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."