found.
Something changed when protests erupted after George Floyd's death, said Higgins, a former police chief of Bergen County, New Jersey. "It's almost like we've opened the floodgates," Higgins said.
In general, instructors teach officers to target only people who are "extremely dangerous," said Higgins, who teaches classes on how to use these munitions.
Projectiles should be "your last resort before you go to lethal force," Higgins said. "That's how dangerous they are."
And officers need to aim shotguns or launchers carefully. "You should never fire indiscriminately into a crowd," Higgins said. "You should always pick your target."
Projectiles can be fired directly at a target, while "skip rounds" are fired at the ground in the hope of hitting the target as they ricochet upward. That method of shooting is notoriously inaccurate, Mesloh said.
Mesloh said he has spoken out about the problems with police projectiles for years, to little effect.
There are no manufacturing standards or quality control measures for less-lethal projectiles, Mesloh said.
In field tests, he has found that bean bag rounds can travel far faster than advertised. He focused on rounds that were supposed to fly out of a shotgun at 250 to 300 feet per second, 2½ to 3 times faster than a major league fastball. Several traveled 600 feet per second. One bean bag clocked in at 900 feet per second, about the same speed as a .45-caliber bullet, he said.
Faster projectiles are more likely to kill than slower ones, and they fly straighter. So an officer who expects the projectile will dip and hit a suspect's leg could end up hitting him on the torso or head, Mesloh said.
Police can also make dangerous errors if they shoot projectiles while wearing gas masks. "The visibility with gas masks is zero," Mesloh said. "I wouldn't want to shoot anything while wearing one."
Instructors typically get eight hours of training with less-lethal projectiles before they're allowed to teach others. Their students — regular police officers — receive four hours of instruction, including just five or six practice shots. Bean bag rounds used with shotguns cost $6 each, which limits how many can be used for training, Mesloh said.
Police and their advocates emphasize that officers dealing with crowds must make high-stakes decisions in chaotic situations without time for reflection. Often they fear for their physical safety, said Nick Rogers, a detective and the president of the Denver police union.
"Unfortunately, the narrative of the protests has kind of been hijacked," he said. "We probably had 30 to 40 police suffering injuries from bricks and rocks. And that's not being reported."
Denver police didn't respond to a request to confirm that.
In San Jose, police Capt. Jason Dwyer said firing projectiles is safer than trying to control a crowd using nightsticks. Dwyer, who was struck by a rock, said at a press conference that police were justified using projectiles and tear gas against the crowd, who turned his city into a "war zone."
"I've been a cop for 21 years, spent about half that time in special operations," Dwyer said. "But I can tell you, I've never seen anything like it."
A South Carolina law enforcement leader defended the response against protesters in Columbia on May 31, a clash that included the firing of projectiles.
"There was no doubt what their intent was, and that was to destroy property, police cars, police buildings, whatever," Richland County Sheriff Leon Lott said during a news conference. "So we had to stop them. And we did stop them."
But Patrick Norris, 28, said he was protesting peacefully when he was shot in the back. He and a group of 150 to 200 protesters were met by about 50 officers from the Columbia Police Department, Richland County Sheriff's Department and the South Carolina Department of Corrections, according to a federal lawsuit Norris filed against the sheriff, the sheriff's department, the city of Columbia and its police department and unnamed officers with the agencies and the state Department of Corrections. Court summonses have been issued to the defendants, who have not yet filed responses.
Officers carried protective shields and were clad in body armor and riot helmets, said Norris, a truck driver and veteran of marriage equality rallies and gay pride parades.
For about two minutes, the protesters chanted, "Hands up, don't shoot," Norris said. Then it appeared that someone ordered the officers to move forward. Almost instantly, the scene escalated into a battle. "They met us with immediate and intense force for no reason," Norris said. "It was pure chaos, with a large group of armed people unloading on unarmed protesters."
Local media reported that the protesters had thrown objects at the law enforcement officers and tried to sneak into Columbia Police Department headquarters. Norris scoffed at that.
He said he saw a bright flash, followed by a loud explosion that left shrapnel injuries on one of his legs. "Multiple loud pops were heard," believed to have been "the first of the rubber bullets fired into the crowd by unknown law enforcement officers," the lawsuit alleged.
"Officers then began shooting tear gas canisters into the crowd of protestors," the lawsuit said. Norris, who had turned to run, "was struck numerous times in the back" by projectiles that left red welts seen in photos included with the lawsuit.
The Columbia Police Department policy on the use of force states that less-lethal weapons meant to be fired directly at a target can't be used indiscriminately against a crowd, even if it's violent, and "shall not be used for crowd management, crowd control or crowd dispersal during demonstrations or crowd events."
The use of force policies of the other law enforcement agencies could not immediately be determined. Norris said he doesn’t know who fired at him.
Shot without warning
Soren Stevenson, 25, said he was unarmed when he was shot by law enforcement May 31 in Minneapolis.
Protesters were peaceful but unnerved by police in riot gear, Stevenson said. He moved to the front of the crowd, about 30 feet from police, to protect protesters behind him.
Suddenly, officers launched two explosive devices at demonstrators. Tear gas filled the air.
“The police knew it was a peaceful protest,” Stevenson said. "I did not hear any instructions or commands from police. It went from protest to shooting, just like that.”
Stevenson said he was trying to comprehend the explosions when something slammed into his face, knocking the lenses from his glasses and spinning him around.
“I was very confused. I reached up and touched my face, and it was just soft — that whole left side," he said. "It broke a lot of bones in my face, and my nose was moved from where it belongs to underneath my right eye.”
Stevenson doubled over, but stayed on his feet. He said he didn’t notice blood or pain until volunteers cleansed the wound at a medic station.
Stevenson said there were fractures to his skull, cheekbone, nose and jaw. He also suffered a concussion.
Doctors immediately performed reconstructive surgery. On June 10, surgeons took out Stevenson’s eye. They inserted a prosthetic that is expected to eventually settle with surrounding tissue, and he’ll get a glass lens at some point. But he’ll never again have normal vision.
In three decades as an ophthalmologist, "I've seen just about everything bad that can happen to an eye," said Dr. George Williams, who has not been involved in Stevenson's care. "I can't imagine a more effective way to destroy an eyeball than these so-called kinetic impact technologies."
"Frankly, you're better off being stabbed in the eye with something sharp that creates a clean, plain wound," said Williams, clinical spokesperson for the American Academy of Ophthalmology. "This creates irregular wounds where the tissue is just blown out. There is oftentimes nothing left to fix."
His group and Physicians for Human Rights have called for a ban on less-lethal projectiles, including sponge-tipped bullets, pepper-spray balls and bean bag rounds.
These projectiles "don't seem to be very effective at crowd control," Williams said. "All they seem to do is hurt people."
Frozen with fear
Nadia Rohr, 24, froze when Detroit police aimed what looked like "a bright-orange Nerf gun" directly at her.
She and her girlfriend were at the front of a group of marchers when they turned a corner and came face-to-face with a wall of police in full riot gear, banging their batons on their shields.
"I locked eyes with a police officer," said Rohr, who said she was peaceful and unarmed at the May 31 protest. "I was in a direct line of fire.”
Rohr said her girlfriend tried to pull her away, but the projectile still hit her in the back of the head.
According to Rohr's medical records, the projectile fractured her skull, caused bleeding beneath the outer lining of her brain and ripped a deep gash across her scalp that took nine stitches to close.
The Detroit Police Department didn't respond to requests to review its policy. Guidelines from 2014 authorize Detroit officers to use less-lethal force only to protect someone from physical harm, stop dangerous or criminal behavior or control someone resisting arrest.
C.J. Montano, 24, has a bruise on his forehead in the shape of a circle — visible evidence of the projectile that caused bleeding inside his brain.
"They shot me directly in the face," said Montano, a former Marine who was hospitalized in the intensive care unit after attending a May 30 protest in Los Angeles. "It was definitely intentional."
Montano described a chaotic scene. He and a group of nonviolent protesters knelt on the ground, yelling and chanting, about 5 feet from a line of officers armed with projectile launchers. Nearby, other protesters were throwing water bottles at police — mostly Los Angeles officers, though some sheriff's deputies were there too, Montano said.
Montano said he told police he would ask the protesters to stop throwing water bottles at the police if the officers didn't shoot him. He did so, but they shot him anyway with small projectiles, he said.
The police announced they would move forward, and he warned the crowd that they would have to back up.
As the crowd moved back amid tear gas, he and another man were left in a no man's land, 50 feet from police and another 50 feet away from the crowd, Montano said.
Officers shot again.
"I got hit in the hip and the stomach at the same time with larger rounds," Montano said. "They shot the other gentleman. Although my hands were up, they shot me in the rib cage. I fell on the ground and moved behind a sign to catch my breath. … Their shots were getting higher and higher every time I stood up."
Five minutes later, Montano said, he stood up with his hands in the air. He said that's when he felt a powerful force hit his forehead.
"It was just like a really, really hard thud," Montano said. "I lost all vision in my left eye, all hearing in my left ear."
The Los Angeles Police Department is investigating 56 allegations of misconduct by officers during the protests that decried police brutality — half of which involved alleged use of force.
The problem with police response in many cities was that leaders assumed crowds would be hostile, said Chris Stone, a criminal justice expert and professor at the University of Oxford. Stone sat on a panel that reviewed the death of a woman in Boston who was shot with a pepper ball in the early 2000s.
Uniform standards for using less-lethal projectiles would go a long way in “strengthening professionalism, strengthening proportionalism and a reasonable response to the protests,” he said.
Officers violated rules against shooting nonviolent people
Montano's description of the shooting appears to violate the Los Angeles Police Department's policy, which explicitly prohibits police from using pepper-spray balls, sponge and foam projectiles and other less-lethal force against people who passively resist or disobey them.
According to the Los Angeles policy, police should fire projectiles only "if an officer reasonably believes that a suspect or subject is violently resisting arrest or poses an immediate threat of violence or physical harm.”
Demonstrators in Minneapolis, San Jose, Denver and Dallas described being shot with less-lethal projectiles even though those departments don't allow them to be used against nonviolent people. In some cases, such as in Denver and Minneapolis, law enforcement from other agencies were called in to help and it's unclear who fired.
In San Jose, attorney Sarah Marinho, who is representing Sanderlin, said that police violated their rules when they shot him, that he was armed only with a small cardboard sign. At the time he was shot, Sanderlin was begging police to stop firing at unarmed people, including women, at close range.
"The facts are not in dispute," said Marinho, noting that a TV news team recorded the scene. "He was a safe distance away. He was not invading the police officers' space."
A San Jose police duty manual states that specially trained officers may fire projectiles against people when suspects are "armed with a weapon likely to cause serious bodily injury or death" or in "situations where its use is likely to prevent any person from being seriously injured."
In an interview with the San Jose Mercury News, Sanderlin said he stepped between protesters and the police to ask them to stop firing at peaceful demonstrators, including a woman who had been hit in the chest. Police told him to move, he said.
"I shook my head, held my sign over my chest, and thought, 'I really hope this guy doesn't shoot me,’" said Sanderlin, who volunteers with a group that trains San Jose police recruits on how to avoid racial bias. "He fired off a rubber bullet, and I realized he wasn't aiming for my chest. I was hit directly in the groin."
San Jose police have said they are investigating the shooting; they did not return phone calls for this story.
San Jose Mayor Sam Liccardo tweeted, "What happened to Derrick Sanderlin was wrong," and he pledged to push for a ban on less-lethal projectiles.
Stephen James, an assistant research professor at Washington State University, said he was disheartened to see countless videos showing "officers appearing to indiscriminately use pepper balls as if they were paint-balling on a Sunday afternoon."
Police departments have more trouble enforcing discipline with weapons during protests or riots because officers almost never train for those circumstances, may be fatigued and often are fearful, he said.
Though these projectiles should never be used to disperse a crowd, he said, they do have an important role in the law enforcement arsenal. If police are heavily outnumbered in riot or protest situations, less-lethal firearms can be used as a "credible threat" to maintain safety and order.
"I would never advocate for taking them away," James said. "If you take away less-lethal weapons, then deadly force is the fallback."
Learning from the past
For residents and police in Baltimore, Floyd's killing recalled one of the city's most painful moments.
Five years earlier, Baltimore erupted in violence after a man named Freddie Gray died in police custody. A Justice Department investigation concluded Baltimore police had routinely violated residents' constitutional rights, discriminated against blacks and used excessive force.
Baltimore brought in new leadership. Community groups began working with police. Policies changed.
And after video showed a Minneapolis police officer kneeling on George Floyd's neck, a curious thing happened in Baltimore: Demonstrations were peaceful. There are no accounts of police firing less-lethal weapons.
Erricka Bridgeford, founder of the Baltimore Ceasefire 365 anti-violence group, said officers marched and knelt with protesters, prompting cheers from the crowd. "They allowed people space to yell and vent their pain," she said.
Baltimore now has strict rules governing the use of kinetic impact projectiles. In the police department's use-of-force policies, the No. 1 principle is the "sanctity of human life." Whenever a less-lethal weapon is fired in the line of duty, it must be reported and investigated within 24 hours.
Bridgeford said she was heartbroken when she saw police in other cities shooting demonstrators with rubber bullets and pepper-spray balls. She didn't call them "less lethal," saying those words make police feel free to open fire.
Those weapons are used to instill fear, she said, "like siccing dogs on people or pulling out water hoses."
The weapons aren't "a way to de-escalate. It's a way to harm people," Bridgeford said. "Treating a crowd of people like animals? 'Oh, my God, they're shooting into the crowd!' How is that a good strategy?"
This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.