The following factors are listed as contributors to positional deaths:
Obesity - a large abdomen means that when a person is prone, the contents of the abdomen can be forced upwards under the diaphragm restricting breathing;
Psychosis - stimulation of the heart under drugs can produce cardiac disturbances which combine with difficulty in breathing to lead to fatal results;
Pre-existing physical conditions - any condition that impairs breathing under normal circumstances (heart disease, asthma, emphysena, borobchilities and other chronic lung diseases) will put a person at higher risk when they are physically restrained;
Pressure on the abdomen - even a thin person will have difficulty breathing if there is pressure on the abdomen. The more security officers there are holding a person down in a prone position, the greater the risk that there will be pressure on the abdomen, making it difficult to breathe.
The brochure identifies one of the symptoms and signs of improper restraint as sudden tranquility - an active, loud, threatening, violent, abusive person suddenly becoming quiet and tranquil, not moving.
Slim built 21-year-old Dinesh Raman Chinnaiah had kicked a prison warden while exiting his cell, was subsequently subdued, as they say in the movies, with extreme prejudice by unknown number(s) of officers, before being dumped into the disciplinary housing unit (DHU) cell "in a prone position". You don't need an IQ 0f 180 to appreciate that Dinesh was manhandled with retribution intent in mind. You can read volumes into the startling brevity of the Ministry of Home Affairs (MHA) statement concerning how a young life was snuffed out.
While it was admirable of Deputy Superintendent Lim Kwo Yin to assume personal responsibility for the thuggish tactics of his men - did Defence Minister Ng Eng Hen own up for Private Dominique's death? - there is no account/autopsy of how Dinesh was asphyxiated. If he was conscious and unrestrained while being ferried to his cell, he could have rolled over to gasp for life sustaining breath intakes.
We are simply told the inmate was restrained "according to protocol", left unattended, until Lim re-entered the cell later to check, and found him to be unresponsive.
The family of the deceased is upset that the senior prison officer charged with causing death through negligence received only a $10,000 fine. Three years on, they are still not sure exactly how Dinesh died, and have yet to decide on a legal course of action. If the Shane Todd investigation is anything to go by, the odds are definitely not in their favour. Don't waste money.