A 2016 case underscores how willing some American pathologists have been to rule in-custody deaths of Black people accidents or natural occurrences caused by the sickle cell trait, which is almost always benign. The New York Times has found at least 46 other instances over the past 25 years in which medical examiners, law enforcement officials or defenders of accused officers pointed to the trait as a cause or major factor in deaths of Black people in custody. Fifteen such deaths have occurred since 2015.