At least 115 people were injured this summer when police shot them in the head or neck with so-called “less-lethal” projectiles at protests over racial injustice and police brutality, according to a report published Monday.

It’s the most comprehensive tally of such injuries to date, with about twice as many victims as KHN and USA Today cited in a July examination of how police across the U.S. wielded the weapons to control crowds.

But Physicians for Human Rights, the organization that compiled the incidents, believes even its figures are an undercount because its analysis is based on publicly available data and excluded some reports without adequate evidence.

The organization identified Austin, Texas; Portland, Oregon; and Los Angeles as hot spots during the period studied, May 26 to July 27.

Abigail Rodas, who was shot in the jaw with a rubber bullet on May 30, was one of the victims in Los Angeles, according to a lawsuit filed against the city and the police chief on behalf of Black Lives Matter Los Angeles, the Los Angeles Community Action Network and 14 people, including six who were struck with projectiles.

According to the suit, Rodas was leaving a protest when she “was struck in the face by a projectile and momentarily lost consciousness.”

A steel plate was used to repair her jawbone, the lawsuit says. She couldn’t talk for about 10 days and could drink only liquids for a week, it says.

“Nearly three weeks after the injury, she has screws in her gums and rubber bands to immobilize her jaw while the bones rejoin,” the suit says.

The city denied the allegations in a court filing, saying any use of force “was reasonable and necessary for self-defense.”

Protests Shine Light on Use of ‘Less-Lethal’ Weapons

The sheer number of incidents in those two months was shocking, said Dr. Rohini Haar, lead investigator for the analysis and an emergency physician in Oakland, California.

“It seems systematic,” Haar said. “It seems like there needs to be a reckoning with the use of force in protests.”

The projectiles in question are often called “rubber bullets,” but in law enforcement they’re known as “kinetic impact projectiles.”

They include plastic projectiles tipped with hard sponge or foam, “bean bag” rounds that consist of fabric socks containing metal shot, and “Sting-Balls” — grenades that spray hard rubber pellets. The report also cites incidents in which tear gas canisters were fired at people.

Though the weapons are referred to as “less lethal,” Haar said, there should be a shift to language that acknowledges how dangerous they can be. “Weapons are just as lethal as somebody wants them to be,” she said.

A study published in 2017 in the medical journal BMJ Open, which Haar co-authored, found that 3% of people hit by projectiles worldwide died. Fifteen percent of the 1,984 people studied were permanently injured.

In a letter to the editor of the New England Journal of Medicine, a group of Austin doctors said 19 patients were treated for bean bag-related wounds at the downtown hospital closest to the protests over two days in late May.

C.J. Montano, one week after attending a Los Angeles protest where the police shot a projectile at his head.(C.J. Montano)

For its analysis, Physicians for Human Rights searched social media, news accounts, lawsuits and other publicly available sources. They counted incidents on social media only if they were documented by photos or videos, and included news reports without visual evidence only from major newspapers or local affiliates of major outlets.

Physicians for Human Rights identified by name most of the people who were struck.

Among the group’s recommendations are banning weapons that release scattershot or multiple projectiles from a single canister because they can hit people indiscriminately, Haar said. Metal projectiles are particularly dangerous, she said.

She called for more training and adherence to departments’ rules on the use of such weapons.

“One of the findings of our study is police do not even appear to be following their own protocols for how to use these weapons or when,” Haar said.

There are no national standards for police use of less-lethal projectiles and no comprehensive data on their use, USA Today found.

Demonstrators in Los Angeles, Minneapolis, San Jose, Denver and Dallas told USA Today they were shot with less-lethal projectiles even though those departments don’t allow the weapons to be used against nonviolent people. Some witnesses said police aimed at faces or fired at close range.

Police have said they fired the weapons to protect themselves and property in chaotic, dangerous situations.

‘Protesters Feel Like They’re Being Attacked’

Haar, who has been studying these projectiles since 2014, said they have no place in crowd control. “Even before you get to the use of weapons, there needs to be a change in how we engage with protesters in terms of communication,” she said.

For example, police can get the phone number of a protest leader, opening the lines of communication. Police have other options besides firing projectiles, Haar said, such as “arresting the person that is actually violent, not just dispersing the entire crowd, or changing what you decide is an illegal assembly.”

Haar said the use of these projectiles tends to escalate tensions, “where the protesters feel like they’re being attacked.” Those who aren’t struck, she said, “are often incited. It’s not until that full crowd is dispersed that the anger goes away. The volatility has a cumulative impact that can last weeks or months.”

At least seven major U.S. cities and a few states have enacted or proposed limits on the use of less-lethal projectiles.

However, similar efforts have stalled in the face of opposition from police agencies or other critics. And as the summer stretched on, local and federal law enforcement agencies continued to use less-lethal weapons when confronting protesters.

Haar said city councils have reached out to her recently, showing they are “really trying to reckon with what they want in their communities.”

“I see more hope now than I have in all of my years of research,” she said. “I think the attention now is remarkable, and we actually have a really good chance of getting some actual, meaningful change.”

USA Today’s Kevin McCoy contributed to this report.

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