Medical examiners walk uneasy path

March 24, 2006
Jacob Quinn Sanders, The Portland Tribune

Charged with determining a cause of death for the man who died Monday after being shocked with a Portland police Taser, the Oregon state medical examiner’s office finds itself in a potentially sticky situation.

The Oregon State Police funds the office, making it the rare governmental medical authority whose budget depends on a law-enforcement agency. Former medical examiner’s office officials said that relationship can skew how doctors in the office make cause-of-death decisions in cases that involve police, who have an interest in limiting legal liability.

And medical examiners in other states said Taser International, the Arizona-based maker of the stun gun that may have contributed to Monday’s death, has in the past sued and otherwise pressured officials who listed their product as even a contributing cause of death.

Timothy Grant, 46, died Monday afternoon after he acted delirious, ran into traffic and engaged cops in what the Portland Police Bureau said was a struggle in the street near Northeast 23rd Avenue and Sandy Boulevard. An officer shocked him twice with a Taser. Grant lost consciousness and died while receiving medical attention from paramedics a half-hour later.

Grant’s death is the second in Oregon following a police Taser shock where no other weapon was involved. The first also occurred this year: Southern Oregon University triple-jumper Nicholas Hanson, 24, died Jan. 22 after Ashland police shocked him after he threatened suicide. His official cause of death was a drug overdose, authorities said.

The medical examiner’s office is generally called in to determine a cause of death in homicides, suspicious deaths, deaths from accidents and deaths involving police officers. And the office can come under tremendous pressure to make a particular finding.

Glenn Rudner worked as a forensic pathologist in the Oregon medical examiner’s office for 13 months in 2003 and 2004 before its chief, Karen Gunson, fired him. According to what medical examiner’s officials have said in court records, police complained that he was uncooperative, refusing to let them observe or ask questions during autopsies and declining to testify before grand juries, even though it was part of his job.

“It’s a corrupt system,” Rudner said. “It’s a huge conflict of interest for a police agency to fund what is supposed to be an independent office. There is always pressure from law enforcement. They don’t want to get sued because of one of our decisions.”

William Brady, Oregon state medical examiner from 1969 to 1985, who now works as an expert witness for plaintiffs’ lawyers, said the concern is valid.

“The pressures are real in (medical examiner’s) offices around the country, and how the offices react to those pressures varies widely,” he said.

If a Taser shock aggravated a pre-existing condition, he said, then the cause falls into a “gray area” that makes it “easy to go one way,” meaning finding no fault with police actions.

As for whether liability issues could affect an autopsy outcome, he said, “I wonder, too. É I think that’s a very strong argument for an independent medical examiner’s program.”

He expressed confidence, however, in the expertise of the Oregon medical examiner’s office.

Eugene Gray, the forensic administrator who runs business operations for the state medical examiner’s office and deals most directly with the Oregon State Police, called statements about outside pressure “ludicrous.”

“We come up with the manner and cause of death, not the police,” he said. “A death certificate is a physician’s medical opinion. Unfortunately, in Oregon, this is a question that comes up, but there is absolutely no relationship whatsoever between our findings and any preference the police have.”

Gunson, the Oregon state medical examiner, said she felt no outside pressure Ñ evidenced, she said, by her expediting a toxicology report on Grant’s body, which she hopes to receive next week.

“I want to know what’s going on,” she said.

Officers now on leave
Before the Police Bureau distributed Tasers to all patrol officers last year, Chief Derrick Foxworth said they would help save money. Officers who might otherwise have been injured in a fight with a suspect would not with a Taser, he said. And officers who use a Taser instead of their 9 mm Glock handguns are less likely to be placed on administrative leave during a subsequent bureau investigation.

Officer Paul Park, 35, who hit Grant twice with his Taser in the neck and back, was placed on administrative leave pending the outcome of an investigation. His two cover officers, Ney Phothivongsa, 34, and Rodney Murdock, 37, also were placed on leave.

Foxworth is in Virginia at a training session and was unavailable for comment.

Park used his Taser on Grant in “drive-stun” mode, police said, meaning he jammed the weapon into Grant instead of firing darts from up to 21 feet away. The Taser delivers a 50,000-volt shock, seizing muscles and dropping a suspect to the ground.

Drive-stun is more controversial than the darts, in part because Taser International’s own training materials note that “if only the stun mode is used, (the Taser) becomes a pain compliance technique” rather than a self-defense tool.

Sgt. Bob Day of the Police Bureau’s Training Division, who oversees Portland police Taser use, said cops have used those weapons about 1,000 times since the start of June 2005. Of those, officers used darts 213 times and drive-stunned suspects 100 times, though there are occasions when cops used both. In the rest of the incidents, officers merely pointed their Tasers at suspects but did not use them.

The city’s Independent Police Review Division has logged 31 citizen complaints of police Taser use since 2002. The complaints ranged from fear an officer would use a Taser to lingering, persistent pain after being shocked.

After Grant’s death, Detective Paul Dolbey, a spokesman, was careful to note that only a trained medical professional could determine a cause of death.

“But there is no reason to believe it was due to the Taser,” he said.

In an e-mail later to reporters, he made a passing reference to “excited delirium,” a controversial factor that some medical examiners list in Taser-case autopsies that is often reliant on the presence of drug use or heart disease. It is not a recognized diagnosis of the American Medical Association.

A spokesman for Taser International, Steve Tuttle, did not consent to an interview, instead e-mailing a statement to the Portland Tribune.

“Until all the facts surrounding this tragic incident are known,” Tuttle wrote, “it is inappropriate to jump to conclusions on the cause of Mr. Grant’s death.”

The Oregon medical examiner’s office has not yet released a cause of death, preferring to wait for toxicology results, Gunson said.

One of a few
Oregon is one of a handful of states that have coroners or medical examiners funded by a law-enforcement agency. Oregon’s office has a budget of $4.2 million, which pays for four forensic pathologists, two medical transcriptionists, one morgue attendant and one administrator. The state medical examiner, Gunson, also appoints deputy medical examiners in larger Oregon counties who are paid by the local county government. The deputies are generally not involved in suspicious, controversial or police-involved deaths.

Of 30,000 deaths a year in Oregon, the state medical examiner’s office investigates and signs death certificates for about 3,600, Gray said.

Grant’s is one of those.

Spencer Neal, a lawyer with a long record of suing Portland cops, said a medical examiner’s finding that the Taser is at fault would likely affect liability for the Police Bureau.

“That’s certainly going to be helpful” for anyone suing over a Taser-related death, he said.

But he said he was confident in the integrity of the medical examiner’s office.

“My limited experience with the M.E.s is you can’t buy them off,” he said.

Beyond the issues surrounding the medical examiner, however, is Taser International.

About 165 police agencies in Oregon supply their officers with Tasers, Tuttle wrote in his e-mail, as do some 8,750 agencies worldwide.

The company sued Roland Kohr, an Indiana regional medical examiner, in 2004, after he appeared on CBS’ “The Early Show” to discuss an autopsy in which Kohr considered the Taser to be a contributing cause of death.

“They filed suit two days before Christmas,” Kohr said. “Ho, ho, ho.”

Kohr said he felt targeted because of his ruling in that death.

“I’m nobody,” he said. “I’m out here in the middle of the country and they came after me like that. Makes you think about why they might do that.”

And Charlie Boseman, a deputy coroner in Anderson County, S.C., told the Arizona Republic newspaper in 2004 that Taser International pressured his office to reverse its ruling that a Taser contributed to a death. Company officials denied pressuring Boseman.

The Republic has documented 140 deaths following police Taser use in the United States and Canada since 1999. In Chicago in February 2005, a medical examiner reported a Taser as the primary cause of a death Ñ the first time that had happened.

Amnesty International studied 74 deaths that followed law-enforcement Taser use, finding in 2004 that only 11 of the suspects were armed and that police routinely used Tasers on people who did not or, because of mental illness, could not follow their commands.

Taser International is adamant that its product is safe, Tuttle wrote.