He throws razor sharp, bat shaped shurikens at people hard enough to knock them backwards a few feet, he's thrown countless villains down stairs or off of gangways 3 stories up, hell I can't count the number of guys he's thrown out windows or off of bridges. I mean sure, his smoke bombs have probably set off a few bad guys emphysema, but the number of people he theoretically kills from underlying conditions is nothing compared to the number of underlings he's impaled with a batarang or chucked off a high place, or just beat to death with his bare hands. How many punches from a bat gauntlet do you think the average thug can take, I'd be he's caved more faces in than hes given heart attacks.