When a handcuffed Freddie Gray was placed in a Baltimore police van on April 12, he was talking and breathing. When the 25-year-old emerged, "he could not talk and he could not breathe," according to one police official, and he died a week later of a spinal injury.

But Gray is not the first person to come out of a Baltimore police wagon with serious injuries.

Relatives of Dondi Johnson Sr., who was left a paraplegic after a 2005 police van ride, won a $7.4 million verdict against police officers. A year earlier, Jeffrey Alston was awarded $39 million by a jury after he became paralyzed from the neck down as the result of a van ride. Others have also received payouts after filing lawsuits.

For some, such injuries have been inflicted by what is known as a "rough ride" — an "unsanctioned technique" in which police vans are driven to cause "injury or pain" to unbuckled, handcuffed detainees, former city police officer Charles J. Key testified as an expert five years ago in a lawsuit over Johnson's subsequent death.

As daily protests continue in the streets of Baltimore, authorities are trying to determine how Gray was injured, and their focus is on the 30-minute van ride that followed his arrest. "It's clear what happened, happened inside the van," Mayor Stephanie Rawlings-Blake said Monday at a news conference.

Baltimore residents protest and officials respond after the death of Freddie Gray, 27, who was injured while he was being arrested on April 12.

Christine Abbott, a 27-year-old assistant librarian at the Johns Hopkins University, is suing city officers in federal court, alleging that she got such a ride in 2012. According to the suit, officers cuffed Abbott's hands behind her back, threw her into a police van, left her unbuckled and "maniacally drove" her to the Northern District police station, "tossing [her] around the interior of the police van."

"They were braking really short so that I would slam against the wall, and they were taking really wide, fast turns," Abbott said in an interview that mirrored allegations in her lawsuit. "I couldn't brace myself. I was terrified."

It felt like a roller coaster. Except a roller coaster is more secure because you're strapped in. — Christine Abbott, suing city officers in federal court

The lawsuit states she suffered unspecified injuries from the arrest and the ride.

"You feel like a piece of cargo," she added. "You don't feel human."

The van's driver stated in a deposition that Abbott was not buckled into her seat belt, but the officers have denied driving recklessly.

Police officials have not directly linked Gray's van ride to his injuries but did say that he was not buckled in, as required by department policy. Medical experts say Gray could have injured his spine when he was arrested and that injury could have worsened in the van through even an inadvertent bump, turn or stop.

"From my work in the criminal defense arena over the past 40 years, I'm aware of this term 'rough ride' and that it happens," said Byron L. Warnken, a University of Baltimore law school professor who trains police officers in proper techniques for dealing with people they stop. "How frequent it is, how abusive it is — I don't know."

But, he added, if a prisoner dies of a broken neck while in custody, the city has a problem. "The force it takes to break a neck means wrongdoing, in my judgment."

Fractured neck, then death

The most sensational case in Baltimore involved Johnson, a 43-year-old plumber who was arrested for public urination. He was handcuffed and placed in a transport van in good health. He emerged a quadriplegic.

Before he died, he complained to his doctor that he was not buckled into his seat when the police van "made a sharp turn," sending him "face first" into the interior of the van, court records state. He was "violently thrown around the back of the vehicle as [police officers] drove in an aggressive fashion, taking turns so as to injure [Johnson] who was helplessly cuffed," the lawsuit stated.

Johnson, who suffered a fractured neck, died two weeks later of pneumonia caused by his paralysis. His family sued, and a jury agreed that three officers were negligent in the way they treated Johnson. The initial $7.4 million award, however, was eventually reduced to $219,000 by Maryland's Court of Special Appeals because state law caps such payouts.

In 1997, Alston became paralyzed from the neck down in a van after being arrested. Alston said he told the officers he couldn't breathe, but they refused to give him an inhaler for asthma.

Officers said the 32-year-old repeatedly rammed his head into the side of the van, freed himself from a seat belt and thrashed some more.

Alston sued, and at the trial, Dr. Adrian Barbul, a Sinai Hospital trauma surgeon, testified that Alston had no external head injuries when he was taken to the emergency room.

A jury awarded Alston $39 million, but he and the city settled for $6 million. In settlements, the city generally does not acknowledge liability; the officers involved in the case did not face disciplinary actions.

Alston's attorney, Philip Federico, said Thursday that the Gray case brought back memories of Alston, who died about eight years ago. What jumped out was that both men had asthma and were denied when they asked police for inhalers, he said.

Federico said he doesn't condone misconduct by police but cautioned that all of the facts in the Gray case are not yet known. The autopsy will be crucial in showing whether Gray had any head injuries or whether the spine injury came from his neck twisting, he added.

Federico said of the protests and national spotlight in Baltimore: "It's tearing our city apart. We're going in the wrong direction from a race-relations standpoint."

In 1997, the city paid $100,000 to settle a lawsuit brought by the family of Homer Long, who suffered a fatal heart attack in a van in 2003. Family members said the arrest was improper; officers said Long contributed to his death by behaving belligerently during the arrest.

And in 1980, a 58-year-old man broke his neck and became paralyzed during a ride to the Southwestern District. While seated on a bench with his hands cuffed behind his back, John Wheatfall was thrown to the floor and hit his head against a wall, The Sun reported. The officer said he swerved to avoid an oncoming car, and investigators ruled that the officer was not reckless.

At the time, the vans did not have seat belts, and police officials said installing them could cause other injuries during accidents. An official said: "We carry thousands and thousands of people in those wagons, and this is the most serious accident I've ever heard of."

Wheatfall sued for $3 million, but a judge ruled that there was no evidence the officer was negligent. The jury granted Wheatfall $20,000, the maximum amount under a state law when an accident is caused by an unknown driver of another vehicle.