Donald Hutson’s family had been waiting for his release from prison for decades.

But in September 2018, Hutson died at Missouri Eastern Correctional Center after taking the illegal drug K2.

St. Louis Public Radio first reported on his death last year as part of a long-term investigation examining overdoses in Missouri prisons. Our reporting uncovered disturbing details about the night Hutson died, spurring more questions.

His official cause of death was a K2 overdose, according to a toxicology report — but an internal investigation by the Missouri Department of Corrections revealed that officers improperly restrained Hutson while he was overdosing.

“They used extra force on him, and they killed him,” said Tasha Franks, Hutson’s sister. “I’m just so angry. This is something we’ll never forget.”

The Missouri Department of Corrections, like other state prison systems in the U.S., has struggled to keep K2 and other drugs out of its facilities. But illicit drugs continue to infiltrate Missouri prisons, resulting in a steady stream of inmate overdoses.

K2, known as synthetic cannabinoids, often consists of plant material laced with a combination of chemicals. The chemical cocktail and concentration vary from batch to batch, making it particularly dangerous for users.

Users can experience seizures, elevated heart rate and even psychosis.

Cody Umfress, a former lieutenant at Missouri Eastern Correctional Center, was not on duty when Hutson overdosed. Still, he estimates he saw at least 50 inmates high on K2 over a three-year period.

“They’re not in control of their bodies,” Umfress said. “Their arms are flailing around, they’re stumbling around like they’re drunk. They can be acting extremely violent to staff and other inmates.”

An internal investigation

Under department policy, Umfress said, an officer who restrains an inmate on the ground should move them into a seated or standing position as quickly as possible.

But according to an internal investigation by the DOC, that’s not what happened the night Donald Hutson died.

DOC investigator Darrell Wagganer reviewed video surveillance and interviewed six people who witnessed the incident, who described Hutson as “combative.”

Carolina Hidalgo | St. Louis Public Radio

In his report, Wagganer said the video recording showed a “dog pile” of seven or eight officers holding Hutson facedown on the ground, before ultimately restraining him.

The full results of the investigation are sealed under Missouri law. Based on the investigation report summary, excerpted below, officers at the Pacific prison did not follow departmental policy when they restrained Hutson:

“Wagganer stated that according to multiple witness accounts, Hutson was strapped ‘face-down’ to a medical backboard for an excessive amount of time (estimated 30-45 minutes).

According to Wagganer, this method of restraint is not in accordance with the standing [sic] operating procedures of the facility.”

A still image in Hutson’s case file shows him handcuffed with his hands behind his back, “secured to the backboard with a blue strap that went over each shoulder and traveled down his back.”

The Missouri Department of Corrections policy on mechanical restraints allows officers to temporarily cuff an inmate’s hands behind their back while escorting them or to minimize security threats.

The policy, however, prohibits staff from restraining an inmate in a way that causes severe physical pain or “restricts blood circulation or breathing.”

Witnesses reported Hutson possibly stopped breathing while he was strapped facedown to the backboard and “went limp and threw up blood,” according to the investigation report summary.

Shortly after Hutson’s death, Jennifer Sachse, then-warden of Missouri Eastern Correctional Center, told investigators that he became “unresponsive” during the restraining process. But she emphasized that he had not been in danger of suffocation, based on a report filed with the St. Louis County Medical Examiner.

The Missouri Department of Corrections declined an interview request for this story.

According to an internal DOC report, at least eight staff members were involved in the incident. Five are still employed at Missouri Eastern Correctional Center, according to a prison employee who spoke on condition of anonymity. It's unclear whether any have faced disciplinary action for Hutson's death.

Risk of suffocation

According to medical professionals, a person restrained facedown can be at risk of sudden death from positional asphyxiation, a condition in which their breathing is hindered by the position of their body.

Law enforcement agencies have long been aware of this issue, particularly with regard to drug overdoses.

In 1995, the U.S. Department of Justice issued a bulletin, warning that drug and alcohol intoxication is a major risk factor for positional asphyxiation because “respiratory drive is reduced, and subjects may not realize they are suffocating.”

Carolina Hidalgo | St. Louis Public Radio

When treating a patient who has overdosed on K2, doctors and first responders ensure that nothing is interfering with their ability to breathe — including the weight of their own body.

“You want them in a position where their face is unobstructed and there’s nothing on their chest,” said Evan Schwarz, an associate professor of emergency medicine at Washington University. “You don’t want them in a position where they can’t move their chest in and out.”

Though the symptoms of K2 overdose can vary, patients are often frenetic and can be aggressive.

In the hospital, Schwarz said, staff often use benzodiazepines and other sedatives to help subdue them.

“They could be very agitated, hallucinating, maybe even psychotic for hours until the drug clears out of their system,” he explained, adding that sedatives are much safer than physically restraining a patient.

It’s unclear if Missouri inmates who overdose on K2 are given sedatives. Corizon, the private, for-profit company that provides health care in Missouri prisons, declined an interview request.

According to Hutson’s toxicology report, he did not have benzodiazepine sedatives in his system at the time of his death. However, he was given Narcan, which Schwarz said is not effective for a K2 overdose.

An autopsy performed by the St. Louis County Medical Examiner’s office did not reveal any injuries to Hutson’s lungs or airways, but some forensic researchers have reported death due to positional asphyxiation can be difficult to diagnose. Repeated attempts to reach the County Medical Examiner’s office for comment were unsuccessful.

Carolina Hidalgo | St. Louis Public Radio

Hutson’s official cause of death was ruled an accident due to “acute synthetic cannabinoid toxicity,” or K2 overdose, but his family is convinced that the actions of prison staff that night contributed to his death.

Tasha Franks, Hutson’s sister, said she’s always felt personally responsible for her younger brother — and she regrets that she wasn’t able to protect him.

“I just wish everything could just go back,” Franks said. “I wish none of this would have never happened.”

It’s been more than a year since his death, but for Franks, her grief is a wound that won’t heal. Sometimes, she lays awake at night, thinking about him.

“He was getting his life together,” Franks said. “It was all we used to talk about — how he would get out and start his own business. He wanted to do better. But everything we had planned, it didn’t happen.”

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