A 33-year-old autistic man died Friday evening, Oct. 23, after New York City police officers found him unresponsive on the floor while staff at a Quality Services for the Autism Community (QSAC) group home in East Harlem were restraining him, according to preliminary NYPD information reported by FOX 5 New York and CBS New York.

The cause of death has not been determined. The city's Office of the Chief Medical Examiner will perform an autopsy, and the NYPD's Force Investigation Division is investigating. No one has been charged, and police have not said what led staff to restrain him.

What police have said

Officers answered a 911 call reporting an assault in progress shortly before 5:45 p.m. at 3 E. 129th St., in the 25th Precinct. They found the man on the ground, unresponsive, as staff members held him. Officers started CPR and called for an ambulance. He was taken to NYC Health + Hospitals/Harlem in critical condition and pronounced dead there.

A 54-year-old female staff member was also taken to a hospital and was listed in stable condition. Police did not say why she was hospitalized. The man's name is being withheld until his family is notified.

In a statement to CBS New York, QSAC called the site "our Manhattan group home" and said "an investigation has commenced." The nonprofit said its condolences are with the family, and that "this is also a difficult time for the other residents and staff at the group home." It said it could not comment further.

The New York Post reported that a representative of the state Attorney General's Office was at the home late Friday night, and that unnamed sources said the office is investigating. A staff member told the Post the building houses eight people. As of Sunday morning, the Attorney General's Office of Special Investigation, which handles deaths that may have been caused by police or peace officers, had not announced a case.

Who runs the home

QSAC is a nonprofit founded in 1978 by parents of children with autism. It says it serves more than 2,700 people in New York City and on Long Island. According to its residential services page, its homes are Individualized Residential Alternatives (IRAs) and intermediate care facilities, the two main types of residence the state Office for People With Developmental Disabilities (OPWDD) certifies for people with intellectual and developmental disabilities.

What New York's rules say about restraint

OPWDD's rule on behavioral interventions, 14 NYCRR 633.16, covers residences the agency certifies or operates. It does not name specific holds, but it sets standards for any physical intervention:

  • The technique must be designed with "concern for circulation and respiration," avoid pressure on joints, and not be likely to cause pain or injury.
  • Staff must use the minimum force needed to safely interrupt the behavior, and the least restrictive technique that will work in that situation.
  • A restrictive physical intervention may be used only when a person's behavior poses an immediate health or safety risk to the person or others.
  • Any intermediate or restrictive hold must end once the behavior has diminished or stopped, or "immediately if the person appears physically at risk." No single hold may last more than 20 minutes.
  • Everyone using a technique must hold current certification in positive behavioral approaches and physical intervention techniques, and the agency must monitor and oversee every use.

After any hold, the person must be checked for injury as soon as reasonably possible and medical care arranged if an injury is suspected. Each use of a restrictive hold must be reported to OPWDD electronically. The service coordinator and, in most cases, the family or advocate must be told within two business days of an emergency use. A hold that does not meet the rule is itself a reportable incident.

How a death is reported

Under OPWDD's incident rules, the death of anyone receiving services is a "serious notable occurrence," whatever the cause (14 NYCRR 624.4). Section 624.5 requires the agency's chief executive or a designee to report the death to the Justice Center for the Protection of People with Special Needs immediately, and no later than 24 hours after discovery. A full report of death goes into OPWDD's incident system within five working days, and any autopsy results go to the Justice Center and OPWDD within 60 working days. Serious notable occurrences must also be reported to OPWDD right away.

What this means for providers and DSPs

The facts of Friday's death are not yet known, and nothing here suggests what happened. But the state rules show what reviewers typically look at after any restraint: whether the behavior posed an immediate risk, whether staff used the least force needed, whether breathing and circulation were protected, and whether the hold stopped as soon as the person appeared to be in physical distress.

For DSPs, the rule's most practical line is that a hold must end immediately if the person appears physically at risk, even when the behavior has not stopped. Watching for changes in color, breathing, speech or responsiveness during any hold, and calling for medical help at the first sign of trouble, are part of the job the regulation describes.

For frontline supervisors and agency leaders, the rule ties holds to planning. Emergency holds used more than twice in 30 days, or four times in six months, require a documented team review with a clinician to decide whether a behavior support plan is needed or should change. Agencies can check that their own records show each restrictive hold was reported to OPWDD, that injury checks were documented, and that families and coordinators were told on time.

DSN will follow the medical examiner's findings and any action by the Justice Center, OPWDD or the Attorney General.