Fiocchi

As protesters filled the streets of downtown San Jose, Calif., recently, the police fired munitions known as rubber bullets into the crowd — a common technique to disperse throngs.

Breanna Contreras’s head jerked back from the impact as a black projectile “roughly the size of an extra-jumbo marshmallow” struck her temple, near her eye. “I instantly felt my head just starting to throb, blood poured down my face,” Ms. Contreras, a 21-year-old student, said.

A bystander who used her face mask to help stop the bleeding was also struck. “There were so many rubber bullets being fired, I wanted to think how to protect my eyes,” said Peter di Donato, 75, a veteran of anti-Vietnam War protests, who was hit in the leg. Derrick Sanderlin, 29, a community organizer who had worked with the local police on anti-bias training, approached a line of police officers to ask them to stop. But he got hit too — in the groin — and had to have emergency surgery. He said his doctors have told him he may not be able to have children as a result of the injury.

A 2017 analysis published in the British Medical Journal of several decades of the use of rubber bullets, beanbag rounds and other projectiles during arrests and protests found that 15 percent of people who were injured were left with permanent disabilities and 3 percent of those who were injured died. Of those who survived, 71 percent had severe injuries, with their extremities most frequently impacted.

“The reality is, even though they were designed as nonlethal, we sadly know that over time there have been some fatalities linked to these devices,” said Dr. Jeffrey M. Goodloe, who is a member of the board of directors for the American College of Emergency Physicians and the chief medical officer for the Emergency Medical Services System for Metropolitan Oklahoma City and Tulsa.

“Instead of calling them nonlethal, we now call these weapons ‘less lethal’, and that is in comparison to a standard bullet,” Dr. Goodloe said.