Ventricular fibrillation in a man shot with a Taser

Naunheim, Rosanne; Treaster, Matthew; Aubin, Chandra

doi:10.1136/emj.2009.088468

Cited by 25 publications

(18 citation statements)

References 4 publications

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“…9,10 The alcoholand tetrahydrocannabinol-inebriated subject presented with asystole ≈6 minutes after his ECD application, which is consistent with his extreme blood alcohol concentration at 80% of the mean lethal level. 36 His mother was present throughout the incident (in her kitchen); thus, it is unlikely that the officers merely ignored any earlier loss of breathing or cyanosis.…”

Section: Case 2 (Sn)mentioning

confidence: 59%

“…[8][9][10][11][12][13] We obtained autopsy reports, emergency medical services run sheets, law-enforcement records, medical records, and deposition transcripts. We then used objective electronic records such as the ECD download (with clock drift correction), radio logs, 9-1-1 dispatch records, and audio and video recordings to build detailed timelines of each incident.…”

Section: Methodsmentioning

confidence: 99%

“…7 Of the >3 million total ECD applications, there have been 12 published case reports suggesting a potential cardiac arrest link, giving an incidence of 4×10 −6 per application. [8][9][10][11][12][13] In most cases, those authors did not consider important factors that are now better understood. These include separating postural from cardiovascular collapse, the latency of electrically induced ventricular fibrillation (VF), the presence of significant cardiac pathology, failure of prompt defibrillation, the duration of documented breathing, the distance of the ECD electrode from the heart, and the stability of electrically induced VF.…”

Section: Response By Zipes On P 100mentioning

confidence: 99%

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TASER Electronic Control Devices and Cardiac Arrests: Coincidental or Causal?

et al. 2014

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Being arrested is a highly emotional event and can result in a fatal, adrenergically supercharged physiological state. 1 The exertion of arrest-related struggle is several-fold greater than that seen with normal exercise and leads to numerous extreme metabolic and electrolytic derangements, including elevated levels of lactate, CO 2 , potassium, creatine kinase, and myoglobin.2 Only 1.6% of US law-enforcement interactions involve the use or threats of force, and annually there are ≈700 000 cases in which force is used or threatened.3 There are ≈700 arrest-related deaths per year in the United States, yielding a mortality rate of ≈1 in 1000 for a law-enforcement interaction associated with force. 4 Response by Zipes on p 100The electronic control device (ECD) has gained widespread acceptance as the force option for law enforcement because of its dramatic reduction in both suspect and officer injury. At the same time, advocacy groups post statements on the Internet listing the hundreds of arrest-related deaths after ECD use with the implication that the ECD involvement was causal. Studies covering a total of >48 000 forceful arrests have consistently found suspect injury rate reductions of ≈65%.5,6 Of the 250 000 annual ECD field uses in the United States, only 1 in 4000 is involved in an arrest-related death. This reduction in fatality rate is consistent with published data showing that 5.4% of ECD uses "clearly prevented the use of lethal force by police." 7Of the >3 million total ECD applications, there have been 12 published case reports suggesting a potential cardiac arrest link, giving an incidence of 4×10 −6 per application. [8][9][10][11][12][13] In most cases, those authors did not consider important factors that are now better understood. These include separating postural from cardiovascular collapse, the latency of electrically induced ventricular fibrillation (VF), the presence of significant cardiac pathology, failure of prompt defibrillation, the duration of documented breathing, the distance of the ECD electrode from the heart, and the stability of electrically induced VF. We have thoroughly investigated these cases as either TASER scientific advisors or expert witnesses. The goal of this article is to resolve the confusion about these cases by introducing more complete data and by using a consistent case-report scoring methodology. Methods Understanding the Confounders Postural Versus Cardiovascular CollapseIn the normal course of life, an exertional postural collapse is, correctly, often associated with a cardiac arrest. However, it is sometimes forgotten that the ECD design goal is to cause a postural collapse to stop aggression. A sternal rub response is often blunted by the presence of alcohol, illegal drugs, psychotic break, and endorphins from the struggle. Hence, nonresponsiveness is also more difficult to evaluate in the law-enforcement scenario.(Circulation. 2014;129:93-100)

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Section: Case 2 (Sn)mentioning

confidence: 59%

Section: Methodsmentioning

confidence: 99%

Section: Response By Zipes On P 100mentioning

confidence: 99%

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TASER Electronic Control Devices and Cardiac Arrests: Coincidental or Causal?

et al. 2014

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“…This is particularly true in subjects who have had prolonged physical encounters with the police, are using cocaine or other sympathomimetic drugs, have heat exposure or have psychiatric disorders [1]. In addition, there are case reports in which CED discharges caused cardiac arrhythmias and excited delirium in the absence of confounding factors [17,18].…”

Section: What Is the Situation?mentioning

confidence: 99%

Use and safety of conducted electronic devices: what is known?

Nugent¹,

Çevik²

2013

East Mediterr Health J

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Conductive electronic devices (CED), such as Taser ® and stun guns, are sold worldwide for use by security services, although they have also been used for self-defence and even for torture. CED are promoted as non-lethal weapons which can potentially save lives. However, there are multiple reports of deaths temporally associated with CED use. These weapons have definite physiological effects in normal volunteers, especially when accompanied by exertion. Medical examiners often report that deaths followed physical encounters which included the use of CED were due to natural causes, excited delirium and/or drug intoxication. These cases present complex situations in which multiple factors potentially contribute to the death, including electric shocks which cause neuromuscular incapacitation, severe pain and anxiety. Public health officials, physicians and hospital personnel need to be aware that individuals controlled with CED are at increased risk of death. We need better recording of incidents worldwide to understand the extent and outcomes of CED use. Utilisation et sécurité des dispositifs à impulsions électriques : quel est l'état des connaissances ?RÉSUMÉ Les dispositifs à impulsions électriques comme le Taser® et les pistolets à impulsions électriques sont vendus dans le monde entier pour être utilisés par des services de sécurité, mais sont aussi utilisés pour l'auto-défense et même la torture. Ils sont présentés comme des armes non mortelles qui peuvent sauver des vies. Toutefois, de nombreux décès coïncidant avec l'utilisation de ces dispositifs ont été signalés. Ces armes ont des effets physiologiques certains chez des volontaires normaux, en particulier lorsqu'ils sont associés à un effort. Les médecins légistes ont souvent rapporté que les décès suivant des contacts physiques qui comprenaient l'utilisation de dispositifs à impulsions électriques étaient imputables à des causes naturelles, un délire aigu et/ou une intoxication liée à l'utilisation de médicaments et/ou de drogues. Ces cas sont des situations complexes dans lesquelles des facteurs multiples contribuent potentiellement au décès, tels que les chocs électriques à l'origine d'une paralysie neuromusculaire, d'une douleur sévère et d'anxiété. Les responsables de la santé publique, les médecins et le personnel hospitalier doivent être sensibilisés au fait que les personnes neutralisées par des dispositifs à impulsions électriques courent un risque accru de décès. Nous devons améliorer l'enregistrement des incidents dans le monde pour comprendre la portée et les conséquences de l'utilisation des dispositifs à impulsions électriques.

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“…In contrast to this, fibrillation could be induced in pigs [15,16] and was suspected from analyses of fatalities [17]. In addition, case reports associated human cardiac fibrillation with Taser use [18][19][20]. In its product safety and health information Taser Inc. summarizes a list of potential hazards and side effects including death, however, without explicitly mentioning cardiac fibrillation [21].…”

Section: Introductionmentioning

confidence: 99%

Cardiac fibrillation risk of TASER X-26 dart mode application

Leitgeb

Niedermayr

Loos

et al. 2011

Wien Med Wochenschr

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In view of reported fatalities there are still controversial discussions on whether electronic stun law enforcement weapons can cause cardiac fibrillation. Experimental data are contradictory. Simplified theoretical estimations led to a negligible low risk of 8.10(-7). With a detailed numerical-anatomical model of an adult man (NORMAN) cardiac exposure to Taser X26 high-tension pulses was quantitatively assessed and the fibrillation risk estimated by accounting for its dependence on excited volume based on 3D cardiac exposure patterns. For distance mode and worst case dart hits it could be demonstrated that cardiac exposure can reach the 30% fibrillation risk level. Risk reduces considerably if direct current flow across the heart is prevented. The overall fibrillation risk of Taser application is further reduced by the limited probability of critical hits. However, in agreement with experimental findings it is demonstrated that cardiac fibrillation risk of Taser X26 dart mode application is small, however, not negligible.

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Ventricular fibrillation in a man shot with a Taser

Cited by 25 publications

References 4 publications

TASER Electronic Control Devices and Cardiac Arrests: Coincidental or Causal?

TASER Electronic Control Devices and Cardiac Arrests: Coincidental or Causal?

Use and safety of conducted electronic devices: what is known?

Cardiac fibrillation risk of TASER X-26 dart mode application

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