Strangulation a serious concern on Big Island

  • HOLLYN JOHNSON/Tribune-Herald Photo illustration

Big Island prosecutors dealt with what they consider an alarming number of domestic strangulation cases last year — more than 50.

County Prosecutor Mitch Roth said there hasn’t been adequate tracking of strangulation cases in the past, making historical statistical comparison difficult, if not impossible. But he said he thinks the number of cases is on the rise.


“In the last couple of years, we’ve gone through a lot of training,” Roth said. “This is one of the things that is a real determiner of lethality, so we’re taking these cases a lot more seriously. We beefed up training for us and for police.”

A study published in the October 2008 Journal of Emergency Medicine by researchers at Johns Hopkins University School of Nursing found victims of nonfatal strangulation by an intimate partner were seven times more likely to become a homicide victim at a later point in time.

“Strangulation is, in fact, one of the best predictors for the subsequent homicide of victims of domestic violence,” said First Deputy Prosecutor Dale Ross.

Most domestic abuse cases are classified as misdemeanors, but domestic strangulation is a Class C felony punishable by up to five years imprisonment upon conviction.

Nanci Kreidman, CEO of the Domestic Violence Action Center in Honolulu, said she doesn’t know if domestic strangulation is on the rise, but also is alarmed by its apparent prevalence.

“Strangulation is more common than we would believe or we would expect,” Kriedman said. “… And more training for law enforcement would definitely be warranted, because it is a clear precursor for potential death, even if it’s unintended.

“What has shifted is our understanding of how common a practice this is. It has been called ‘choking.’ ‘He choked me.’ And we still don’t have universal language or agreement by law enforcement and programs that ‘strangulation’ is the term we should be using to capture the crime. Because the word ‘choking,’ as horrifying as that sounds … can be minimized more than the word ‘strangulation.’ It is not uncommon for survivors, when they describe their experience with their abuser, to say, ‘He choked me.’”

An article titled “Investigation and Prosecution of Strangulation Cases” in the August/September 2014 issue of Domestic Violence Report, a newsletter published by Civic Research Institute, described the word “choking” when used in domestic violence cases as a misnomer.

“While most victims will report they were ‘choked’ or grabbed by the neck — and it is important to use words the victim is most comfortable using — responders need to acknowledge the seriousness of the abuse that is actually occurring. ‘Choking’ is accidental. Strangulation is intentional. Choking means having the windpipe blocked entirely or partly by some foreign object, like food. Strangulation means to obstruct the normal breathing of a person or blood flow to the brain,” the article stated.

Asked why some assailants strangle, Kreidman described strangulation as “a fairly easy way … to get somebody to shut up or to communicate with somebody that you’re serious.”

“And when you’re standing in front of someone, your neck is very accessible. And that’s why I think it’s common, although often undescribed, unreported and uncharged,” she added.

“Frankly, strangulation is an ultimate form of power and control, where the batterer can demonstrate control over the victim’s next breath, having devastating psychological effects or a potentially fatal outcome,” Ross said.

“Domestic violence kills, and strangulation is right up there in terms of lethality,” added Denby Toci, program director at Child and Family Service in Hilo. Toci, herself a domestic violence survivor, said outward signs of strangulation aren’t always apparent on the victim — presenting an additional challenge for police and medical responders.

“You can’t always tell when you’re looking at the victim, and the effects and the symptoms can carry over after the initial event. Maybe after the initial event, the police officer would not determine that it’s strangulation, because he can’t really see it,” Toci said.

In addition, Roth and Ross pointed to an article titled “Men Who Strangle Women Also Kill Cops” in the same issue of Domestic Violence Report. The article noted a study of two datasets in which officers shot a suspect or were shot by a suspect in Idaho that found 80 percent of the suspects had a prior history of domestic violence, and 30 percent a prior history of nonfatal strangulation against a partner.

In a follow-up study in California examinating offenders who killed on-duty officers over a 20-year period, half had a history of strangulation assault, and all had a history of domestic violence.

“The sample sizes in both cases are small, but there does appear to be a correlation between strangulation assaults and intentional homicide of law enforcement officers,” Ross noted.

According to Deputy Prosecutor Suzanne Tiapula, who prosecutes felony domestic abuse cases in East Hawaii, recently there’s been an average of about one new case of domestic strangulation per week islandwide.

“Domestic violence perpetrators who use strangulation to silence their victims could be charged with attempted homicide,” Ross said. “We will be evaluating these cases in the future to determine when (and) where that might be the appropriate charge.”

Toci encouraged families “to not be afraid to seek out resources and to get into treatment,” but described domestic violence as more than a family issue. “Violence is a community problem, and strangulation is a part of the violence. We need everybody in the community to help. When you see violence, report it. If it’s a family member that is doing the abuse, do something about it. We need the community’s help to end violence in our community. We, the service providers, and the police cannot do it all themselves.”

Kreidman said the first step to deal with strangulation is “to start by naming it, labeling it, calling it what it is.”

“It’s more likely to be minimized or dismissed — not by the criminal justice system, but in general — as a threat, as a problem, as a high-incidence crime if we don’t call it what it is,” she said. “When people start calling it what it is — strangulation — people will begin to take more seriously what is happening to them and describe what is happening to them with a better outcome. At the same time, that has to be matched by law enforcement’s commitment to more training.”

Tiapula and Gael Strack, CEO and co-founder of Alliance for HOPE International and co-author of the article “Investigation and Prosecution of Strangulation Cases,” are the presenters in an advanced training workshop “Strangulation: The Last Warning Shot.”

Dates are Jan. 24 at West Hawaii Civic Center, 74-5044 Ane Keohokalole Highway in Kailua-Kona, and Jan. 25 at The House Hilo Church, 2282 Kanoelehua Ave., 8:15 a.m.-4:15 p.m. both sessions. The target audience is police, prosecutors and social service providers who assist strangulation victims.


Registration is free. For information, call Allen Bartolome at 961-0466 or email by Jan. 17.

Email John Burnett at

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