On July 5 at 8:30 p.m., 50-year-old Charles Adair received medical care at the Wyandotte County jail infirmary for a preexisting wound on his leg. By 8:37 p.m., he was out cold.
Within those seven minutes, it’s believed that Adair was subject to a common police tactic called “prone restraint,” when an arrested person or inmate is placed face down on the ground so his arms can be pulled back and handcuffed.
But in Adair’s case, the restraint included a deputy kneeling on his back, according to a coroner’s report, which caused “mechanical asphyxia,” and killed him. Adair was pronounced dead at 9:19 p.m., about 40 minutes after being found unresponsive, according to the Kansas Bureau of Investigation.
Adair’s death was ruled a homicide.
Dr. Alon Steinberg, a California cardiologist, has written several papers on the dangers of prone restraint on in-custody deaths and has been studying the topic for more than a decade. Steinberg read the Wyandotte County Coroner’s report on Adair’s death, noting that the inmate had an enlarged heart, a pacemaker and cirrhosis due to chronic alcoholism.
But it was clear that the associate medical examiner who signed the coroner’s report found that the primary cause of death was one of the officers kneeling on Adair’s back, Steinberg said.
"(The coroner) thinks the officers were a direct cause of his death,” Steinberg said. “So this wasn't an accident, let's say, or something natural. This is in the hands of the law officers."
Capt. Michael Kroening, the Wyandotte County Sheriff's public information officer, wouldn’t comment on whether the deputy followed proper procedure or on the officer’s employment status. But, he said, “an incident like this would be looked at administratively.”
Last week, KBI sent the case to the Wyandotte County District Attorney’s office, which is reviewing it.
The common police tactic of prone restraint, or handcuffing someone facedown, has been known to be deadly since the mid-1990s. A bulletin from the U.S. Department of Justice issued in 1995 reported, “unexplained in-custody deaths are caused more often than is generally known by a little-known phenomenon called positional asphyxia.”
But such deaths can be prevented. Proper police training suggests that once a suspect is subdued and handcuffed, he should be turned on his side, or, as the federal bulletin said, “get him off his stomach.”
Perhaps the most well-known prone restraint death is that of George Floyd in Minneapolis in 2020, whose final words were "I can't breathe."
Adair, who was in jail on misdemeanor traffic warrants, was being moved by wheelchair from the infirmary to a cell when he had an altercation with either one or several guards “which resulted in one of the officers kneeling on the decedent’s back,” according to the coroner’s report obtained by KCUR.
“They transported him to his cell, where several deputies placed him on the lower bunk. They began attempting to remove the handcuffs, while Adair continued to resist. They gained control, removed the cuffs, and left the cell,” the report said.
The coroner’s report also said Adair had multiple rib fractures, a sternal fracture and muscle hemorrhage, or bruising, on the top of his back and shoulders.
Steinberg, a doctor at Community Memorial Hospital in Ventura, California, said in-custody deaths he’s studied most often involve a person who is placed in the prone position, is in an agitated state, has been using drugs or has psychiatric issues. They can’t breathe in enough oxygen or breathe out carbon dioxide because being on the floor prevents them from pushing out their rib cage or expanding their diaphragm.
“When these people are in a struggle, fighting with officers, they go into what’s called metabolic acidosis and that requires breathing out carbon dioxide to equilibrate the acid level in the body,” Steinberg said. “If it gets too high, people can die from that problem.”
In a May 2025 paper in the Journal of Forensic and Legal Medicine, Steinberg and two other doctors found 229 cases of prone restraint-related deaths from 2010 to 2019. Most of the victims were Black males who were restrained for one to five minutes with weight force being used.
