Wednesday, August 27, 2008

TASER Safety

Roberts, James R. MD

It is difficult to separate unsubstantiated newspaper articles, emotionally charged TV reports, or current YouTube videos from scientific data with regard to the safety of the TASER. Likewise, so-called scientific studies, either on volunteers or animals, are not the same as the real issue at hand. Autopsy reports often assume that the TASER is related to the death just because it was used premortem and because no specific cause of death can be found (not uncommon in many deaths). In the past, medical examiners have related deaths to the TASER. Most quote reports from the 1990s before any true electrical data were available. (J Forensic Sci 1991;36:434; J Forensic Sci 1992;37:956.)

It should be noted that although studies on this device are very incomplete, there is no credible proof that the TASER induces cardiac arrest when used by law enforcement officials in a prescribed manner. In fact, the voltage required to induce VF has been calculated to be 15 to 42 times the charge possible to be delivered from the TASER. (Pacing Clin Electrophys 2005;28(Suppl 1):S284.) It has been stated that there have been no documented cases of VF directly caused by the device in more than 600,000 police uses. (J Am Coll Cardiol 2007;49[6]:732.) Contrast this with lay press headlines that the TASER kills many people. (167 Cases of Death Following Stun-Gun Use, Arizona Republic, February 5, 2006.) If one reads the UpToDate database, the 2007 version states that the TASER is capable of inducing fatal arrhythmias and other injuries. My analysis: We simply don't know for sure, but many self-proclaimed authorities come down on both sides of the debate, many have a personal, financial, or social bias, and many simply don't read the literature.

Other injuries claimed to be associated with the TASER include burns, lacerations, testicular torsion, and miscarriage. Although the concepts may be believable, these are often anecdotal and poorly characterized reports. A miscarriage two weeks after a TASER application is hardly a scientific cause-effect. Thoracic spine compression fractures from the TASER in a volunteer who did not fall but experienced severe muscle contraction has recently been reported. (Ann Emerg Med 2007;50[5]:584.) Fracture and dislocation from electrical shock are well documented.

Some articles that claim the TASER can cause VF. Reference a short letter to the editor by Kim and Franklin (New Engl J Med 2005;353:958) titled Ventricular Fibrillation after Stun Gun Discharge. If one actually reads this sketchy report, it is hardly proof of the article's title. This is clearly only a worrisome observation and certainly not quotable science based on my read. Specifically, a violently agitated subject was subdued with a TASER. Later he had VF but was resuscitated to normal with ACLS interventions. No drug screen or medical history was reported. Kroll claims that this particular case was misreported with serious omissions. His version (personal communication: Obtained from police records) was that following submission of a violently agitated man with a TASER, paramedics found a normal pulse and respirations. Twenty some minutes after this episode, the subject experienced a cardiorespiratory collapse. It is my understanding that no ventricular fibrillation was documented until many minutes after TASER use, and after interventions including multiple medic-delivered cardiac shocks, atropine and epinephrine were administered. As stated, most agitated patients die via bradycardia. I am leery of this supposed documentation of VF after TASER discharge, yet it is universally quoted. So far, I have received no response from the author to my email query.

A theoretical discussion by Ideker (Am J Forensic Med Patho 2007;28[3]:195) states that fundamental laws of electrical stimulation predicted the TASER pulse will not stimulate an ectopic beat in a large majority of normal adults. It is unlikely, at least from a theoretical stance, that a TASER can initiate ventricular fibrillation. It's a nice theoretical discussion but hardly firm clinical evidence.

Ho et al recently reported on respiratory effects of prolonged electrical weapon application to human volunteers. (Acad Emerg Med 2007;14:197.) Human volunteers received a 15-second application of electrical current while wearing respiratory measurement devices. These were certainly brave volunteers. Respiratory parameters were collected during and after exposure. The aim of the article was to see if the TASER contributed to death by impairing respirations. In this study, respiratory measurements were taken pre-exposure, during electrical weapon exposure, and during the first and second minute after exposure. No respiratory impairment was demonstrated either during prolonged continuous or prolonged intermittent TASER discharge. There was no decrease in tidal volume nor was there hypercapnia, hypoxia, or apnea associated in this volunteer model.

Other work has failed to demonstrate any significant changes in cardiac serum markers, hyperkalemia, or acidosis following TASER application. Transient mild increases in CPK and lactate were observed, likely due to muscle contraction. (Acad Emerg Med 2006;13:589.) Shocking does not cause hyperthermia (Forensic Sci Int November 2007, abstract only), and minimal testing has shown no disruption of pacemakers, ICDs, or their leads when exposed to TASERs. (Europace 2007;9[7]:551.)

Author Credentials and Financial Disclosure:
James R. Roberts, MD, is the Chairman of the Department of Emergency Medicine and the Director of the Division of Toxicology at Mercy Health Systems, and a Professor of Emergency Medicine and Toxicology at the Drexel University College of Medicine, both in Philadelphia. Dr. Roberts has disclosed that he has no significant relationships with or financial interests in any commercial companies that pertain to this educational activity.

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Monday, August 25, 2008

Study shows TASER Has No Effect On Human Heart

Echocardiographic Evaluation of a TASER X26 Application in the Ideal Human Cardiac Axis

Ho JD, Dawes DM, Reardon RF, Lapine AL, Dolan BJ, Lundin EJ, Miner JR.Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN, USA.

Objectives:
TASER electronic control devices (ECDs) are used by law enforcement to subdue aggressive persons. Some deaths temporally proximate to their use have occurred. There is speculation that these devices can cause dangerous cardiac rhythms. Swine research supports this hypothesis and has reported significant tachyarrhythmias. It is not known if this occurs in humans. The objective of this study was to determine the occurrence of tachyarrhythmias in human subjects subjected to an ECD application. Methods: This was a prospective, nonblinded study. Human volunteers underwent limited echocardiography before, during, and after a 10-second TASER X26 ECD application with preplaced thoracic electrodes positioned in the upper right sternal border and the cardiac apex. Images were analyzed using M-mode through the anterior leaflet of the mitral valve for evidence of arrhythmia. Heart rate (HR) and the presence of sinus rhythm were determined. Data were analyzed using descriptive statistics. Results: A total of 34 subjects were enrolled. There were no adverse events reported. The mean HR prior to starting the event was 108.7 beats/min (range 65 to 146 beats/min, 95% CI = 101.0 to 116.4 beats/min). During the ECD exposure, the mean HR was 120.1 beats/min (range 70 to 158 beats/min, 95% CI = 112.2 to 128.0 beats/min) and a mean of 94.1 beats/min (range 55 to 121 beats/min, 95% CI = 88.4 to 99.7 beats/min) at 1 minute after ECD exposure. Sinus rhythm was clearly demonstrated in 21 (61.7%) subjects during ECD exposure (mean HR 121.4 beats/min; range 75 to 158 beats/min, 95% CI = 111.5 to 131.4). Sinus rhythm was not clearly demonstrated in 12 subjects due to movement artifact (mean HR 117.8 beats/min, range 70 to 152 beats/min, 95% CI = 102.8 to 132.8 beats/min).

Conclusions: A 10-second ECD exposure in an ideal cardiac axis application did not demonstrate concerning tachyarrhythmias using human models. The swine model may have limitations when evaluating ECD technology.

Source:
National Center for Biotechnology Information, 08/10/2008

Sunday, August 24, 2008

TASER - As Safe As A Weapon Can Be

New study: TASERs “as safe as weapons can be,” not “instruments of death”

A first-of-its-kind case-by-case study of in-custody deaths associated with TASER use has confirmed that the popular electronic control devices are by no means the dangerous and often deadly weapons that Amnesty International, the ACLU and media reports frequently suggest. Self-described as “kind of a nerd” who approaches tedious research as recreation, Chief Howard Williams of the San Marcos (TX) PD patiently tracked down and analyzed 213 cases in which suspects in the US died after being TASERed. The search took more than a year and cost thousands from his own pocket, but in the end Williams has documented what TASER supporters have long believed: "These devices are safe weapons. At least they are as safe as weapons can be.” During the scope of his investigation, which covered cases from 1983 through 2005, Williams concluded that TASER can be confirmed as the direct cause of or a significant contributing factor in only 2 deaths. “That’s less than 1% of the deaths that critics of Taser technology attribute to it.”

Since his study formally ended, he has identified and preliminarily probed some 216 additional post-TASERing fatalities that occurred from 2006 to the present, but he has found no data that would change his initial findings or cast doubt on TASER safety. Critics of TASER have failed to “separate evidence from conjecture or to analyze cases one by one", Williams says. Instead, they’ve drawn misleading assumptions “based simply on the number of deaths, a misunderstanding of how the devices work, or on speculation of potential problems with the use of electromuscular disruption technology.” In contrast, he says his study objectively analyzes “the credible evidence”—including “what medical experts know about sudden death, the technical operations of conducted energy weapons, the physiological effects of TASER devices, and the facts of each case—to determine the true role” of TASERs in suspects’ fatalities.

Williams’ discoveries are reported in a 212-page book, "TASER Electronic Control Devices and Sudden In-custody Death: Separating Evidence from Conjecture", issued recently by Charles C. Thomas Publishers. Call (800) 258-8980 or order a copy online.

“Given all the headlines, the controversy, and the lawsuits generated by TASER-related deaths, it’s ironic that a lone police official steps up to conduct this kind of vital research, rather than it being a priority mandate by a major governmental entity,” says Dr. Bill Lewinski, executive director of the Force Science Research Center at Minnesota State University-Mankato. “Sadly, this speaks to the lack of interest at the state and federal level for funding research into practical, street-level enforcement issues. Chief Williams’ study will not be the final scientific statement on the ramifications of TASER use, but it presents the clearest picture to date regarding a core controversy that in the past has produced far more heat than light.”

Williams first became interested in exploring the “death by TASER” issue, when he was struck by the contrast between what he saw of TASER use on the street, and what he read in the media and heard from activist groups. On one hand, there were officers’ success stories - incidents that might otherwise have escalated to baton beatings or shootings being resolved earlier and less violently, fewer on-the-job injuries by officers, and fewer ER trips for subdued suspects - thanks to TASER. On the other hand were all the allegations by Amnesty and other groups, strongly implying (if not charging outright) that TASER was responsible for scores of offender deaths, and calls for moratoriums on the “dangerous” device.

Williams tells his CJ students at Texas State University, where he’s an adjunct faculty member, “You do not have to trust what anyone tells you. Research it yourself.” So he took his own advice and started looking into TASER-related deaths, determined to see what the evidence revealed. Searching out leads on the Internet and through media databases at Texas State, he compiled a comprehensive list of reported fatalities. Then through freedom of information requests, he pursued each case and got police reports, autopsy results, and other official records wherever possible, and supplemented this data with whatever news coverage he could garner. He amassed stacks of information 2 to 3 feet high on his desk at home and waded through them item by item, tabulating and analyzing. Each of the 213 cases he verified is described in narrative detail in his book and includes the name, age, race and gender of the deceased; the date of the incident and the death; the agency involved; the cause of death, plus contributing factors; and the role of the TASER device deployed. Unique to Williams’ study, these accounts in themselves make fascinating reading and represent a prodigious amount of research. But the payoff, of course, is the conclusions Williams draws from his analyses. These include the following highlights:

Early generation fatalities
The first 42 of Williams’ case studies represent deaths that occurred before 2000 and followed the use of first- and second-generation TASER weapons (the TASER TF-76, the Tasertron and the Air TASER 34000, which “relied mainly on pain compliance”) against aggressive or resistive subjects. A TASER device cannot be confirmed as a cause of death or even as a significant contributing factor in any of these “Group 1” cases, Williams reports. By the study’s definition, TASER can be “confirmed” as a direct cause of death only in instances where the subject likely would have survived had the weapon not been used.

Later generation fatalities
The other 171 deaths, considered “Group 2” events, followed the application of third- and fourth-generation weapons (Advanced TASER M26 and the TASER X26, which depend on “electromuscular disruption technology”). In this category, TASER can be confirmed as a cause of death in only 1 case and confirmed as a significant contributing factor in only 1 other, Williams concludes. “The evidence makes the case that TASER devices are not instruments of death,” Williams asserts. “The only conclusion the evidence supports is that they are safe weapons.”

Case details
The sole case of confirmed death-by-TASER involved extreme circumstances in subduing a 29-year-old black male prisoner in South Carolina named Maurice Cunningham. After a night of hallucinating that snakes were around him, Cunningham escaped his cell in a sheriff’s facility, stabbed 2 officers in the eye with a pencil and tried to gouge out the eyes of a third officer. He was shocked 5 times with a TASER, for a cumulative total of 35 seconds, but “he ripped the probes out and continued to fight,” Williams reports. After an ineffective use of chemical spray, he was zapped with a second TASER, the probes hitting in his left arm and thigh. Williams notes: “The deputy held the trigger for 2 minutes 49 seconds,” before Cunningham collapsed and was soon after pronounced dead. “The coroner listed Cunningham’s cause of death as cardiac arrhythmia due to TASER shocks,” Williams writes. “Pathologists found that his heart suffered damage at a cellular level purportedly from the electrical current, and concluded that the probes…completed a circuit in his body that disrupted the electrical system that controls the heart.” The single case in which Williams classified TASER as a significant contributing cause of death also represents an anomaly of circumstances. This offender was Jerry Pickens, a 55-year-old white male who hostilely confronted sheriff’s deputies in his front yard in Louisiana when they arrived to investigate a family dispute. Against their orders, Pickens tried to re-enter his residence. They TASERed him, and he stiffened and fell, striking his head on the driveway. He was declared brain-dead at the hospital and died 3 days later when doctors pulled the plug on life support. The coroner ruled that he died of a brain hemorrhage from the fall. “Clearly,” Williams writes, “the fall…was caused by application of the TASER.”

Predisposing factors
Williams reports that subjects who die in custody or during an arrest after a TASER is used against them tend to share certain characteristics that seem to “predispose” them to an increased risk of sudden death quite apart from any TASER involvement.
These include: obesity, coronary problems, illicit drug use, mental illness, too much or too little psychotropic medication, alcohol intoxication or withdrawal, diabetes and hypoglycemia, hyperthyroidism, dehydration, head injuries (current or historic) and vigorous physical activity that may trigger ventricular fibrillation. For example, nearly 70% of Group 1 subjects and more than 72% of those in Group 2 were users of illicit drugs (most often cocaine). Nearly 40% in Group 2 showed evidence of heart disease. In all, Williams found, a coroner or medical examiner observed at least 1 predisposing factor in nearly 88% of the cases studied. In more than 35%, at least 2 such factors were confirmed. Williams pointed out to Force Science News that the prevalence of predisposing factors is roughly the same among subjects who die after being TASERed and those who die suddenly in custody without any TASER involvement—further indication that the use of the electronic weapon “is not creating any special risk.” On the other hand, he notes, “The risk of sudden death following violent exertion, such as a struggle with police or straining against restraints, increases manifold for people with predisposing factors.”

TASER failures
Interestingly, Williams documents a high rate of TASER failure associated with post-TASERing deaths. Either the electronic application did not stop the individual or stopped him only temporarily, and some other form of force had to be used to get the subject under control. Among Group 1 cases, the TASER pulse was ineffective in subduing the target some 71% of the time. In Group 2, the ineffective rate was nearly 60%. This may suggest the exceptionally high level of agitation and violent determination in subjects who end up dying, as compared to other offenders who are TASERed where the effectiveness level is much higher. Moreover, the vast majority of subjects in both Groups 1 and 2 did not fatally collapse within 5 to 15 seconds after the application of a TASER device was, “an indication that the current from the TASER pulses did not affect their hearts’ rhythm” as critics often conjecture, Williams says.

Media/activist shortcomings
TASER critics and the media have emphasized that the number of deaths after use of electronic devices is rising, and they conclude that this increase is occurring because TASER causes death. Fallacious thinking", Williams insists. “First, there is no evidence that the total number of in-custody deaths is rising,” he states. "Deaths after TASER use are rising, but that’s because the number of police agencies in the US equipping officers with TASER has increased more than 10-fold since 2001." "What activists and the media seize upon", he says, "is a correlation between TASER use and sudden death." This is an unscientific linking of 2 events." Just because one follows another, Williams writes, not a true cause-and-effect relationship. “The sun rises after the cock crows, but that doesn’t mean there’s a causal relationship,” he offers as comparison. Indeed, he notes, other studies have shown “a much higher correlation between sudden death and heart disease, sudden death and the use of drugs, and sudden death and bizarre behavior, than sudden death and the use of TASER… tens of thousands of people who have been shocked with a TASER device survived without ill effects.” Williams points out that investigators “usually need several days or weeks to determine the facts, complete the investigation, and determine whether a TASER pulse, or any other factor, played a role in an unexpected death.” Typically, the media prominently play initial stories of post-TASERing deaths, but the public gets “little sense of the results of the investigations or of the coroners’ findings.” News reports presented one case he cites in his study “as being related to the discharge of a TASER device, but tests proved that the device was not properly charged and could not have delivered a shock.” Often, results indicating that TASER was not a death factor are buried in little-read sections of newspapers, or totally ignored by tv news. Williams tells of one particularly egregious example of a post-investigation report in which the headline read: “Cocaine Blamed for TASER Death.” “Trying to educate the media is hopeless." Like TASER activist critics, “to many in the media have an agenda. That’s obvious when you read their articles.”

In the future, Williams is hopeful that a central database will be created at the federal level to collect meaningful information on in-custody deaths, similar to the reporting that exists for crime records. This would make possible a more comprehensive ongoing analysis of the role played by the TASER and other factors in suspect fatalities. Meanwhile, he continues gathering information on his own in anticipation of eventually revising and updating his study. He’d like to hear from people who have observations or contributions regarding his work—including critics. “I’m open to debate and discussion,” he says. “If anyone can show me I’m wrong, I’d welcome it. I’m a Little League umpire, so I’m used to criticism.”

To contact Williams, you can email him at: howardewilliams@msn.com

Source: www.policeone.com
The Force Science Research Center

Saturday, August 23, 2008

Sister Defends Use Of Taser

Galliagh, Northern Ireland - police were right to use a Taser stun gun on a man who locked himself and his two young sons in a house, the sister of the boys has said. She said the incident in Londonderry last weekend was "terrifying", and criticised politicians who are against the use of the weapon. "The police could not have done a better job," said the sister.

The man was detained under the Mental Health Act. The Police Ombudsman is investigating the incident.

"I know it's not right for every circumstance for taser guns to be used, but that night it happened and then those people are giving out in newspapers that it shouldn't have happened," she said.

"Not one of them has a clue, not one of them has come near the door to ask what happened, what didn't happen."

Source:
BBC NEWS - Published: 2008/08/22
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Thursday, August 21, 2008

Robert Wayne Bagnell, 44

June 23, 2004 - Died after Vancouver police tried to arrest him upon receiving a call about a man rampaging in a common washroom of the Continental Hotel on Granville Street in downtown Vancouver, where Bagnell lived. He had locked himself in the bathroom and was smashing things before police arrived. Police stayed outside the washroom, waiting for him to calm down, but a fire began on the ground floor. As smoke began filling the building, a TASER-equipped emergency response team was called in, and Bagnell was hit by two separate Tasers.

At inquest, it was revealed that Bagnell's heart was enlarged to one-and-a-half times normal size, an indication of a chronic cocaine use. He also had undergone open-heart surgery to repair a heart valve.

A toxicologist testified Bagnell's blood sample results were 4.2 milligrams of cocaine per litre of blood. The minimum lethal level is one mg per litre (if cocaine is injected or smoked as crack cocaine), but 10 times that if snorted.

The probable cause of death was a "restraint-associated cardiac arrest due to acute cocaine intoxication," Dr. Laurel Gray, a pathologist, testified at the inquest.


A five-man jury concluded Robert Wayne Bagnell died of restraint-associated cardiac arrest due to acute cocaine intoxication and psychosis.

Source:
Neal Hall, Vancouver Sun



Fortressman's notes:

http://truthnottasers.blogspot.com/

Here's a bit if interesting information: the above anti-TASER website was created in memory of Robert Bagnell by his relatives. This helps us to better understand the motive behind the typical anti-TASER mindset. These people are obviously pained at losing a loved one, and are simply directing their anger at what they mistakenly perceive as the cause of an unjust death.
(See "Taser - a Cycle of Fear" section in right column.)

There are certain stages of grief.
1) Shock – Immediately following the death of a loved one it is difficult to accept the loss. A feeling of unreality occurs. During those first days and through any religious rituals or memorials there is a feeling of being-out-of-touch.

2) Emotional Release – the awareness of just how dreadful the loss is accompanied by intense pangs of grief. In this stage a grieving individuals sleeps badly and weeps uncontrollably

3) Panic - For some time a grieving person can feel in the grip of mental instability. They can find themselves wandering around aimlessly, forgetting things, and not being able to finish what they started. Physical symptoms also can appear -- tightness in the throat, heaviness in the chest, an empty feeling in the stomach, tiredness and fatigue, headaches, migraine headaches, gastric and bowel upsets.

4) Guilt – At this stage an individual can begin to feel guilty about failures to do enough for the deceased, guilt over what happened or what didn’t happen.

5) Hostility – Some individuals feel anger at what “caused” the loss of the loved one.

As with most assigned "TASER-related" deaths, to point the finger at TASER in this case simply defies any and all logical comprehension. The TASER in no way influenced Mr. Bagwell to ingest & abuse cocaine, nor caused his heart to become enlarged to 1 1/2 times its normal size. This man's death was a consequence of his own choices.
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