Whether prone restraint is legal depends entirely on where it happens and who is doing it. A growing number of states ban the practice outright in schools, federal healthcare regulations tightly limit it in hospitals and psychiatric facilities, and police use is judged against constitutional standards that vary with the person’s legal status. There is no blanket federal prohibition. When prone restraint is used in violation of the rules that do apply, the person restrained or their family can pursue a federal civil rights lawsuit, file administrative complaints, and in rare cases see staff criminally charged.
What Counts as Prone Restraint
Prone restraint means holding someone face-down on the floor or another flat surface while using body weight or physical pressure to prevent them from moving. The chest and stomach stay pressed against the ground, and the arms are usually pinned behind the back or beneath the body. To qualify under most regulatory definitions, the force applied has to be enough to stop the person from rolling over or standing up.
State definitions line up fairly closely. Georgia and Massachusetts both define it as placing a student face-down and applying physical pressure to keep them in that position.1Dartmouth College. Child Prone Restraint in New Hampshire What separates prone restraint from other holds is the downward-facing orientation, not the intent behind the contact or how long it lasts.
Why the Law Treats It Seriously
Pressing someone face-down compresses the chest and restricts breathing. The traditional explanation was “positional asphyxia,” but more recent research argues the actual cause of death is cardiac arrest triggered by metabolic acidosis, worsened by reduced ventilation and falling cardiac output.2PubMed. Prone Restraint Cardiac Arrest: A Comprehensive Review of the Scientific Literature and an Explanation of the Physiology The body produces acid buildup from struggling, and when the person cannot breathe deeply enough to compensate, the heart can stop.
At least 121 people have died in the United States while being held prone by law enforcement officers alone, a count that excludes deaths in schools, psychiatric facilities, and group homes. Civil settlements have reached into the millions. Denver paid $3 million after Michael Marshall died following more than nine minutes prone and handcuffed in 2015, and Tucson paid $2.9 million after Carlos Ingram Lopez died under similar circumstances in 2020.39News. At Least 121 People Have Died While Held Prone by Officers in US Those deaths are the reason legislatures have moved to restrict the practice.
One warning sign matters for anyone reading this: the shift from struggling to silence is the most dangerous moment. Staff sometimes read a person going limp as compliance when it actually signals respiratory or cardiac failure.4Children’s Hospital of Philadelphia. Signs of Respiratory Distress in Children
Prone Restraint in Schools
Schools are where the legal landscape has shifted most. California’s Education Code flatly prohibits prone restraint, along with any technique that restricts breathing or places pressure on a student’s back or torso.5California Department of Education. Prohibiting the Use of Prone Restraint – Laws, Regulations, and Policies Illinois bans the practice in all public schools, special education cooperatives, and nonpublic facilities, and extends the ban to Illinois students placed in out-of-state schools even where that state allows it.6Illinois State Board of Education. Public Act 102-0339 Fact Sheet Minnesota banned prone restraint on students with disabilities in 2015 and expanded the ban to all students in 2023.7Minnesota House of Representatives. Prone Restraint: Laws, Reporting Rules, and Civil Actions
In states that still allow prone restraint in schools, the common rule is that physical restraint of any kind is a last resort, permitted only when a student’s behavior poses an immediate threat of serious physical harm and less intrusive interventions have failed or are clearly inappropriate. Massachusetts regulations require schools to document the de-escalation strategies attempted and the alternatives considered before any restraint is initiated.8Massachusetts Department of Elementary and Secondary Education. 603 CMR 46.00 – Prevention of Physical Restraint and Requirements if Used
At the federal level, the Individuals with Disabilities Education Act requires schools to use positive behavioral interventions and supports for students with disabilities.9Office of the Law Revision Counsel. 20 USC 1400 – Short Title; Findings; Purposes IDEA does not name specific holds. The Keeping All Students Safe Act, reintroduced in both chambers in December 2025, would make it illegal for any school receiving federal funding to use prone or supine restraint or to seclude children, allowing physical restraint only when necessary to protect the safety of students and staff.10U.S. Representative Don Beyer. House and Senate Reintroduce Bipartisan Legislation to Protect Students from Dangerous Seclusion and Restraint Practices As of early 2026, the bill has been referred to the Senate Committee on Health, Education, Labor, and Pensions and has not advanced further.11Congress.gov. S.3448 – Keeping All Students Safe Act
Hospitals and Residential Facilities
Psychiatric hospitals and residential treatment centers run on healthcare rules, not education codes. The federal Centers for Medicare and Medicaid Services require that any patient who is restrained be evaluated face-to-face within one hour by a physician, licensed practitioner, or registered nurse trained in restraint procedures.12eCFR. 42 CFR 482.13 – Condition of Participation: Patient’s Rights Ongoing monitoring must cover vital signs, circulation, range of motion, and psychological state, and staff must keep the person’s airway clear. Facilities that violate these rules can lose Medicare certification.
Police Encounters and Jails
Prone restraint by law enforcement is judged under constitutional standards, and which standard applies turns on the person’s legal status at the time. During an arrest or investigative stop, force is evaluated under the Fourth Amendment’s “objective reasonableness” test from Graham v. Connor.13U.S. Department of Justice. Justice Manual 1-16.000 – Department of Justice Policy on Use of Force For pretrial detainees who have not been convicted, the Fourteenth Amendment applies, and the Supreme Court held in Kingsley v. Hendrickson that the detainee need only show the force used was objectively unreasonable.14Justia U.S. Supreme Court. Kingsley v. Hendrickson, 576 U.S. 389 (2015) Convicted prisoners fall under the Eighth Amendment’s ban on cruel and unusual punishment, which requires showing that officers acted “maliciously and sadistically.”
These distinctions matter when a case is built. The same prone hold applied to a pretrial detainee, a convicted inmate, and a person during a street arrest is measured by three different yardsticks.
Suing Over an Unlawful Prone Restraint
The main legal tool for challenging an unlawful prone restraint is a federal civil rights lawsuit under 42 U.S.C. § 1983. The statute lets anyone whose constitutional rights were violated by a government employee acting in an official capacity sue for damages.15Office of the Law Revision Counsel. 42 USC 1983 – Civil Action for Deprivation of Rights In prone restraint cases, the claim usually alleges excessive force or deliberate indifference to a serious medical risk. Successful plaintiffs can recover compensatory damages for physical injuries, emotional distress, and medical costs, and courts may award attorney fees to the prevailing party under a separate statute.16Office of the Law Revision Counsel. 42 USC 1988 – Proceedings in Vindication of Civil Rights
Qualified Immunity
The biggest obstacle in most § 1983 cases is qualified immunity. Government employees are shielded from personal liability unless the plaintiff can show the employee violated a “clearly established” constitutional right. In practice, that often means pointing to an existing court decision with sufficiently similar facts. A court can find a constitutional violation occurred and still dismiss the case because the right was not clearly established at the time. This is where many restraint claims fall apart.
Filing Deadlines
Section 1983 has no statute of limitations of its own. Federal courts borrow the personal-injury limitations period from the state where the incident happened, which is typically two to three years. The clock starts when the plaintiff knows or has reason to know about the injury. State tolling rules can pause or extend the deadline, including for minors. Waiting too long to consult a lawyer is one of the most avoidable mistakes in these cases.
Disability Discrimination and Administrative Complaints
When the person restrained has a disability, Title II of the Americans with Disabilities Act prohibits public entities from discriminating against qualified individuals with disabilities or excluding them from services, programs, or activities.17Office of the Law Revision Counsel. 42 USC 12132 – Discrimination Using prone restraint in response to disability-related behaviors, especially where the facility failed to provide appropriate accommodations or behavioral supports, can support a discrimination claim.
Families can also file administrative complaints with the Office for Civil Rights at the U.S. Department of Education, which can investigate schools and require changes to institutional policies.18U.S. Department of Education. File a Complaint The Department of Justice can investigate patterns of abuse in state-run institutions under the Civil Rights of Institutionalized Persons Act, which covers jails, psychiatric facilities, juvenile detention centers, and nursing homes.19Office of the Law Revision Counsel. 42 USC 1997 – Definitions These investigations can produce consent decrees mandating facility-wide reforms, staff retraining, and ongoing federal monitoring, and courts sometimes issue injunctions ordering a facility to stop using specific restraint techniques entirely.
Criminal Charges
Criminal prosecution of staff involved in restraint deaths remains rare. When charges do come, they typically involve involuntary manslaughter or reckless endangerment. Five jail guards and a nurse were charged with involuntary manslaughter after John Neville died following more than 17 minutes in a prone position in a North Carolina jail in 2019. Two Colorado deputies faced manslaughter charges after Demetrius Shankling died of asphyxiation during transport.20KARE 11. Charges Rare, Convictions Nonexistent in Prone Restraint Deaths
Prosecutors face unique challenges in these cases. Unlike a shooting, where the use of lethal force is immediately obvious, they have to prove that the specific amount and duration of pressure was unreasonable and caused the death. Defense attorneys routinely argue the person died from drug intoxication, a preexisting heart condition, or the exertion of struggling, rather than from the restraint. Convictions have historically been extraordinarily difficult to obtain.