Tasers can be safe, but oversight is crucial

February 19, 2006
By Robert Davis, USA TODAY

Tasers, the controversial stun guns used by police to subdue suspects, are safe when used with restraint, a coalition of emergency-medicine doctors says.

But even so, the doctors, who are tackling this issue for the first time, said in a consensus statement Saturday that oversight programs are needed to ensure that Tasers are used properly.

Tasers, and similar devices known as conductive energy devices, incapacitate by delivering a five-second jolt of electricity. They have been under fire because people have died after being subdued.

Amnesty International USA, which monitors Taser deaths, said last year that 103 people in the United States and Canada died between June 2001 and March 2005 after contact with a Taser. The organization charged that there is widespread abuse, that in some cases, Taser use is torture.

But the Metropolitan Municipalities EMS Medical Directors Consortium, doctors who oversee emergency medical services in 30 major cities, said the devices, if used appropriately, are low risk compared with other options, such as guns and batons or police dogs.

Proper use, the doctors say, is delivering as few shocks as possible, and only when the officer or anyone else present is at risk of injury. The consortium based its findings on a review of medical literature, autopsy reports and police practices. "We don't want people to get hurt or have cardiac arrest," says Paul Pepe, Dallas' EMS medical director, who heads the consortium.

The group says it hopes every community using Tasers will follow the recommendations.

More than 8,500 U.S. law enforcement agencies use Tasers, says spokesman Steve Tuttle of manufacturer Taser International Inc.

The doctors are concerned because Tasers are used differently in every city. Some police departments stun a few people a month; others 20 to 30 people a day. "Some cities are more liberal with their use, and the devices are considered more of a behavior-modification tool," says Gary Vilke, San Diego County EMS medical director.

The group says every city should create a registry to track and scrutinize Taser use. "If you are not recording Taser discharges, you are not requiring responsibility," says Corey Slovis, Nashville's EMS medical director. This step will encourage officers to think more before they zap, he says.

Usually, delivering a single, five-second shock is enough to get somebody's full attention and compliance, Vilke says.

But some of the people most likely to be shocked more than once — those so unruly that they're dangerous to themselves and others — may also be suffering from a condition called excited delirium. Many of the people who have died following repeated Taser shocks have suffered the syndrome, which the doctors say makes people wild and uncontrollable.

The syndrome, which is associated with anything from a drug overdose to a severe psychiatric illness, can cause metabolic changes that put the person at higher risk of sudden cardiac arrest.

"The real cause of death in some of these cases is excited delirium," says Kathleen Schrank, EMS medical director in Miami. "These are not people to be put in the back of a police car and taken to jail."

"You could basically say, 'Boo!' next to these people and they would be at risk of dying," says James Dunford, medical director of San Diego emergency medical services. "We don't know everything, but we do know that these people are dying unrelated to the Taser."

"These are the people for which there is almost no other options than shooting them," Dunford says.

The doctors say Tasers are safe when used with restraint, reducing the number of serious injuries from police batons and guns. But they say guidelines are needed so that police and medics can work together to prevent Taser-related injuries and deaths.

Nashville is launching a new type of response. In coming weeks, when a 911 dispatcher or a police officer on the scene suspects that an unruly person is suffering from excited delirium, he or she will call out paramedics, more police officers and a police sergeant.

In the perfect response, Slovis says, paramedics would stand ready with an injection to calm the person. As the Taser shock is administered, the police officers would restrain the person — they can touch the person without getting shocked themselves — and the medic would move in to inject the tranquilizer.

But even after a person is subdued, risks remain. Another medical problem that the coalition found was positional asphyxia, in which people stop breathing when they are restrained and placed on their stomachs, making it impossible to take full, deep breaths.

"You can't sit on people and you can't put pressure on their chest wall," says Slovis. "As soon as you are suppressing their ventilation, you put them at risk."

The coalition also says cities must reconsider where they put Taser use on the police department's acceptable-use-of-force scale. Some cities have used Tasers on anyone who does not comply with police commands.

Dallas police reduced the number of people being shocked by telling officers that some physical threat has to be present. "The officers have to feel that they are threatened or that the public is at risk," says Lt. Robert Owens of the city police department.

He trains his officers to recognize the danger of repeated shocks. "The people who died got an average of 25 seconds. That's five cycles on average," he says. But the Taser prevents serious injuries when used properly, he says.

The other option on a police officer's belt is a baton. "People who will not be controlled, your only option is to beat them up if you don't have any other tools," he says. If an officer has to fight, he says, "you're going to get hurt and they are going to get hurt."

How Can You Justify Using A Taser 12 Times?

February 14, 2006
Joe Friesen, Globe and Mail (Canada)

BEAMSVILLE, ONT. -- Samantha Foldi faces life as a widow from her wheelchair. For nearly 10 years, since a car accident left her partially paralyzed, she relied on her husband Jim for so much. He quit his construction job to help with her rehab and to care for their four children. He once rescued them from a fire, lowering his wife to safety out a bedroom window.

Mr. Foldi, 39, died last summer -- after a late-night confrontation with police. Officers fired a 50,000-volt taser stun gun 12 times during the struggle; it's not known how many times he was hit.

The province's Special Investigations Unit, the civilian body that probes fatal incidents involving police, said last week that the police are not criminally responsible for his death.

Mr. Foldi is one of 13 people in Canada to have died after being hit with a stun gun. Amnesty International has called for police to stop using the devices; Ontario's deputy chief coroner says they're a safe alternative to deadly force.

In an interview last week, Ms. Foldi, 35, sat at the dining room table she and Jim shared with their children in Beamsville, Ont., halfway between Hamilton and St. Catharines. Photos of her husband, a huge, square-jawed man with the look of a tough-guy actor, were spread in front of her. Her body shook when she spoke, and the effort of forming the words gave her voice the sound of a slow, southern drawl.

"It's hard all the time now without Jim," she said. "It took my man from me. I'm just really confused why they did that."

Mr. Foldi, 6 foot 2, 250 pounds, began behaving erratically at 2:40 a.m. last Canada Day, prompting several 911 calls to Niagara Regional Police, the SIU says. He ran to a house on Crescent Drive, a half block from his home, pounded on the door and shouted, "Help me."

He ran to a second home and smashed a window, cutting his hand badly. Bleeding, he entered another home just as police arrived. Two officers followed him into the home and one fired an X-26 taser once. The SIU says the probes did not remain in or on Mr. Foldi's body.

Mr. Foldi leaped from a first-floor window. When the officers confronted him again, he ignored orders to give up. They pepper-sprayed him twice, and he tried to run away. Three officers grabbed him and fought to subdue him.

During the three-minute struggle, one officer discharged his taser 11 times, using what's known as a drive stun technique, where the device is pressed against a person and fired. Mr. Foldi fell to the ground and was handcuffed. He started breathing heavily, lost consciousness and never recovered.

The SIU says police were justified in using force to arrest Mr. Foldi.

His family is furious.

"That's the biggest letdown. How can you justify using a taser 12 times?" asked Mr. Foldi's younger brother, Steven.

"He was a threat to nobody. He didn't have a weapon on him. An injured man asking for help, and this is the response?"

A coroner's inquest will eventually be asked to determine what killed Mr. Foldi.

The SIU says he had a potentially lethal amount of an illegal substance in his system. Foldi family members have been told it was cocaine.

They say they didn't know about his drug use, and they were in Hamilton the night he died, but they reject the idea of an overdose.

"If he overdosed he would've been doing the chicken dance on the floor," Ms. Foldi said.

The SIU report says that during the struggle Mr. Foldi showed "phenomenal strength," one of the signs frequently ascribed to a state known as excited delirium.

Excited delirium is not a medical diagnosis but a term forensics experts use to describe a combination of signs and symptoms that can lead to sudden death. It is usually associated with cocaine use, but can be connected to psychiatric illness or acute alcohol withdrawal.

"People in excited delirium are impervious to pain and they have superhuman strength and they need to be subdued for their safety and the safety of others," Jim Cairns, Ontario's deputy chief coroner, said. Often, even several officers are unable to bring a person in that state under control, he said.

"After this huge fight that often goes on, they suddenly go quiet and tranquil. It seems as though they're getting a second wind. In fact, they're not. They're dying at that point," Dr. Cairns said. The cause of death is often an irregular heartbeat brought on by abnormalities in blood chemistry, he said.

Dr. Cairns said tasers can mitigate the need to resort to deadly force.

A probe fired from a taser delivers 50,000 volts, usually overwhelming a person's nervous system and sending muscles into uncontrollable contractions.

But if it's used in drive stun mode, although it emits the same amount of electrical energy, it can't cause a neuromuscular response.

"It's not effective at all if someone's in a state of excited delirium," Dr. Cairns said.

Guidelines suggest you shouldn't use the drive stun mode any more than necessary, he said, adding there's no evidence it can kill.

The Niagara police, who had been using tasers for only a week when the Foldi incident took place, said they couldn't comment while a coroner's inquest is pending.

Ms. Foldi had hoped for answers from the SIU probe. Now the family will consider launching a lawsuit.

"Not for the money, but we can't let them get away with it," she said. "Jim is gone. It's like a part of my heart is, too."

Study raises concerns over Tasers' safety

Feb 13, 2006
Robert Anglen, Arizona Republic

A study measuring electric shocks from a Taser stun gun found that it was 39 times more powerful than the manufacturer claimed, raising new questions about the weapon's safety.

The study, published last month in the peer-reviewed Journal of the National Academy of Forensic Engineers, concluded that the shocks are powerful enough to cause fatal heart rhythms. It is one of the few scientific studies of Taser's electric jolt in which the company did not participate.

"The findings show the energy delivered by the weapon to be considerably understated by the manufacturer," the Journal study said. "These findings place the weapon well into the lethal category."

Officials with Scottsdale-based Taser International Inc. condemned the findings, saying they are exaggerated, erroneous and "beyond the laws of physics."

They pointed to a test conducted last week in response to the Journal article. A lab hired by Taser found that the weapon produced power that was significantly less than what the Journal study found and met all specifications.

Taser contends that the author of the Journal study, electrical engineer James Ruggieri, does not have the technical expertise to make conclusions about stun guns. Taser is suing Ruggieri for defamation over his claims in a presentation and testimony in a wrongful-death case last year that Tasers can cause fatal heart rhythms.

In a separate finding, the Army also concluded last year that Tasers could cause ventricular fibrillation, the irregular heart rhythm characteristic of a heart attack.

A memorandum from the Aberdeen Proving Grounds in Maryland, where the Army develops, tests and evaluates weapons, said, "Seizures and ventricular fibrillation can be induced by the electric current."

At issue was whether soldiers should be shocked with the stun guns during training exercises, as Taser recommends.

The Army's occupational health sciences director determined that Taser is an effective weapon but added in the February 2005 memo that "the practice of using these weapons on U.S. Army military and civilian forces in training is not recommended, given the potential risks."

Taser for years has maintained that its stun guns have never caused a death or serious injury. Company officials say the guns save lives, reduce injury and save millions of dollars in legal costs because they prevent deadly confrontations.

But since 1999, more than 167 people have died after police Taser strikes in the United States and Canada. Of those, medical examiners have cited Tasers in 27 deaths, saying that they were a cause of death in five cases, a contributing factor in 17 cases and could not be ruled out in five cases.

Several law enforcement agencies have filed lawsuits accusing Taser of misleading them about the stun gun's safety and claim that the company failed to conduct adequate tests before selling the weapon. Some police departments have delayed or halted Taser purchases because of safety concerns.

Taser denies these claims and says its record of safety is bolstered by dozens of medical and university studies and by the company's experts.

Law enforcement officials and testing experts agree that there is no widely accepted standard for measuring Tasers. Studies have shown various results.

In May, for example, an international testing laboratory hired by Canadian authorities initially reported that two stun guns were significantly more powerful than the manufacturer specified. The guns also fired at different levels of power.

The stun guns were used on a man who died after being shocked by Vancouver, British Columbia, police in 2004.

Taser challenged the test last week, and the laboratory backed off its results. Officials with the lab, Intertek ETL Semko, said testing protocols provided by the police differed from those of the stun-gun manufacturer. As a result, Intertek said the tests could not be relied upon.

Bruce Brown, deputy commissioner of a British Columbia agency investigating the police role in the Vancouver death, said his agency wants to enlist Canada's National Police Research Center to conduct a rigorous study of the stun gun's power.

"We've sent people to the moon, so there has got to be a way to come up with a peer-reviewed (standard)," he said.

The 50,000-volt Taser works by shooting two darts up to 25 feet. The darts are connected to wires that deliver a burst of electricity that is designed to instantly immobilize a suspect. The gun also can be used as a handheld device, without the darts, by touching two metal probes directly against a person's body in what police call a "drive stun."

The shock from a Taser is measured in electric pulses. Tasers typically used by police deliver 15 to 19 pulses a second in a five-second interval, although the gun will continue firing without interruption as long as the trigger is held down.

Tasers operate at 50,000 volts, but Taser says the stun guns do not pose an electrical safety risk because the pulse's current is too low and its duration too short to affect internal organs, including the heart.

Ruggieri's study found that the Taser's pulse was more powerful and longer than the gun's specifications indicate. Ruggieri studied a Taser M-18, which is nearly identical to the Taser M-26 used by police except it has less power.

Taser specifies that the M-18 produces 10 pulses a second at 1.76 watts per pulse. Ruggieri said his tests showed the Taser produced 14 pulses a second at 50 watts per pulse.

Ruggieri said it took him months of research to conduct and complete the tests.

He said he relied on Taser's research and previous stun-gun studies to create a verifiable methodology for testing the Taser.

His findings are based on how electric current penetrates the body.When established electrical standards were applied to the stun gun's electrical discharge, Ruggieri said the current could be fatal. He said measurements of the electric current showed that, according to electric safety standards, the gun had a 50 percent risk of causing ventricular fibrillation.

Taser Vice President Steve Tuttle called the claim "ludicrous" and said it is "clearly refuted by the fact that well over 100,000 human volunteers have been exposed to the Taser discharge without fatality."

Taser maintains that skin tissue blocks electric current and is equivalent to 1,000 ohms of resistance.

But Ruggieri said skin tissue breaks down as electricity is applied, decreasing resistance and increasing the impact of the shocks on the human body.

"This creates a runaway effect of increasing current with decreasing resistance," Ruggieri said.

An independent electrical engineer who reviewed the Journal study at the request of The Arizona Republic said Ruggieri's conclusions were credible and based on scientific principles.

Robert Nabours, who has degrees in electrical engineering from Stanford and the University of Arizona, said scientific and medical evidence support Ruggieri's claims that skin tissue breaks down when subjected to electric pulses. Among the evidence are findings from Harvard and Massachusetts Institute of Technology doctors.

Ruggieri focused on the Taser in its "drive stun" mode. He said measurements of the current found that the power was about 39 times greater than the manufacturer's specifications. Taking into account the lowered resistance of skin tissue, Ruggieri said the stun gun generated 704 watts of power as opposed to 18 watts.

Ruggieri contends that one of Taser's main claims of safety, that the duration of the electric pulse is too short to cause injury, could not be proven. He said his tests of the current showed that duration of the pulse also increases as resistance drops.

The lab hired by Taser, Exponent of Phoenix, could not replicate Ruggieri's results. Exponent, which has offices throughout the country, is a consulting firm that employs scientific and engineering experts who, like members of the National Academy of Forensic Engineers, often serve as expert witnesses in court cases.

Exponent electrical engineer Ashish Arora said Ruggieri reported 17 times more power than the Taser he tested. Arora said that in his tests, the power of the stun gun measured at or below specifications.

Arora said the pulses Ruggieri measured could also not be verified, even when resistance was dropped. He said that caused concern.

He said he would have expected some similarity in the results. But he said the tests results "were completely different."

There were differences between Exponent's and Ruggieri's tests, both involving how the gun was charged and how the current was measured.

Ruggieri said he used a battery specified by the manufacturer to mirror a real-world setting. He changed the battery after each jolt to ensure that the power did not degenerate. Exponent used a power supply to charge the battery.

Ruggieri said a power source could limit the amount of power going into the gun in a way that a battery would not.

Ruggieri also measured the output using two high-voltage meters attached to each of the Taser probes, which he said gave more-accurate readings.

Exponent used a single meter. Arora said the single probe and battery wouldn't change the results.

Taser has repeatedly attacked Ruggieri's credibility since he made a presentation critical of the stun guns to the American Academy of Forensic Sciences in February 2005. Taser claimed his presentation was based on "junk science" and "propaganda" and that his conclusions have been disputed by numerous government, university and medical studies.

Some of Ruggieri's claims were independently verified, including his assertion that Taser had misapplied Underwriters Laboratories standards in suggesting the stun gun could not cause ventricular fibrillation.

Taser sued Ruggieri in November, several months after he announced the Journal findings at an engineering conference in Chicago.

In a news release last year, Taser described Ruggieri as a high school dropout with no medical training.

Ruggieri said he left high school to attend college in New York. He later obtained a master's degree in computer science from the University of Phoenix.

Ruggieri's resume shows that he is a professional engineer with licenses in five states. He said he has investigated electrical accidents for federal agencies and helped write electrical safety standards for top electrical laboratories and commissions.

Taser officials challenged the academy journal, calling it an "obscure bulletin," saying none of the peer reviewers was qualified to assess the findings.

"That unfortunately allowed Mr. Ruggieri to utilize inappropriate science and flawed mathematics in attempts to support his unsupportable conclusions," Taser's Tuttle said.

Journal Editor Marvin Specter said the academy is affiliated with the National Society of Professional Engineers and is made up of experts in several engineering disciplines.

The Journal lists a technical review committee for Ruggieri's study that includes 20 engineers, including one well-known Taser consultant. The reviewers' identities are confidential and have not been released, Specter said.

Specter said Ruggieri's paper went through a rigorous peer-review process before being published in the biannual journal.

In an interview last week, Ruggieri said Taser has launched personal attacks to distract from the real issue.

"This isn't about me. It's about the findings, the study," he said.

Tasers A Role In Man's Death

February 4, 2006
ABC News, California

In the South Bay, medical examiners say taser guns used by San Jose police to subdue a man played a role in that man's death. The main cause of Jose Rios' death in November was heart failure, during his fight with officers obesity and cocaine-related heart disease were also listed as factors. But the coroner's office concluded another contributory cause of death was tasering and pepper spraying.
Investigators say Rios began fighting with police after arguing with his wife and trying to grab their four-year-old son.

Cardiac Electrophysiological Consequences of Neuromuscular Incapacitating Device Discharges

CONCLUSIONS: In an experimental model, NID discharges across the chest can produce cardiac stimulation at high rates. This study suggests that NIDs may have cardiac risks that require further investigation in humans.