Death of Md. man who suffered cardiac arrest in police, EMS custody ruled homicide
The medical examiner determined Renardo Green's cause of death was "prone restraint cardiac arrest"
Alex Mann and Lilly Price
The Capital, Annapolis, Md.
ANNAPOLIS, Md. — The Maryland Office of the Chief Medical Examiner has ruled an Annapolis man died by homicide when he suffered cardiac arrest in the custody of city police officers and emergency medical services personnel in June.
Dr. Victor W. Weedn, the chief medical examiner, performed the autopsy on Renardo Green in June and determined the 51-year-old died because he was restrained on his stomach, which prevented him from breathing, caused his heart to stop and led to him becoming brain-dead, according to the autopsy report signed Sept. 20. Weedn determined Green's cause of death was "prone restraint cardiac arrest."
Drug intoxication contributed to Green's death, Weedn found. Green had PCP, TCP, methadone, fentanyl and cocaine in his system, according to the autopsy report.
Police and paramedics came to Green's apartment in June after his wife called for help because was under the influence of PCP and being destructive. He was never placed under arrest or suspected of a crime. Annapolis police said around the time of his death they were not investigating because it was considered a medical incident.
However, the autopsy report, which has not been made public but was reviewed by The Capital and The Baltimore Sun, sheds new light on the circumstances surrounding Green's death and the investigation of it.
Amid a state and national push for transparency from law enforcement, city and county officials have provided little information about the investigation into Green's death. Neither the Annapolis Police Department nor the Anne Arundel County State's Attorney's Office acknowledged publicly Green died by homicide. Both declined to answer questions.
City Attorney D. Michael Lyles did not respond Thursday afternoon to questions or multiple requests for comment. A spokesperson with the Annapolis police department said Dec. 7 the case was being reviewed by the State's Attorney's Office.
Annapolis Mayor Gavin Buckley said in response to The Capital article Friday evening that he learned Green's death was ruled a homicide "just a few weeks ago," and didn't inform the public of the ruling because the State's Attorney's Office was still reviewing the case.
Tia Lewis, state's attorney's office spokeswoman, said "the matter is still under investigation" but declined to say by whom.
A spokesman for the Annapolis Fire Department said Fire Chief Douglas Remaley was "aware that the medical incident is under review" and "for that reason is withholding any comments at this time."
None of this information was relayed to Brittany Green, Renardo Green's daughter, who learned from a reporter her father's death was classified as a homicide and that it was under investigation.
"I think it's wrong," Brittany Green said. "My name was on all his paperwork and I still should have known what's going on with my dad's death."
Her father died on June 4 at Anne Arundel Medical Center — three days after he was placed on a ventilator and considered brain-dead, according to his family. Green, a lifelong Annapolis resident, was known by his nickname "Hot Dog" and for his boisterous, funny personality.
Green's wife called 911 around 2 a.m. June 1 and told the operator Green had taken PCP and was shouting and breaking things in her apartment in Eastport. She said she wanted him out of the apartment and requested an ambulance because Green was bleeding heavily after cutting his hand, according to a recording of the call. Green is heard yelling in the background of the 911 call.
Police body camera video shown to The Capital and three city officials in June after Green died showed him lying on the apartment's floor on his stomach under the foot of a relative when police arrived.
It was the second time officers responded to the Harbour House community for Green in five hours, according to body camera footage. Officers and medics arrived around 9 p.m. May 31 and found Green disoriented and sitting on a curb; Green stood up and waved the responders away.
When police arrived again around 2 a.m. to the Madison Street apartment, Green flailed his arms and legs and continuously screamed profanities while officers attempted to calm him, according to the footage and police reports. Police officers used two sets of handcuffs to restrain his hands behind his back and shackled his legs.
Officers turned Green on his side and waited for emergency personnel to arrive as Green yelled, according to the video. The footage showed Green appeared to struggle for breaths between words.
Green's wife told police he had been using PCP for four years, police wrote in the report. Officers planned to take Green to the hospital for an emergency evaluation.
Multiple attempts to reach Green's wife were unsuccessful.
In the apartment, EMS lifted Green onto a spine board using a sheet and strapped him to the stretcher with his stomach down, the video showed. EMS applied extra straps when they moved Green onto a wheeled gurney just outside of the building, and Green continued to yell while being rolled to the ambulance, according to the police reports.
He was found to be unresponsive while he was being loaded onto the ambulance or shortly thereafter, according to the autopsy report. EMS detected his heartbeat was slow; then, Green went into the most severe form of cardiac arrest, sometimes referred to as flatlining, the autopsy report said.
The city did not show any body camera footage from the ambulance, although an officer rode with Green and EMS, according to the police reports.
Generally, medics and paramedics are to avoid restraining a patient in a "prone, hobbled or hogtied position," according to the 2020 protocols published by the Maryland Institute for Emergency Medical Services Systems, the agency that oversees all the EMS clinicians in the state. They are only supposed to employ restraints when they believe the patient poses a danger to themselves or others — situations where the patient is agitated or violent.
If police have already handcuffed the patient, EMS personnel are to collaborate with officers to reposition the patient in the "face up positions with hands anterior and secured to [the] stretcher," the protocols say. EMS are supposed to secure the patient for the ambulance ride, using straps if necessary. But, the protocols advise, "be prepared at all times to logroll, suction, and maintain airway."
Being restrained in the prone position inhibits breathing and the ability of the heart to pump blood effectively, according to a 2021 paper published in the Journal of Medicine, Science and the Law.
Paramedics took steps to resuscitate Green while in the ambulance, turning him over onto his back, intubating him and administering three rounds of epinephrine, the autopsy report said. Still, Green did not have a pulse when he arrived at the hospital. He was resuscitated in the emergency room and moved to intensive care but never regained consciousness, according to the report.
When his office made available the body camera footage from the incident, Buckley described the incident as "pretty textbook to me on how you handle someone humanely and sensitively."
After his death, Buckley described Green, who was a former city employee, as a "big man in physical stature" who had a "big heart and an infectious laugh."
(c)2021 The Capital (Annapolis, Md.)