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Display Settings: Abstract

Pediatrics. 1996 Jun;97(6 Pt 1):891-5.

Fatal dog attacks, 1989-1994.

Sacks JJ, Lockwood R, Hornreich J, Sattin RW.

Division of Unintentional Injury Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.

OBJECTIVES. To update data on fatal dog bites and see if past trends have continued. DESIGN. To merge data from vital

records, the Humane Society of the United States, and searches of electronic news files. SETTING: United States.

SUBJECTS. U.S. residents dying in the U.S. from 1989 through 1994 from dog bites. RESULTS. We identified 109 dog

bite-related fatalities, of which 57% were less than 10 years of age. The death rate for neonates was two orders of

magnitude higher than for adults and the rate for children one order of magnitude higher. Of classifiable deaths, 22%

involved an unrestrained dog off the owner's property, 18% involved a restrained dog on the owner's property, and 59%

involved an unrestrained dog on the owner's property. Eleven attacks involved a sleeping infant; 19 dogs involved in fatal

attacks had a prior history of aggression; and 19 of 20 classifiable deaths involved an unneutered dog. Pit bulls, the most

commonly reported breed, were involved in 24 deaths; the next most commonly reported breeds were rottweilers (16) and

German shepherds (10). CONCLUSIONS. The dog bite problem should be reconceptualized as a largely preventable

epidemic. Breed-specific approaches to the control of dog bites do not address the issue that many breeds are involved in

the problem and that most of the factors contributing to dog bites are related to the level of responsibility exercised by dog

owners. To prevent dog bite-related deaths and injuries, we recommend public education about responsible dog ownership

and dog bite prevention, stronger animal control laws, better resources for enforcement of these laws, and better reporting

of bites. Anticipatory guidance by pediatric health care providers should address dog bite prevention.

PMID: 8657532 [PubMed - indexed for MEDLINE]

PubMed

U.S. National Library of Medicine

National Institutes of Health

MeSH Terms

LinkOut - more resources

Fatal dog attacks, 1989-1994. [Pediatrics. 1996] ... http://www.ncbi.nlm.nih.gov/pubmed/8657532

1 of 1 1/15/10 1:08 PM

!"#$"%&'()*+,&-../

properly," he says. The dog should also be well-mannered, constantly under supervision when in public areas, and safely confined-with some

added precautions to prevent innocent trespassers from coming in contact with the dog. "Kids do come onto property," heeds Beck, adding that

young children cannot read "Beware of Dog" signs.

In California, for example, if a dog is reported to an animal control officer or law enforcement officer as being a threat to the neighborhood, the

state's dangerous dog law requires the dog's owner to be notified and a hearing held to determine if the dog is potentially dangerous (could cause

serious injury) or vicious (has caused serious injury). Dogs that are found to be potentially dangerous must be licensed, vaccinated, and kept

indoors or in "securely fenced yard from which the dog cannot escape, and into which children cannot trespass." Dogs that are found to be vicious

may be destroyed by the animal control department if the court finds that the release of the dog back into the owner's custody "would create a

significant threat to the public health, safety and welfare." The California courts may also prevent an owner – who is found to own a vicious dog –

from owning another dog for a period of up to three years.

To keep abreast of what is going on

regarding breed banning and dangerous

dog legislation in your area, the following

organizations maintain legislative

web-sites. Humane Society of the United

States – The HSUS maintains a web-site

devoted to dog bite prevention,

education, and legislative issues at:

http://www.nodogbites.org.

American Kennel Club – The AKC's

Canine Legislation Department publishes

a monthly newsletter, "Taking Command,"

that is available to the legislative

chairperson of local, regional and

national breed clubs. For the rest of us

dog owners, an electronic version can be

downloaded monthly from the AKC's

web-site at http://www.akc.org. The

AKC also offers a free packet of

information on dangerous dog legislation

for those who are trying to battle or

prevent breed banning in their areas.

Rott-n-Chatter – This informative

web-site is from the Rottweiler folks who

maintain up-to-date legislative

information on all breed bans for all

states. It can be accessed at:

http://www.rott-n-chatter.com

/rottweilers/laws/breedspecific.htm

The HSUS supports dangerous dog laws and has supported the passage of several laws in various

states. The HSUS places the responsibility of the rampant dog bite statistics and even dog bite

fatalities squarely on the shoulders of the dog owner – not the type of dog. "Every dog owner must

accept responsibility for preventing dog bites by spaying and neutering their pets, training and

socializing them properly, and by ensuring that their dogs are safely confined," says Leslie Sinclair,

DVM, HSUS's director of veterinary issues for companion animals. Pigeonholing a certain breed as

dangerous and then banning it doesn't get rid of the problem, she notes, pointing out that dog

owners who want a dangerous dog will simply turn to another breed. The Doberman Pinscher was

the "scary" dog of the 1970s, the Pit Bull in the 1980s, and now the Rottweiler in the 1990s.

Sinclair clarifies, however, that the HSUS doesn't deny that certain breeds, such as the Pit Bull,

have a history of being abused by humans and have been used – and are still being used illegally –

for dog fighting in which the dog does not let go until it kills the other animal. With a good dangerous

dog law, Sinclair says "The legislation focuses on the human who allowed the problem to develop,

and who will "do it again" with another dog, if allowed to." She adds, "Good laws protect dogs and

require better care for the dogs."

Watch Your Step

Currently, "watchdog" organizations that track breed banning legislation say that twelve states have

adopted dangerous dog laws and have "outlawed" laws banning specific breeds. Other states are

not regulated in this way. "People need to understand that dog ownership of certain breeds is

getting tougher all the time," says Mickie Brown, legislative chairperson of the Bull Dog Club of

America. She advises dog owners – particularly those of targeted breeds – to stay current on their

local situation. Animal legislation may not hit the front page of the paper, so it is possible for a dog

owner to suddenly be in a situation in which he or she must either give up the dogs, or move.

"Dog owners of breeds that are often singled out for breed banning have an added responsibility,"

Sinclair echoes. "They not only need to keep an eye on the issues, they also need to be model dog

owners." Dogs that are highly-trained, well socialized, and properly cared for, she notes, help to

counter random images of those that are abused, isolated, ill-kept, and poorly trained. They might

also help to prevent legislators from taking the easy way out with a breed ban law, and perhaps

consider more complex laws that are fairer to responsible owners and better for dogs as a whole.

! 1999 Joan Hustace Walker, Chesapeake, VA

Legislation

WELCOME SITE INFO BREED-INFO SAD REALITY POSITIVE PRESS TRAINING TIPS LEGISLATION

INSPIRATION PETE THE PUP MEMORIAL PITBULL LINKS OLD TIME PITS RESPONSIBLE PIT BULL CARDS

Pet Pitbull - Positive Press http://www.pitbullsontheweb.com/petbull/articles/...

2 of 3 1/15/10 12:43 PM

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Rottweilers now 'deadliest dog'Veterinarians: Pit bulls second, but dogs aren't to blame

ASSOCIATED PRESS

WASHINGTON, Sept. 15 — It's not a record anyone would be proud of, but a studyreleased by veterinarians Friday found that rottweilers have passed pit bulls as thedeadliest dog breed in the United States. The authors didn't blame the animals, but peoplefor not knowing how to train their dogs and others for not knowing when to stay awayfrom unfamiliar dogs.

'People are more in fear of crime and violence, and this hasled to a selection of bigger dogs. If you start selecting biggerdogs, you’ll get bigger bites.'

CENTERS FOR DISEASE CONTROL EPIDEMIOLOGIST

ROTTWEILERS were involved in 33 fatal attacks on humans between 1991 and 1998, the American Veterinary Medical

Association said.

Pit bulls, which had been responsible for more deaths than any other breed, were involved in 21 fatal attacks over the same

period.

Rottweilers, first bred in Germany, surged in popularity during the 1990s as more people sought them for protection, said

Jeffrey Sacks, an epidemiologist with the Centers for Disease Control and Prevention.

"People are more in fear of crime and violence, and this has led to a selection of bigger dogs," he said. "If you start selecting

bigger dogs, you’ll get bigger bites."

FOCUS ON HUMANS

The study’s authors, using data from the Humane Society of the United States and media accounts of dog maulings, reported

27 people — 19 of them children — died from dog attacks in 1997 and 1998.

The numbers highlight widespread mistreatment of dogs and a growing public ignorance of how to behave around them,

researchers said. They blamed adults for not teaching children to stay away from unfamiliar dogs.

"It’s not a Rottweiler problem or a pit bull problem," said Randall Lockwood, the Humane Society’s vice president for research

and educational outreach. "It’s a people problem."

NONFATAL ATTACKS RISE

The annual number of reported fatal attacks has not varied widely in the past 20 years, the study said. But overall attacks are

on the rise — likely because families are busier, leaving them less time to train their dogs and watch their children.

"A dog has to have its behavior monitored and consequences put in place," Sacks said. "People don’t seem to have a lot of

time in their lives for that."

Pit bulls led all breeds for fatal attacks between 1979 and 1998, with at least one pit bull involved in 66 mauling deaths, the

study said. Rottweilers were blamed for 37 — most of those in the 1990s — followed by German shepherds with 17 and

huskies with 15.

Researchers cautioned the breakdown does not necessarily indicate which dogs provide the highest risk of fatal attacks

because incomplete registration of dogs and mixed breeds make it hard to determine how many of each type of dog Americans

own.

American Pit Bull Terrier--PIT BULL REPORTER... http://www.pbreporter.com/rottweilers_now_.htm

1 of 1 1/12/10 7:34 PM

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Journal of the American Veterinary Medical Association November 15, 2000

AVMA Journals Home | JAVMA online

Responsible ownership the alternative to breed

banning, other restrictions

DEAN J. MONTI

A man is out for a stroll in his community with his Bull Terrier. He is

stopped by the local animal control officer and told that "pit bulls"

are restricted from his community. The man cannot prove that his

dog is not a pit bull-type dog and that it is a well-trained, household

pet. The dog is confiscated and euthanatized.

Think it could never happen in your community? Although only one

state currently has a statewide breed restriction (Ohio), hundreds of

communities within the United States are actively pursuing breed

bans and breed-restrictive legislation.

When Robert Duffy, executive director of the American Dog Owners

Association, learned that breed banning attempts in Germany during

the past year included approximately 16 breeds, he worried that the

spectrum of breed banning in the United States could increase as

incidents characterize certain breeds as dangerous.

"We get involved in many of these issues," he said, "writing to

legislators, asking how animal control officers can be charged with enforcing breed bans and restrictions

when they have little or no training to identify specific breeds. Even if they could, there is really no way of

defining what a 'pit bull' is and isn't."

In an ADOA letter he sends to legislators across the country, Duffy cites approximately 15 breeds that are

similar in appearance to breeds that have been targeted as dangerous. "Owners of these dogs would not

take kindly to their dogs being misidentified and something bad happening to them as a result," he said.

"In a lot of cases the animal control officer is the final judge."

Duffy has identified cities all over the country that are attempting to ban or restrict pit bull-type dogs,

and, increasingly, Rottweilers. In October, the village of Broadview, Ill, passed a breed-restrictive

ordinance adding Doberman Pinscher to those two categories. According to Duffy, Broadview is not a

home rule state, and is therefore bound by Illinois law that doesn't allow for breed-restrictive ordinances.

He said that Broadview's passing the ordinance, therefore, may be in violation of Illinois law. Broadview is

not unique, however. Duffy added that many communities disregard state laws when pursuing these

ordinances, which could open the door for lawsuits if an owner's pet is treated unjustly. Duffy has been

keeping a close watch on the kinds of breed that are being singled out.

"Pit bull-type dogs, Bull Terrier, American Staffordshire Terrier, and Staffordshire Terrier are among other

breeds being targeted of late," he said. "Rare and mixed breeds are also victims."

According to Dr. Randall Lockwood, vice president of research and educational outreach for the Humane

Society of the United States, "Constitutional and practical issues are raised in the enforcement of breed-

specific ordinances because of difficulty inherent in determining breed with certainty."

Data in a report published in the Sept 15, 2000 issue of the JAVMA indicate that breed-specific legislation

is not the solution to dog bite prevention. The report revealed that, during the past 20 years, at least 25

breeds of dog have been involved in 238 human fatalities. Pit bull-type dogs and Rottweilers were

identified as being involved in 66 and 39 fatalities, respectively, over that 20-year period; however, other

purebreds and crossbreds caused the remainder of fatalities.

Search AVMAS e a r c h T i p s | A d v a n c e d S e a r c h

Responsible ownership the alternative to breed ... http://www.avma.org/onlnews/javma/nov00/s111...

1 of 2 1/15/10 1:13 PM

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Twenty-four percent of deaths involved dogs that were not restrained and were not on their owners'

property, 58 percent of deaths involved dogs that were not restrained but were on their owners' property,

17 percent involved restrained dogs on their owners' property, and one percent involved a restrained dog

off its owners' property.

Dr. Gail C. Golab, co-author of the study and assistant director of the AVMA Education and Research

Division, confirmed, "Breeds responsible for human fatalities have varied over time. Since 1975, dogs

belonging to more than 30 breeds—including Dachshunds, Golden Retrievers, Labrador Retrievers, and a

Yorkshire Terrier—have been responsible for fatal attacks on people."

The authors of the study say that, although fatal human attacks may appear to be a breed-related

problem, dogs of other breeds may bite and cause fatalities at higher rates.

"A dog of any breed can become dangerous when bred or trained to be aggressive," Dr. Jeffrey Sacks,

epidemiologist for the CDC, said. "Fatal attacks represent only a very small proportion of dog bite injuries

and shouldn't be the primary factor driving public policy regarding dangerous dogs."

Duffy said that when a breed is restricted in a community, or if certain breeds are put on the "bad dog"

list, insurance rates for owners of those dogs become exorbitant.

"It's really a kind of banning," he said, "because the liability rates imposed are so great that most people

can't afford the insurance. In some places, you can't even get liability insurance because you own a [dog

of a] certain breed."

Inevitably, he says, owners who have trained, well-behaved dogs become affected by the small

percentage of owners whose dogs have been involved in aggressive incidents.

"All the responsible owners of the breed are put to financial hardship," Duffy said. "Their insurance is

likely to go right out the window."

Duffy would prefer to see communities adopt a law that takes all breeds of dog into consideration and is

focused on penalizing the owner of the dog with the objectionable behavior.

Dr. Golab agrees. She favors consistent enforcement of generic, non-breed-specific, dangerous-dog laws

with an emphasis on chronically irresponsible owners. She recommends increased enforcement of animal

control ordinances such as leash laws and fencing requirements, prohibition of dog fighting, and

neutering. Dr. Golab also emphasizes the value of educational programs for adults and children that teach

pet selection strategies, pet care and responsibility, and bite prevention.

Pediatrician and medical epidemiologist Dr. Julie Gilchrist from the CDC also promotes the idea of

responsible pet ownership. "Dog bite reduction strategies are more likely to be effective if they focus on

reducing inappropriate dog and dog owner behaviors, regardless of the dog's breed, instead of on

banning specific breeds."

The AVMA's dog bite prevention campaign continues to inform the public about techniques for avoiding

dog bites, and to promote responsible pet ownership. Breeds don't need to be banned, but dog owners'

irresponsible behavior should be.

Sharon Granskog, AVMA public information assistant, contributed to this report.

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Responsible ownership the alternative to breed ... http://www.avma.org/onlnews/javma/nov00/s111...

2 of 2 1/15/10 1:13 PM

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Pit Bulls in the City

--A Revealing

Discussion on Breed

Specific Legislation,

Surprising Comments

from the Director for

the Center for the

Human Animal Bond--

BY STEVE DALE

Part 1

"Pit bulls are different; they're like wild animals," says Alan Beck, director for

the Center for the Human Animal Bond at Purdue University School of

Veterinary Medicine, West Lafayette, IN. "They're not suited for an urban

environment. I believe we should open our eyes and take a realistic

approach to pit bulls."

Those who condemn pit bulls and call for breed bans targeting these dogs

tend to be members of the general population, or most often, it seems,

politicians. Beck isn't calling for breed bans – he stops just short of that

resulting from research yet to be published. Still, it's exceedingly rare for an

animal expert to vilify pit, and few would doubt Beck's credentials. He's

renowned for his decades of groundbreaking research on using animals in

therapeutic settings, such as nursing homes. He's the co-author of "Between

Pets and People: The Importance of Animal Companionship" (Purdue

University Press, West Lafayette, IN, 1996; $29.95).

Controversy about dangerous dogs seems to be in the media daily, and

mostly it's pit bull-bull-type dogs who are guilty. Many communities around

the world have responded with breed specific bans, but many experts

contend that's not the right answer.

In 2000, the Humane Society of the United States (HSUS), American

Veterinary Medical Association (AVMA) and the Centers for Disease Control

and Prevention (CDC) teamed to investigate whether or not breed specific

legislation (banning individual breeds, such as pit bulls, from communities) is

effective. The results of their studies were published in several scientific

journals.

"We learned breed specific legislation is not the way to tackle the issue of

dog bites," says Dr. Julie Gilchrist of the CDC Injury Center in Atlanta, GA.

"Instead, we should look at the people with those dogs responsible for the

bites."

Animal Behaviorist Randy Lockwood, Vice President of research and

education at the HSUS in Washington D.C. says about 100 percent of dogs

involved in fatal attacks were unaltered males, also in the overwhelming

majority of instances the dogs were previously complained about but animal

control or law enforcement failed to take action. Other risk factors include

dogs who roamed the neighborhood or dogs who were tethered.

"I believe the answer is to strengthen and then enforce laws that encourage

responsible dog ownership for all dogs of all breeds," says Dr. Bonnie Beaver,

a veterinary behaviorist in College Station, TX who has worked on breed

specific issues, and is now the president of the AVMA. The thinking is if dogs

IN THIS SECTION:

Steve Dale Biographical

Info

Article Archive

STEVE DALE:

To arrange a personal interview

with Steve Dale, or for answers

to your pet questions, contact

petworld@aol.com

Home > Pet World

Good News for Pets > Pet World http://www.goodnewsforpets.com/petworld/archiv...

1 of 4 1/12/10 4:38 PM

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Proactive Dog Policy: Why Seattle Needs It | by Colleen Lynn 7

• For each dog bite fatality there are about 670 hospitalizations and 16,000 emergency

room visits, 21,000 other medical visits (office and clinic), and 187,000 non-medically

treated bites.

• Dog bites are the second highest activity that sends children to emergency care

superseding the following activities: playground accidents, all-terrain vehicles and

moped use, volleyball, inline skating, horseback riding, baby walkers and

skateboards.

Not All Dogs Are Equal

The theory that "all dogs are equal" and should not be subject to "breed profiling" has placed the general

public at great risk. Hundreds of US cities are reacting by creating BSL to protect families and pets from

pit bull type dogs. On an international level, entire countries have banned them, including: England,

Scotland, Wales, Northern Ireland, Italy, Spain, Germany, Norway, New Zealand, Puerto Rico, Singapore

and the UAE.

Experts Agree that Not All Dogs are Equal

In the canine world, aggressive personalities are both made and born. Herding dogs, for instance,

instinctually herd; it is an inherited trait. Pit bulls and fighting breeds instinctually fight and therefore

require special supervision. Alan Beck, a world-renowned dog ecologist, recently submitted testimony on

behalf of Ontario, Canada's pit bull ban:

“While all breeds of dogs can and do bite on occasion, pit bulls (due to their inherent fighting nature,

strength and high pain threshold) have a much higher potential of being involved in a serious attack

than most, if not all, breeds. There is no doubt that the fear of pit bull dogs is reasonable and social

tension about them should also be considered when a community is developing policy."

He adds in his conclusion that:

"Pit bulls are like a "loaded gun." Like guns, in the wrong hands there is great potential for serious

harm to humans and pets. Even in the hands of the "innocent" there is serious potential for harm

as is evidenced by the common media reports of attacks where pit bull owners are reported as

saying they were responsible and never had a problem until the attack in question."10

Alan Beck, PhD

Alan Beck is an ecologist with a doctorate from The Johns Hopkins School of Public Health. From 1974-1979 he

directed the Bureau of Animal Affairs, in the Department of Health, City of New York. For the next ten years, he

directed the "Center for the Interaction of Animals and Society" at the University of Pennsylvania. Since 1990,

he has been the Dorothy N. McAllister Professor of Animal Ecology and Director of the "Center for the Human-

Animal Bond" at Purdue University.

For more than two decades, he conducted studies on the interaction of people and their pet animals, the

epidemiology and behavior of animal bite injury, and the epidemiology of rabies. He has also served as a

consultant on the reporting of animal bite and animal control for the Centers of Disease Control (CDC) and

several municipalities around the country.

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As state and local lawmakers work to pass laws to keep the pit bull population under control, pit bull owners say breed-

specific laws unfairly label pit bulls as vicious even if a dog hasn't attacked a person or another dog.

For a dog of any other breed to be considered "vicious" under Ohio law, it has to kill another dog or cause injury to a

person.

Under Ohio law, people owning "vicious" dogs must pay more for liability insurance and keep their animal confined in a

locked, fenced yard or a secure enclosure with a roof.

In Toledo, residents may own only one pit bull, which must have a leash and be muzzled when in a public place.

Pain at the pound

Toledo resident Emmanuel Rodriguez shook his head in frustration last week at the Lucas County dog pound when an

employee told him he couldn't take his pit bull, Bo Stank, home because of the city's laws applying to vicious dogs.

"My dog's the friendliest dog in the world," he said angrily. But the employee told Mr. Rodriguez he must pay a $100 fine

and an additional $100 to have Bo neutered if he wants his dog back, because of a recently passed Toledo City Council

ordinance.

"You have until July 24 to pay all your fees," a pound employee told him. "You need to know if you don't pay by then, your

dog will be euthanized."

Mr. Rodriguez's pit bull was seized by county dog catchers after it was seen running loose without a collar near children on

July 6 near Asbury Park in West Toledo.

Witnesses said Bo returned home without incident. But when police arrived, they said Bo approached them in an

aggressive manner and one officer threatened to shoot the dog.

Mr. Rodriguez said Bo never has bitten anyone.

"He was only out for 10 minutes," Mr. Rodriguez told Karla Hamlin, a Lucas County deputy dog warden.

"It only takes a minute for somebody to get hurt," she responded.

Nature vs. nurture

Dr. Gail Golab, director of animal welfare for the American Veterinarian Medical Association, called Mr. Rodriguez

irresponsible for not confining his dog properly. But she said breed-specific laws are a "knee-jerk" reaction by lawmakers

who don't address the real issue.

"[The veterinarian association does] not believe that the breeds considered to be pit bulls are inherently vicious," she said.

"It's not so much nature as it is nurture. It's about teaching dogs how to behave around people and teaching people how to

behave around dogs."

Dr. Golab said dog-bite statistics that suggest pit bulls bite most often are not necessarily accurate. They are hard to

properly formulate, she said, because it's hard for some people to identify what breed bit them and the only bites that

typically get recorded are ones reported in the media, to lawyers, or police.

The breed of dog that supposedly bites the most has changed over time, and there's a correlation with the breed's

popularity, she said.

"If you were to look back 20 years ago, you'd see German shepherds were responsible for the most dog injuries," she

said. "Five years later, you saw pit bulls. At other times you saw Rottweilers at the top spot, and still other times you saw

Doberman pinschers."

Defining 'pit bull'

Many experts have a hard time determining what a pit bull is.

The veterinarian association, which along with the American Kennel Club and the United Kennel Club set the standards

for dog breeds in the United States, says the term pit bull does not refer to a specific breed of dog. It's a generic label that

refers to several breeds.

Printer-friendly version http://www.toledoblade.com/apps/pbcs.dll/article...

2 of 4 1/12/10 4:36 PM

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2008 Annual Meeting Abstracts

Back to 87th Annual Meeting

Back to Program Outline

A ten-year, two-institution review of pediatric dog attacks: Advocating for a nationwide prohibition of

dangerous dogs

Jugpal S. Arneja, MD, FRCSC1, Kara Pappas, B.S.

1, William Huettner, M.D.

1, Arlene A. Rozzelle, M.D.

1, Gurbalbir Singh,

M.D., FRCSC2.

1Children's Hospital of Michigan/Wayne State University, Detroit, MI, USA,

2University of Manitoba, Winnipeg, MB, Canada.

PURPOSE:

Affectionately referred to as ‘man’s best friend’, dog attacks in the pediatric population often test this analogy. Pediatric dog

attacks are a significant public health issue that negatively affects the psychological well-being of a child. We performed

analysis of our cumulative two-institution pediatric dog attack data, present representative cases and offer evidence to

support a nationwide prohibition of dangerous dogs.

METHODS:

A retrospective review was performed at two urban Children’s hospitals from 1996-2005 of all dog attacks presenting to

the plastic surgery service. Charts were reviewed with analysis of patient demographics, injury site, operative intervention,

and dog-specific data.

RESULTS:

109 patients were included for review, with 83% of attacks occurring in the facial region. Mean age was 3.9 years (range

2-18 years). 67% of attacks involved multiple anatomic sites, 95% required surgical intervention with 30% requiring a skin

graft or flap reconstruction. 88% of dogs were known to the victim, 46% of attacks were provoked, 73% of dogs were

euthanized and 57% of dogs were deemed to be of a dangerous breed (Pit Bill or Rottweiler). Mean hospital duration was

4.7 days and 27% required additional reconstructive plastic surgery. Figures below illustrate a representative case of a

4-year old female attacked by her aunt's dog, resulting in a complete nasal amputation, preoperatively (upper), at time of

forehead flap reconstruction (middle), and five years post-operatively (lower), with an acceptable functional and aesthetic

reconstruction.

CONCLUSION:

Dog attacks in the pediatric population produce significant costs including physical morbidity, psychological disability, and

financial strains. A majority of attacks were by a known dog, in the facial region, by dogs which we define as of a

dangerous breed. Much of the injury patterns are unique to children and these injuries and associated costs can be

significantly diminished, as the problem is often preventable. Our cases present the ‘tip of the iceberg’ as our cases only

represented consultations directed to Plastic Surgery. The Province of Ontario, Canada has banned Pit Bulls since 2004, as

have several American cities. We describe the scope of the problem, preventative guidelines, and outline why

organizational advocacy in plastic surgery should be directed towards a national prohibition of dangerous dogs.

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1 of 3 5/17/09 10:44 PM

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MEDICINE SURGERY PEDIATRICS

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Multimedia

References

Keywords

eMedicine Specialties > Emergency Medicine > Environmental

Bites, Animal: Multimedia

Author: Alisha Perkins Garth, MD, Staff Physician, Harvard Affiliated Emergency Medicine Residency, Brigham and Women's

Hospital, Massachusetts General Hospital

Coauthor(s): N Stuart Harris, MD, FACEP, Assistant Professor in Surgery, Harvard Medical School, Massachusetts General Hospital;

Attending Physician, Massachusetts General Hospital

Contributor Information and Disclosures

Updated: Jun 25, 2009

Print This Email This

Multimedia

(Enlarge Image)

Media file 1: The devastating

damage sustained by a

preadolescent male during a pit

bull attack. Almost lost in this

photograph is the soft tissue

damage to this victim's thigh.

This patient required 2 units of

O- blood and several liters of

isotonic crystalloid. Repair of

these wounds required a

pediatric surgeon, an

experienced orthopedic surgeon,

and a plastic surgeon. Attacks

such as these have caused a

movement in some areas of the

country to ban pit bulls.

(Enlarge Image)

Media file 2: Massive soft tissue damage of the right leg caused by a pit bull

attack. This patient was transferred to a level one pediatric trauma center for

care. At times, staff members may need counseling after caring for savagely

mauled patients.

(Enlarge Image)

Media file 3: Massive soft tissue damage of the lower left leg caused by a pit

bull attack. Most of the fatalities from dog bites are children. Rottweilers and pit

bulls are responsible for about 60% of fatalities.

Search for CME/CE on This Topic »

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1 of 2 1/14/10 11:39 AM

CASE REPORT

Pitbull Mauling Deaths in Detroit

Cheryl L. Loewe, MD, Francisco J. Diaz, MD, and John Bechinski, DO

Abstract: Between the years 1987 and 2005, there were 6 deathsreported in Wayne County, Michigan, associated with pitbull dogattacks. This article discusses the age incidence, scene investigation,nature of the injuries, and discussion relative to fatal dog attacks, anunusual accidental type of death.

Key Words: mauling, pitbull, fatal dog bite

(Am J Forensic Med Pathol 2007;28: 356–360)

The following 6 cases from the Wayne County MedicalExaminer’s Office in Detroit, Michigan, involve acciden-

tal blunt force injuries sustained in fatal pitbull dog attacks.The findings seen at autopsy, in general, consist of multiplelacerations, sets of puncture wounds, and extensive scalpavulsions, primarily sustained to the head and neck region ofthe body, which result in extensive mutilating injuries to thebody and death results from exsanguination. There is atendency for these animals to attack the neck region anddestroy the blood vessels of the neck and cause extensiveavulsions of the scalp and ears. In the majority of the cases,the victims were children or elderly. Four of the victims werechildren (age range 2 months to 6 years), 1 victim was amiddle-aged adult (age 44), and 1 victim was an elderly adult(age 91). Three of the victims were male and 3 of the victimswere female. Three of the victims were white and 3 of thevictims were black.

MATERIALSThe following 6 cases of death caused by pitbull maul-

ing are presented, which were all investigated and autopsiedbetween the years 1987 and 2005 at the Office of the WayneCounty Medical Examiner, Detroit, Michigan. A thoroughscene investigation and a complete autopsy with documenta-tion of external and internal injuries were performed in allcases. Complete toxicological screening was performed on allcases. In some cases, the animal(s) involved in the attackwere shot and the gastric contents were recovered from the

dead animal. The cases will be discussed in sequence in anorder according to increasing age.

CASE REPORTS

Case 1A 2-month old white male infant was found decapi-

tated on the living room floor. A 12-year-old sibling wassleeping on the sofa in the same room and awoke becausethe baby was crying. The infant was attacked by the familypitbull, who was previously stray and recently acquired bythe family. Autopsy revealed decapitation with bite markssurrounding the ragged tissue margins on the neck. Thedog was destroyed and examination of the gastric contentsrevealed multiple fragments of bone, skin and soft tissue,the nose, 1 globe, and both ears of the infant. Toxicologywas negative (Figs. 1A and 1B—ref. case 9589-87— blackand white photographs).

Case 2A 1-year-old white male child was placed on the

kitchen floor by his 54-year-old grandmother, who was baby-sitting the child. The grandmother stepped out of the roommomentarily and returned to find the child being attacked bythe family pitbull. The salient autopsy findings include mul-tiple lacerations and sets of puncture wounds to the face,neck, and arms. Extensive scalp and facial avulsions werealso present. Internally, there was a puncture wound to theright internal jugular vein. The animal forcefully attackedthe neck region of the body, causing fracture dislocation ofthe vertebral spine at the level of C7–T1. There were alsopunctures, lacerations, and crushing injury to the larynx.Toxicology was negative (Figs. 2A, 2B, 2C, and 2D—ref.case 04-3275—images 11, 19, 21, and 28).

Case 3A 1-year-old male child was attacked while playing in

the front yard of his home by 2 pitbull dogs who wereroaming the streets freely. The mother had stepped inside thehome briefly to answer the telephone and saw her son beingattacked through the window.

Autopsy revealed a large gaping hole in the right side ofthe neck with numerous puncture wounds to the right maincarotid and right jugular vein, the esophagus, and trachea.The entire back was covered by scratch marks and puncturewounds. Multiple lacerations were present on the face, thechest, and the groins. Toxicology was negative (Fig. 3—ref.case 93-8688—kodachrome).

Manuscript received January 30, 2006; accepted June 28, 2006.From the Office of the Wayne County Medical Examiner, Detroit, Michigan.Reprints: Cheryl L. Loewe, MD, Office of the Wayne County Medical

Examiner, 1300 E. Warren, Detroit, MI 48207. E-mail: cloewe@co.wayne.mi.us.

Copyright © 2007 by Lippincott Williams & WilkinsISSN: 0195-7910/07/2804-0356DOI: 10.1097/PAF.0b013e31815b4c19

The American Journal of Forensic Medicine and Pathology • Volume 28, Number 4, December 2007356

Case 4A 6-year-old black female child was walking to

school in an alley adjacent to her backyard. The family wasin the process of moving to a nearby neighborhood and the2 family pitbulls had just been set free after being lockedup in the basement before the incident. The child grew upwith these 2 pitbull dogs. Both dogs, who were roamingloose in the backyard, attacked the child in the alley anddragged her into the backyard of the dwelling. The child’spantyhose and skirt were pulled down below the knees.The mother of the child attempted to pull the dogs off ofher daughter and called her husband for assistance. Thepolice arrived and shot the dogs. The child was acciden-tally shot by police gunfire in the back of the knee.Autopsy examination revealed numerous lacerations, punc-ture wounds, and avulsions to the face and neck, 67 in total.Brush burn abrasions consistent with drag marks were alsopresent. Neck dissection disclosed complete transection of theleft common carotid artery. In addition, there were multi-ple skull and facial fractures with evidence of bloodaspiration in the lungs. Multiple fragments of skull bonewere absent and/or separately received with the body,including the left orbit and the left maxilla. A superficialgunshot entrance wound involving soft tissue was also

demonstrated on the back of the right knee and a bulletwas recovered from the wound track. Toxicology wasnegative (Figs. 4A and 4B—ref. case 3365-05—images 5and 15).

FIGURE 1. A, Partially reconstructed face recovered fromdog stomach. B, Decapitation.

FIGURE 2. A, Lacerations: Face, neck, and back. B, Perfora-tion neck blood vessels. C, Puncture wounds on larynx. D,Fracture of vertebral spine.

The American Journal of Forensic Medicine and Pathology • Volume 28, Number 4, December 2007 Pitbull Mauling Deaths

© 2007 Lippincott Williams & Wilkins 357

Case 5A 44-year-old black woman was attacked by 2 pitbulls

who resided at an occupied dwelling while walking down thestreet. The subject was observed laying on the ground and 1dog was attacking the neck region of the victim, while theother dog was attacking her lower back. A citizen notified thepolice who arrived and shot the animals with their serviceweapons. Autopsy revealed multiple clusters of abrasions,deep lacerations, and puncture wounds distributed over theface, the front and back of the neck the arms, the lower back,

and the legs. There was complete avulsion of the left ear andpartial avulsion of the right ear. Extensive scalp avulsionswere also noted. There was complete transection of the leftbrachial artery, the left basillic vein, and the right commoncarotid artery. There was a bone defect in the T1 vertebra anddislocation of the first right rib. Toxicology revealed a post-mortem blood ethanol of 0.11 g/dL (no figures available).

Case 6A 91-year-old black woman was attacked by her own

family pitbull dog at home. The autopsy revealed multipleextensive scalp avulsions, 1 measuring 5 inches in diameteron the back of the head with exposure of the calvarium anddeep undermining pockets of subgaleal hemorrhage. Numer-ous lacerations were present on the eyes, both cheeks, themouth, the lower face, the left upper neck, both ears, and theleft side of the head. Many paired puncture wounds werenoted consistent with animal teeth. Two of the lacerations onthe face were deep and associated with absence of the lip,skin, facial muscle and soft tissue, right maxilla, and zygoma,resulting in exposure of the sinuses and oropharyngeal cavity.A closed right hip fracture was present. Internal examinationrevealed pale, bloodless viscera, blood aspiration in bothlungs and comminuted fracture of the bilateral zygoma,bilateral maxillary bones, the palatine bone, and the rightmandible with loss of several upper and lower teeth andlaceration of the tongue. Toxicology was negative (Figs. 5Aand 5B—ref. case 05-11440—images 14 and 4).

DISCUSSIONThese cases presented demonstrate rather dramatic mu-

tilating injuries sustained to the human body after pitbullattack. The common trend in the observable injuries includeinjury to the blood vessels and/or organs of the neck in all ofthe cases, resulting in exsanguination. Extensive scalp avul-sions were also observed in most of the cases and the portionof avulsed scalp is unattached to the head and likely eaten bythe animal. The patterned sets of puncture marks are anotherconsistent finding compatible with the dentition of the animal(Fig. 6A—ref kodachrome—dog mouth—ref. case 93-8688).Scratch marks were noted in some cases and a comparison ofthese patterned injuries are consistent with the animal clawsthat inflicted them (Fig. 6B—ref. case 93-8688—dog paw).In 2 of the cases, the animal attacked forcefully enough tofracture and/or separate the vertebral spine. Complete decap-itation injury was present in 1 case and the gastric contentsrecovered from the animal confirm that the soft tissue andbone are eaten by the animal. In half of the cases, there werefractures of the facial bones and/or calvarium. Avulsions orpartial avulsions of the ears was another common finding.The majority (67%) of the victims were small children, thoseleast likely to protect themselves. The same reasoning canapply to elderly victims.

The head and neck region of the child was at the levelof the dogs teeth, making these anatomic regions moreaccessible to the dog during attack. Of the dog-maulingdeaths of neonates in the literature, all occurred on the dog

FIGURE 3. Lacerations and abrasions, neck and back.

FIGURE 4. A, Lacerations, face. B, Gunshot wound on the leg.

Loewe and Diaz The American Journal of Forensic Medicine and Pathology • Volume 28, Number 4, December 2007

© 2007 Lippincott Williams & Wilkins358

owner’s property and involved 1 dog and a sleeping child.Few people are aware that some dogs view infants as poten-tial prey.1

One study of fatal dog attacks in the United Statesshowed that the pitbull breed was determined to be the mostfrequent (41.6%) dog breed implicated in human attacks.1

Pitbull terriers, German Shepherds and Rottweilers are thebreeds most often involved in fatal attacks, 70% are commit-ted by a pet dog within the owner’s yard or its proximity, andmost dogs involved in biting or attacking are known to thevictim or the victim’s family.2 People may behave differentlytoward their own dogs than toward stray dogs and this mayexplain this difference. Surprisingly, stray dogs are usuallyinvolved in attacks of a more innocent nature and bitestypically occur on the hands and legs as opposed to the headand neck.3 In general, fatalities due to dog bites are rare. In 1study, from 1979 to 1998, 238 deaths were reported in theUnited States.4 While the sex of the pitbull involved in thesefatal attacks was unrecorded, in general, male dogs, espe-cially the non-neutered, bite more frequently.1 Younger dogsalso tend to bite more often, with dogs aged 6 to 11 monthshaving the highest bite rate.3 Dogs acting in a pack are farmore dangerous than the same animal individually, and inthis study 2 of the cases involved more than 1 dog.

Dogs have 42 teeth, 20 in the upper jaw and 22 in thelower jaw. The canine masseter-pterygoid complex is short

and strong and its insertion on the mandible provides apowerful mechanical advantage.5 Many of the canines in-volved in dog attacks can generate up to 1800 pounds of forceper square inch with a bite,6 which is enough force topenetrate sheet metal, so it is reasonable to see how there isenough force to snap the vertebral spine or fracture the skull,as demonstrated in this series of cases.

The majority of reported dog attacks seem to happenwhen the dog is “unprovoked,” meaning that both parents andchildren failed to see what their behavior meant to their dog.7

Different types of aggression leading to attacks indifferent circumstances can be distinguished, for example,dominance aggression when the dog challenges a member ofthe “family pack” such as a new baby, protective aggressionwhen the victim is regarded as a threat to the family, posses-sive aggression toward a victim that invades the dog’s terri-tory or attempts to move an item “possessed” by the dog suchas food or toys.8 Some of the aggressive reactions of a dogrelate to genetically controlled breed characteristics, namelythe Pitbull and Rottweiler breeds, and some communitieshave enacted breed-specific restrictions or bans.4 Aggressioncan, however, be equally be derived from environmentalcircumstances and learning. In the inner city, quite often thepitbull breed is acquired for purposes of protection, guarding,and even fighting so that these dogs are obligated or dutybound to behave aggressively.9 Also, pain and fear, especially

FIGURE 5. A, Lacerations, face. B, Avulsion, scalp. FIGURE 6. A, Pitbull jaw-teeth. B, Pitbull paw.

The American Journal of Forensic Medicine and Pathology • Volume 28, Number 4, December 2007 Pitbull Mauling Deaths

© 2007 Lippincott Williams & Wilkins 359

in dogs that have been maltreated, can provoke aggressivebehavior.

Victims of dog bites can be found completely un-dressed or partially undressed, which may erroneously sug-gest a sexual assault rather than a dog bite setting10 and the6-year-old child described in case 4 of this series serves as anexample.

CONCLUSIONSThe authors acknowledge that this series of fatal dog-

mauling deaths represent a small sample of cases, but fortu-nately dog-mauling deaths are rare in our society. Sadly, theyaffect mostly small children, are unprovoked and are oftencaused by the family pet rather than the stray dog roaming theneighborhood.

The salient injuries observed include blunt force inju-ries consisting of lacerations and puncture wounds primarilyinvolving the head and neck and avulsions of scalp whichresult in exsanguination. The forces exerted by the animalmay be strong enough to snap the vertebral spine, fracture theskull, or even cause decapitation.

The pitbulls aggressiveness may be a combination ofgenetic based aggressiveness coupled with inner city envi-ronmental factors in that these animals are quite often trainedto protect, fight, and guard and are therefore duty-bound tobehave aggressively. The younger, male, non-neutered pitbullis at greater risk of attacking.

Criminal charges and convictions of owner(s) of a doginvolved in a fatal attack are reported, and the majority of the

offenses were based on reckless disregard for another indi-viduals’ safety.9 The majority of the convictions ranged frominvoluntary manslaughter or criminal recklessness to evenmurder, second degree.9

Finally, the dog-bite prevention recommendationsstated by the CDC include adequate owner and public edu-cation through veterinarians and the public schools, animalcontrol at the community level, and accurate surveillance ofreported dog bites.9

REFERENCES1. Sacks JJ, Lockwood R, Hornreich J, et al. Fatal dog attacks, 1989–1994.

Pediatrics. 1996;97(6, Pt 1):891–895.2. Lauridson JR, Myers L. Evaluation of fatal dog bites: the view of the

medical examiner and animal behaviorist. J Forensic Sci. 1993;38:726–731.

3. Wright JC. Canine aggression toward people: bite scenarios and preven-tion. Vet Clin North Am Small Anim Pract. 1991;21:299–314.

4. Sacks JJ, Sinclair L, Gilchrist J, et al. Breeds of dogs involved in fatalhuman attacks in the United States between 1978 and 1998. J Am VetMed Assoc. 2000;217:836–840.

5. Miller SJ, Copass M, Johansen K, et al. Stroke following Rottweilerattack. Ann Emerg Med. 1993;22:262–264.

6. Calkins CM, Bensard DD, Partrick DA, et al. Life-threatening dogattacks: a devastating combination of penetrating and blunt injuries.J Pediatr Surg. 2001;36:1115–1117.

7. Matthews JR, Lattal KA. A behavioral analysis of dog bites to children.J Dev Behav Pediatr. 1994;15:44–52.

8. Shewell PC, Nancarrow JD. Dogs that bite. BMJ. 1991;303:1512–1513.9. National Canine Research Foundation. Fatal Dog Attack Studies.

Manorville, NY: National Canine Research Foundation; 2002.10. Tong GTF, Pang TC. Unusual injuries: savaged to death by dogs. Med

Sci Law. 1965;5:158–160.

Loewe and Diaz The American Journal of Forensic Medicine and Pathology • Volume 28, Number 4, December 2007

© 2007 Lippincott Williams & Wilkins360

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836 Vet Med Today: Special Report JAVMA, Vol 217, No. 6, September 15, 2000

Special Report

From 1979 through 1996, dog attacks resulted inmore than 300 human dog bite-related fatalities

(DBRF) in the United States.1-3 Most victims were chil-dren. Studies indicate that pit bull-type dogs wereinvolved in approximately a third of human DBRFreported during the 12-year period from 1981 through1992, and Rottweilers were responsible for about halfof human DBRF reported during the 4 years from 1993through 1996. These data have caused some individu-als to infer that certain breeds of dogs are more likelyto bite than others and should, therefore, be banned orregulated more stringently.4,5 The purposes of the studyreported here were to summarize breeds associatedwith reported human DBRF during a 20-year periodand assess policy implications.

ProcedureWe collected data from The Humane Society of the

United States (HSUS) and media accounts related todog bite attacks and fatalities, using methods from pre-vious studies.1-3 The HSUS maintains a registry of humanDBRF, including date of death, age and sex of decedent,city and state of attack, number and breeds of dogsinvolved, and circumstances relating to the attack. Tosupplement HSUS reports, as in the past, a database6 wassearched for accounts of human DBRF that occurred in1997 and 1998. Our search strategy involved scanningthe text of newspapers and periodicals for certain wordsand word combinations likely to represent human DBRFfollowed by a review of articles containing those terms.Data obtained from HSUS and news accounts weremerged to maximize detection of human DBRF andavoid duplicate reports. One new human DBRF from1996 was identified in the 1997 and 1998 reports andwas added to the existing data for 1996.

A human DBRF was defined as a human deathcaused by trauma from a dog bite. In addition toexcluding 9 human deaths, as described in previousreports (eg, dying of rabies from a dog bite, stranglingon a leash or scarf pulled by a dog, dying from fire ant

From the Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, US Department of Health andHuman Services, US Public Health Service, Centers for Disease Control and Prevention, 4770 Buford Hwy NE (MS K-63), Atlanta, GA 30341(Sacks, Gilchrist); The Humane Society of the United States, 2100 L Street, NW, Washington, DC 20037 (Sinclair, Lockwood); and theDivision of Education and Research, American Veterinary Medical Association, 1931 N Meacham Rd, Ste 100, Schaumburg, IL 60173(Golab). Dr. Sacks’ present address is the National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Controland Prevention, 4770 Buford Hwy NE (MS K-45), Atlanta, GA 30341. Dr. Sinclair’s present address is Shelter Veterinary Services, 9320 JarrettCt, Montgomery Village, MD 20886.

Use of trade names and commercial sources is for identification purposes only and does not imply endorsement by the authors or their affili-ated agencies.

The authors thank Dr. Suzanne Binder for technical assistance.

Embargoed for Release Until 8 AM, September 15, 2000

Breeds of dogs involved in fatal human attacksin the United States between 1979 and 1998

Jeffrey J. Sacks, MD, MPH; Leslie Sinclair, DVM; Julie Gilchrist, MD; Gail C. Golab, PhD, DVM; Randall Lockwood, PhD

Objective—To summarize breeds of dogs involved infatal human attacks during a 20-year period and toassess policy implications.Animals—Dogs for which breed was reported involvedin attacks on humans between 1979 and 1998 thatresulted in human dog bite-related fatalities (DBRF).Procedure—Data for human DBRF identified previ-ously for the period of 1979 through 1996 were com-bined with human DBRF newly identified for 1997and 1998. Human DBRF were identified by searchingnews accounts and by use of The Humane Society ofthe United States’ registry databank.Results—During 1997 and 1998, at least 27 peopledied of dog bite attacks (18 in 1997 and 9 in 1998). Atleast 25 breeds of dogs have been involved in 238human DBRF during the past 20 years. Pit bull-typedogs and Rottweilers were involved in more than half ofthese deaths. Of 227 reports with relevant data, 55(24%) human deaths involved unrestrained dogs offtheir owners’ property, 133 (58%) involved unrestraineddogs on their owners’ property, 38 (17%) involvedrestrained dogs on their owners’ property, and 1 (< 1%)involved a restrained dog off its owner’s property. Conclusions—Although fatal attacks on humansappear to be a breed-specific problem (pit bull-typedogs and Rottweilers), other breeds may bite andcause fatalities at higher rates. Because of difficultiesinherent in determining a dog’s breed with certainty,enforcement of breed-specific ordinances raises con-stitutional and practical issues. Fatal attacks representa small proportion of dog bite injuries to humans and,therefore, should not be the primary factor drivingpublic policy concerning dangerous dogs. Many practi-cal alternatives to breed-specific ordinances exist andhold promise for prevention of dog bites. (J Am VetMed Assoc 2000;217:836–840)

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JAVMA, Vol 217, No. 6, September 15, 2000 Vet Med Today: Special Report 837

bites after being pushed on a mound by a dog, or dyingfrom a motor vehicle or bicycle crash while beingchased by a dog), for 1997 and 1998, we excluded 3additional deaths: death resulting from infection sec-ondary to a dog bite, death attributable to trauma frombeing knocked over but not bitten, and death resultingfrom myocardial infarction, which was caused by anindividual being chased but not bitten. For the 20-yearstudy, we excluded 4 human deaths from attacks byguard or police dogs “at work” and approximately 90deaths when breed information for the attacking dogwas unavailable; thus, this study included approxi-mately 72% of cases of human DBRF and is notexhaustive.

We tallied data in 2 ways to provide alternativesfor breed data interpretation. First, we used a humandeath-based approach in which we counted whether aparticular breed was involved in a death. When multi-ple dogs of the same breed were involved in the samefatal episode, that breed was counted only once (eg, if10 Akitas attacked and killed a person, that breed wascounted once rather than 10 times). When crossbreddogs were involved in a fatality, each suspected breedin the dog’s lineage was counted once for that episode.Second, we tallied data by dog. When multiple dogs ofthe same breed were involved in a single incident, eachdog was counted individually. We allocated crossbreddogs into separate breeds and counted them similarly(eg, if 3 Great Dane-Rottweiler crossbreeds attacked aperson, Great Dane was counted 3 times under cross-bred, and Rottweiler was counted 3 times under cross-bred). Data are presented separately for dogs identifiedas pure- and crossbred. Lastly, dogs were classified as towhether they were on or off the owners’ property andrestrained (eg, chained or leashed) or unrestrained atthe time of the attack.

ResultsFatalities during 1997 and 1998—During 1997

and 1998, at least 27 people died as the result of dogbite attacks (18 people in 1997 and 9 in 1998). Of 27human DBRF, 19 (70%) were children (1 was ! 30 daysold, 3 were between 7 and 11 months old, 9 werebetween 1 and 4 years old, and 6 were between 5 and11 years old), and 8 were adults (ages 17, 44, 64, 70,73, 75, 75, and 87). Approximately half (n = 15 [56%])of the human DBRF were male.

Five (19%) deaths involved unrestrained dogs offthe owners’ property, 18 (67%) involved unrestraineddogs on the owners’ property, 3 (11%) involvedrestrained dogs on the owners’ property, and 1 (4%)involved a restrained dog off the owner’s property.Eighteen (67%) deaths involved 1 dog, 5 (19%)involved 2 dogs, and 4 (15%) involved 3 dogs. Sixtypercent of attacks by unrestrained dogs off the owners’property involved more than 1 dog.

Fatal attacks were reported from 17 states(California [4 deaths]; Georgia and North Carolina [3each]; Kansas, Texas, and Wisconsin [2 each]; andAlaska, Arkansas, Colorado, Florida, Kentucky,Massachusetts, Michigan, Missouri, New York, SouthDakota, and Tennessee [1 each]).

Some breed information was reported for all 27attacks. As in recent years, Rottweilers were the mostcommonly reported breed involved in fatal attacks, fol-lowed by pit bull-type dogs (Table 1). Together, these2 breeds were involved in approximately 60% ofhuman deaths.

Twenty-year data—Some breed information wasavailable for 238 human DBRF. More than 25 breeds ofdogs were involved in DBRF during the past 20 years(Table 2). Of 227 human DBRF for which data were

1979– 1981– 1983– 1985– 1987– 1989– 1991– 1993– 1995– 1997–Breed 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 Total

PurebredPit bull-type 2 5 10 9 11* 8 6 5 4* 6 66Rottweiler 0 0 1 1 3 1 3 10 10 10 39German Shepherd Dog 2 1 4* 1 1 4* 2 0 2 0 17Husky-type 2 1 2 2 0 2 2 1 2 1 15Malamute 2 0 3 1 0 2 3 1 0 0 12Doberman Pinscher 0 1 0 2 2 2 1 0 0 1 9Chow Chow 0 1 0 0 0 2 3 0 2 0 8Great Dane 3 1 0 0 0 0 0 1 1 1 7Saint Bernard 1 2 1 0 0 0 0 0 0 3 7

CrossbredWolf-dog hybrid 0 1 1 2 1 4 1 2 2 0 14Mixed-breed 0 3 1 2 1 2 0 1 1 1 12German Shepherd Dog 0 2 0 2 2 2† 0 1 2 0 10†Pit bull-type 0 1 0 3 2† 3 1 1 0 0 10†Husky-type 0 1 1 2 1 1 0 0 0 0 6Rottweiler 0 0 0 0 1† 1 0 1 1 2 5†Alaskan Malamute 0 0 0 0 0 2 1 0 0 0 3Chow Chow 0 0 0 0 0 1 0 1 1 0 3Doberman Pinscher 0 0 0 0 1 0 0 0 0 1 0Saint Bernard 0 0 0 0 0 0 1 0 0 0 1Great Dane 0 0 0 0 0 0 0 0 0 1† 0†

No. deaths for which 10 20 26* 24 22 34* 24 25 26* 27 238breed was known

*Numbers differ from previous reports because police/guard dogs "at work" were excluded, and 1 new DBRF was identified as occurring in 1996. †A purebred dogand a crossbred dog of this breed were involved in a single fatality; therefore, that breed is counted only once in the total column.

Table 1—Breeds of dogs involved in human dog bite-related fatalities (DBRF) in the United States, by 2-year period, between 1979 and1998. Death-based approach of counting most frequent purebreds and crossbreds involved in 7 or more human DBRF

838 Vet Med Today: Special Report JAVMA, Vol 217, No. 6, September 15, 2000

available, 55 (24%) deaths involved unrestrained dogsoff the owners’ property, 133 (58%) involved unre-strained dogs on the owners’ property, 38 (17%)involved restrained dogs on the owners’ property, and1 (< 1%) involved a restrained dog off the owner’sproperty.

Four hundred three dogs were responsible forthese attacks. There were almost twice as many dogsinvolved in off-owner-property attacks, compared withattacks occurring on the owners’ properties. In 160human deaths, only 1 dog was involved; in 49 deaths,2 dogs were involved; and in 15 deaths, 3 dogs wereinvolved. Four and 7 dogs were involved in 3 deathseach; 5, 6, and 10 dogs were involved in 2 deaths each;and 11 and 14 dogs were responsible for 1 death each.

Discussion Ideally, breed-specific bite rates would be calculat-

ed to compare breeds and quantify the relative danger-ousness of each breed. For example, 10 fatal attacks byBreed X relative to a population of 10,000 X’s (1/1,000)implies a greater risk than 100 attacks by Breed Y rela-tive to a population of 1,000,000 Y’s (0.1/1,000).Without consideration of the population sizes, Breed Ywould be perceived to be the more dangerous breed onthe basis of the number of fatalities.

Considering only bites that resulted in fatalities,because they are more easily ascertained than nonfatalbites, the numerator of a dog breed-specific humanDBRF rate requires a complete accounting of human

DBRF as well as an accurate determination of thebreeds involved. Numerator data may be biased for 4reasons. First, the human DBRF reported here are like-ly underestimated; prior work suggests the approachwe used identifies only 74% of actual cases.1,2 Second,to the extent that attacks by 1 breed are more news-worthy than those by other breeds, our methods mayhave resulted in differential ascertainment of fatalitiesby breed. Third, because identification of a dog’s breedmay be subjective (even experts may disagree on thebreed of a particular dog), DBRF may be differentiallyascribed to breeds with a reputation for aggression.Fourth, it is not clear how to count attacks by cross-bred dogs. Ignoring these data underestimates breedinvolvement (29% of attacking dogs were crossbreddogs), whereas including them permits a single dog tobe counted more than once. Therefore, we have elect-ed to present data separately for purebred and cross-bred dogs to demonstrate at least 2 alternative count-ing methods. Relative rankings do not differ greatlywhether one focuses only on purebred dogs or includescrossbred dogs. The crossbreed issue is also problemat-ic when estimating denominators (ie, breed-specificpopulation sizes).

The denominator of a dog breed-specific humanDBRF rate requires reliable breed-specific populationdata. Unfortunately, such data are not currently avail-able. Considering American Kennel Club registrationdata7 for Rottweilers in parallel with fatality data forthat breed indicates that as the breed has soared in pop-

Death-based approach Dog-based approach

Breed Purebred Crossbred Total Purebred Crossbred Total

Pit bull-type 66 11* 76* 98 20 118Rottweiler 39 6* 44* 60 7 67German Shepherd Dog 17 11* 27* 24 17 41Husky-type (includes at least 2 Siberian) 15 6 21 15 6 21Malamute 12 3 15 13 3 16Wolf-dog hybrid 0 14 14 0 15 15Mixed-breed (NOS) 0 12 12 0 47 47Chow Chow 8 3 11 8 13 21Doberman 9 1 10 12 1 13Saint Bernard 7 1 8 7 1 8Great Dane 7 1* 7* 11 2 13Labrador Retriever 1 4 5 1 7 8Akita 4 0 4 4 0 4Sled-type (NOS) 3 0 3 12 0 12Bulldog 2 1 3 2 1 3Mastiff 2 1 3 4 1 5Boxer 2 1 3 4 1 5Collie 0 3 3 0 6 6Bullmastiff 1 1 2 1 1 2Hound-type (NOS) 1 1 2 1 1 2Retriever-type (NOS) 1 0 1 1 0 1Chesapeake Bay Retriever 1 0 1 1 0 1West Highland Terrier (NOS) 1 0 1 1 0 1Terrier-type (NOS) 1 0 1 1 0 1Japanese Hunting Dog (NOS) 1 0 1 1 0 1Newfoundland 1 0 1 1 0 1Coonhound 1 0 1 1 0 1Sheepdog (NOS) 1 0 1 1 0 1Australian Shepherd 0 1 1 0 3 3Rhodesian Ridgeback 1 0 1 1 0 1Cocker Spaniel 1 0 1 1 0 1

*A purebred dog and a crossbred dog of this breed were involved in a single fatality; therefore, that breed is counted onlyonce in the total column.

NOS ! Not otherwise specified.

Table 2—Breeds of dogs involved in human dog bite-related fatalities between 1979 and 1998, usingdeath-based and dog-based approaches

JAVMA, Vol 217, No. 6, September 15, 2000 Vet Med Today: Special Report 839

ularity, so have Rottweiler-related deaths (24,195 regis-trations from 1979 through 1982 and 0 deaths; 272,273registrations from 1983 through 1990 and 6 deaths; and692,799 registrations from 1991 through 1998 and 33deaths). However, official registration or licensing dataare likely to be biased, as owners of certain dog breedsmay be less likely than those owning other breeds toregister or license their dogs4 and, thus, should not beused to calculate these rates. Finally, it is imperative tokeep in mind that even if breed-specific bite rates couldbe accurately calculated, they do not factor in owner-related issues. For example, less responsible owners orowners who want to foster aggression in their dogs maybe drawn differentially to certain breeds.

Despite these limitations and concerns, the dataindicate that Rottweilers and pit bull-type dogsaccounted for 67% of human DBRF in the United Statesbetween 1997 and 1998. It is extremely unlikely thatthey accounted for anywhere near 60% of dogs in theUnited States during that same period and, thus, thereappears to be a breed-specific problem with fatalities.

Although the fatality data are concerning, one mustbroaden the context to consider both fatal and nonfatalbites when deciding on a course of action. Nonfatal dogbites continue to be a public health problem in theUnited States. Although this and prior reports1-3 docu-ment more than 330 DBRF during a 20-year period,these tragedies represent only the most severe manifes-tation of the problem. In 1986, nonfatal dog bites result-ed in an estimated 585,000 injuries that required med-ical attention or restricted activity.8 By 1994, an estimat-ed 4.7 million people (1.8% of the US population) sus-tained a dog bite; of these, approximately 800,000 (0.3%of the US population) sought medical care for the bite(332,000 in emergency departments), and 6,000 werehospitalized.9-11 This 36% increase in medically attendedbites from 1986 to 1994 draws attention to the need foran effective response, including dog bite prevention pro-grams. Because (1) fatal bites constitute less than0.00001% of all dog bites annually, (2) fatal bites haveremained relatively constant over time, whereas nonfatalbites have been increasing, and (3) fatal bites are rare atthe usual political level where bite regulations are pro-mulgated and enforced, we believe that fatal bites shouldnot be the primary factor driving public policy regardingdog bite prevention.

Several interacting factors affect a dog’s propensityto bite, including heredity, sex, early experience,socialization and training, health (medical and behav-ioral), reproductive status, quality of ownership andsupervision, and victim behavior. For example, a studyin Denver of medically-attended dog bites in 1991 sug-gested that male dogs are 6.2 times more likely to bitethan female dogs, sexually intact dogs are 2.6 timesmore likely to bite than neutered dogs, and chaineddogs are 2.8 times more likely to bite than unchaineddogs.12 Communities have tried to address the dog biteproblem by focusing on different factors related to bit-ing behavior.

To decrease the risk of dog bites, several communi-ties have enacted breed-specific restrictions or bans. Ingeneral, these have focused on pit bull-type dogs andRottweilers. However, breeds responsible for human

DBRF have varied over time. Pinckney and Kennedy13

studied human DBRF from May 1975 through April1980 and listed the following breeds as responsible forthe indicated number of deaths: German Shepherd Dog(n = 16); Husky-type dog (9); Saint Bernard (8); BullTerrier (6); Great Dane (6); Malamute (5); GoldenRetriever (3); Boxer (2); Dachshund (2); DobermanPinscher (2); Collie (2); Rottweiler (1); Basenji (1);Chow Chow (1); Labrador Retriever (1); YorkshireTerrier (1); and mixed and unknown breed (15). Asascertained from our data, between 1979 and 1980,Great Danes caused the most reported human DBRF;between 1997 and 1998, Rottweilers and pit bull-typedogs were responsible for about 60% of human DBRF.Indeed, since 1975, dogs belonging to more than 30breeds have been responsible for fatal attacks on people,including Dachshunds, a Yorkshire Terrier, and aLabrador Retriever.

In addition to issues surrounding which breeds toregulate, breed-specific ordinances raise several practi-cal issues. For optimal enforcement, there would needto be an objective method of determining the breed ofa particular dog. Pedigree analysis (a potentially time-consuming and complicated effort) combined withDNA testing (also time-consuming and expensive) isthe closest to an objective standard for conclusivelyidentifying a dog’s breed. Owners of mixed-breed orunregistered (ie, by a kennel club) dogs have no way ofknowing whether their dog is one of the types identi-fied and whether they are required to comply withbreed-specific ordinances. Thus, law enforcement per-sonnel have few means for positively determining adog’s breed and deciding whether owners are in com-pliance or violation of laws.

Some municipalities have attempted to addressthis classification issue of unregistered and mixed-breed dogs by including within their ordinances adescription of the breed at which the ordinance isdirected. Unfortunately, such descriptions are usuallyvague, rely on subjective visual observation, and resultin many more dogs than those of the specified breedbeing subject to the restrictions of the ordinance.

When a specific breed of dog has been selected forstringent control, 2 constitutional questions concerningdog owners’ fourteenth amendment rights have beenraised: first, because all types of dogs may inflict injuryto people and property, ordinances addressing only 1breed of dog are argued to be underinclusive and, there-fore, violate owners’ equal protection rights; and second,because identification of a dog’s breed with the certaintynecessary to impose sanctions on the dog’s owner is pro-hibitively difficult, such ordinances have been argued asunconstitutionally vague, and, therefore, violate dueprocess. Despite such concerns, a number of breed-spe-cific ordinances have been upheld by the courts.14-16

Another concern is that a ban on a specific breedmight cause people who want a dangerous dog to sim-ply turn to another breed for the same qualities theysought in the original dog (eg, large size, aggressioneasily fostered). Breed-specific legislation does notaddress the fact that a dog of any breed can becomedangerous when bred or trained to be aggressive. Froma scientific point of view, we are unaware of any formal

840 Vet Med Today: Special Report JAVMA, Vol 217, No. 6, September 15, 2000

evaluation of the effectiveness of breed-specific legisla-tion in preventing fatal or nonfatal dog bites.

An alternative to breed-specific legislation is to reg-ulate individual dogs and owners on the basis of theirbehavior. Although, it is not systematically reported, ourreading of the fatal bite reports indicates that problembehaviors (of dogs and owners) have preceded attacks ina great many cases and should be sufficient evidence forpreemptive action. Approaches to decreasing dangerousdog and owner behaviors are numerous. The potentialimportance of strong animal control programs is illus-trated by our data; from 1979 through 1998, 24% ofhuman DBRF were caused by owned dogs (typicallymore than 1) that were roaming off the owners’ proper-ty. Some deaths might have been averted through morestringent animal control laws and enforcement (eg, leashlaws, fencing requirements). Although the bite preven-tion effectiveness of such animal control ordinances andprograms has not been systematically evaluated, free-roaming dogs and dogs with menacing behavior areproblems that need to be addressed even if they do notbite (eg, causing bicycle or car crashes).

Generic non–breed-specific, dangerous dog lawscan be enacted that place primary responsibility for adog’s behavior on the owner, regardless of the dog’sbreed.17 In particular, targeting chronically irresponsi-ble dog owners may be effective.18 If dog owners arerequired to assume legal liability for the behavior andactions of their pets, they may be encouraged to seekprofessional help in training and socializing their pets.Other options include enforcing leash laws and lawsagainst dog fighting. We noticed in the fatal cases, thatless than one half of 1% of DBRF were caused byleashed animals off the owners’ property. Subdivisionsand municipalities that outlaw fences or limit fences toheights insufficient for controlling large dogs may beincreasing the probability of children interacting withunsupervised dogs. Scientific evaluations of the effectsof such regulations are important.

Education of dog owners can address several issues:(1) understanding breed profiles19,20 may assist owners inselecting the appropriate dog for their lifestyle and train-ing abilities, (2) convincing owners to seriously consid-er the sex and reproductive status of their dogs is impor-tant because male and sexually intact dogs are more like-ly to bite than are female and neutered dogs,12 and (3)teaching owners about the importance of socializationand training may decrease their likelihood of owning adog that will eventually bite.

Veterinarians play a key role in educating pet own-ers, but because many dogs that bite may not be seenby a veterinarian prior to the bite incident, programsthat encourage responsible ownership must also bepresented through other venues. Public educationstrategies should include school-based and adult edu-cational programs addressing bite prevention and basiccanine behavior, care, and management. Programsshould strive to ensure that dogs receive proper social-ization, exercise, and attention; that they are given ade-quate food, water, shelter, and veterinary care; thatthey are neutered if they are not maintained for legiti-mate and responsible breeding purposes; and that theyare trained humanely and confined safely. However,

like breed-specific legislation, all these approachesappear formally unevaluated for effectiveness.

Targeting and evaluation of prevention effortsrequires improved surveillance for fatal and nonfataldog bites. Dog bites should be reported as required bylocal or state ordinances, and reports of such incidentsshould include information about the circumstances ofthe bite, ownership, breed, sex, reproductive status ofthe dog, history of prior aggression, and the nature ofrestraint prior to the bite incident. Collection of dataon the entire dog population (eg, breed, age, sex)would help resolve comparative risk issues and may beaccomplished by combining paperwork on mandatoryrabies immunizations with registration of breed andsex. Only with numerator and denominator data andwith formal evaluations of the impacts of strategiestried by various communities will we be able to makescience-based recommendations for decreasing thenumber of dog bites. In the interim, adequate fundingfor animal control agencies, enforcement of existinganimal control laws, and educational and policy strate-gies to reduce inappropriate dog and owner behaviorswill likely result in benefits to communities and maywell decrease the number of dog bites that occur.

References 1. Sacks JJ, Sattin RW, Bonzo SE. Dog bite-related fatalities in

the United States, 1979–1988. JAMA 1989;262:1489–1492.2. Sacks JJ, Lockwood R, Hornreich J, et al. Fatal dog attacks,

1989–1994. Pediatrics 1996;97:891–895.3. Centers for Disease Control. Dog bite related fatalities—

United States, 1995–1996. Morbid Mortal Weekly Rep1997;46:463–467.4. Lockwood R. Humane concerns about dangerous dog laws.

University of Dayton Law Rev 1988;13:267–277.5. Lockwood R, Rindy K. Are “pit bulls” different? An analy-

sis of the pit bull terrier controversy. Anthrozoos 1987;1:2–8.6. NEXIS-LEXIS [online database available at http://www.lexis-

nexis.com/lncc]. Dayton, Ohio: Lexis-Nexis Group; 1999.7. American Kennel Club. Dog registration statistics, Jan 1,

1990–Dec 31, 1998. New York: American Kennel Club.8. Sosin DM, Sacks JJ, Sattin RW. Causes of nonfatal injuries in

the United States, 1986. Accid Anal Prev 1992;24:685–687.9. Sacks JJ, Kresnow M, Houston B. Dog bites: how big a prob-

lem? Injury Prev 1996;2:52–54.10. Weiss HB, Friedman D, Coben JH. Incidence of dog bite

injuries treated in emergency departments. JAMA 1998;279:51–53.11. Quinlan KP, Sacks JJ. Hospitalizations for dog bite injuries.

JAMA 1999:281:232–233.12. Gershman KA, Sacks JJ, Wright JC. Which dogs bite? A

case-control study of risk factors. Pediatrics 1994;93:913–917. 13. Pinckney LE, Kennedy LA. Traumatic deaths from dog

attacks in the United States. Pediatrics. 1982;69l:193–196.14. Pollock S. Banning pit bulls in the District of Columbia.

Memorandum to the Washington Humane Society from the Arnoldand Porter Law Firm. Washington, DC, 1999.

15. Burt MR. Canine legislation: can dogs get a fair shake incourt? J Am Vet Med Assoc 1997;210:1139–1142.

16. Wapner M, Wilson JF. Are laws prohibiting ownership of pit bull-type dogs legally enforceable? J Am Vet Med Assoc2000;216:1552–1554.

17. Companion animals section and division of higher educa-tion programs. Guidelines for regulating dangerous or vicious dogs.Washington, DC: Humane Society of the United States, 1987.

18. Lockwood R. Dangerous dogs revisited. The Humane SocietyNews 1992;37:20–22.

19. Hart BL, Miller MF. Behavioral profiles of dog breeds. J AmVet Med Assoc 1985;186:1175–1180.

20. Hart BL, Hart LA. Selecting pet dogs on the basis of clusteranalysis of breed behavior profiles and gender. J Am Vet Med Assoc1985;186:1181–1185.

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