TASER Electronic Control Device Research Articles

Sudden cardiac arrest associated with application of shocks from a TASER Electronic Control Device

Sudden cardiac arrest associated with application of shocks from a TASER Electronic Control Device

Letter by Sheridan Regarding Articles, “TASER Electronic Control Devices Can Cause Cardiac Arrest in Humans” and “TASER Electronic Control Devices and Cardiac Arrests: Coincidental or Causal?”

Circulation presents a provocative juxtaposition of the polarized opinions of Zipes1 and Kroll et al2 on whether the TASER electronic control device (ECD) can induce ventricular fibrillation by an action of precordially administered TASER discharge. The debate is focused on the 8 cases studied by Zipes.1 This issue is of some importance, as an understanding of the range of clinical effects of ECDs can, and should, inform the circumstances in which these devices are used and what medical contingencies might be needed …

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

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, CO2, 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 100 The 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.”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.8–13 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 …

Correction

HomeCirculationVol. 127, No. 23Correction Free AccessCorrectionPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessCorrectionPDF/EPUBCorrection Originally published11 Jun 2013https://doi.org/10.1161/CIR.0b013e31829bd44aCirculation. 2013;127:e839This article corrects the followingSudden Cardiac Arrest and Death Following Application of Shocks From a TASER Electronic Control DeviceIn the article by Zipes, “Sudden Cardiac Arrest and Death Following Application of Shocks From a TASER Electronic Control Device,” which appeared in the May 22, 2012 issue of the journal (Circulation. 2012;125:2417-2422), Dr Zipes did not acknowledge the contributions of Atty. John Burton, Dr Kamaraswamy Nanthakumar, Dr John Miller, and Ms Joan Zipes. The current online version of the letter has been corrected. Previous Back to top Next FiguresReferencesRelatedDetailsCited By Kroll M, Brave M, Pratt H, Witte K, Kunz S and Luceri R (2019) Benefits, Risks, and Myths of TASER® Handheld Electrical Weapons, Human Factors and Mechanical Engineering for Defense and Safety, 10.1007/s41314-019-0021-9, 3:1, Online publication date: 1-Dec-2019. Related articlesSudden Cardiac Arrest and Death Following Application of Shocks From a TASER Electronic Control DeviceDouglas P. Zipes,Circulation. 2012;125:2417-2422 June 11, 2013Vol 127, Issue 23 Advertisement Article InformationMetrics © 2013 American Heart Association, Inc.https://doi.org/10.1161/CIR.0b013e31829bd44a Originally publishedJune 11, 2013 PDF download Advertisement

Letter by Ho and Dawes Regarding Article, “Sudden Cardiac Arrest and Death Following Application of Shocks From a TASER Electronic Control Device”

We read with interest the case series “Sudden Cardiac Arrest and Death Following Application of Shocks From a TASER Electronic Control Device” (ECD),1 where Zipes focused on the issue of sudden death related to law enforcement restraint. We are emergency medicine physicians and also sworn peace officers. We have also examined these cases in detail. We are concerned that potential misinterpretation of these cases will lead to the unintended consequence of elevated officer and suspect morbidity and mortality. In this analysis, it is our opinion that several facts were missed, dismissed, or …

Letter by Heegaard et al Regarding Article, “Sudden Cardiac Arrest and Death Following Application of Shocks From a TASER Electronic Control Device”

The TASER International’s Scientific Medical Advisory Board read with interest the medical expert series from Dr Zipes.1 Complete, balanced, and impartial medical expert testimony are important contributors to advancing medical science. In this series, we believe that Dr Zipes missed or disregarded crucial information. Cases 4 and 5 are examples; there are others. In case 4, video, acoustic, forensic, and probe analysis indicate no contact made between the TASER probe and the suspect’s chest. The emergency medical technician paramedic present documented and testified under oath that both pulse and respirations were present for >8 minutes after electronic control device (ECD) deployment.2 Dr Zipes, as an expert witness in this case, either missed or disregarded this information. For case 5, every medical personnel interpreted …

Letter by Nanthakumar and Waxman Regarding Article, “Sudden Cardiac Arrest and Death Following Application of Shocks From a TASER Electronic Control Device”

We read with interest the important article by Zipes. Zipes has reported 8 cases of ventricular fibrillation (VF) after TASER shocks.1 His findings indeed validate animal reports that have shown that TASER discharges can stimulate the myocardium. His findings are predicted by our early work on the vector, duration of the TASER discharge, and the associated sympathetic stress that are related to the onset of myocardial capture, the degree of myocardial capture, and the propensity to ventricular fibrillation.2 Two important facts that Dr Zipes produced in his article need attention. Zipes has demonstrated 1 episode of asystole following TASER discharge and another recording in which it was was difficult to differentiate fine VF from asystole.1 Although …

Response to Letters Regarding Article, “Sudden Cardiac Arrest and Death Following Application of Shocks From a TASER Electronic Control Device”

I thank the authors of the Letters to the Editor for their interest in my article. As Drs Nanthakumar and Waxman indicate, the left ventricular epicardium becomes inexcitable during ischemia (such as would be provoked by ventricular fibrillation [VF]), whereas Purkinje fibers and endocardial muscle remain fully responsive.1 In fact, one can record asystole in some ECG leads when VF is actually still present in others.2 I agree that determining the response to a TASER shock that induces rapid capture and VF is critical. I am glad they think the article sheds light on a complicated issue. Drs Vilke, Chan, and Karch question the “clinically healthy” wording I explained in a published correction for my article3 to mean clinically healthy from a cardiovascular standpoint without manifest cardiovascular symptoms. They suggest that several people may have had cardiac pathology. If true, underlying heart disease or substances such as alcohol and some drugs would likely facilitate electrical induction of VF from the TASER shock. If the pathology were the cause of the VF, one would have to assume it triggered VF precisely at the time of the TASER shock, an improbable coincidence. They indicate that one case had long QT “on the day of his TASER activation.” This was …

Sudden Cardiac Arrest and Death Following Application of Shocks From a TASER Electronic Control Device

The safety of electronic control devices (ECDs) has been questioned. The goal of this study was to analyze in detail cases of loss of consciousness associated with ECD deployment. Eight cases of TASER X26 ECD-induced loss of consciousness were studied. In each instance, when available, police, medical, and emergency response records, ECD dataport interrogation, automated external defibrillator information, ECG strips, depositions, and autopsy results were analyzed. First recorded rhythms were ventricular tachycardia/fibrillation in 6 cases and asystole (after ≈ 30 minutes of nonresponsiveness) in 1 case. An external defibrillator reported a shockable rhythm in 1 case, but no recording was made. This report offers evidence detailing the mechanism by which an ECD can produce transthoracic stimulation resulting in cardiac electrical capture and ventricular arrhythmias leading to cardiac arrest. ECD stimulation can cause cardiac electrical capture and provoke cardiac arrest resulting from ventricular tachycardia/ventricular fibrillation. After prolonged ventricular tachycardia/ventricular fibrillation without resuscitation, asystole develops.

Response to TASER electronic control devices and eye injuries

Response to TASER electronic control devices and eye injuries

TASER electronic control devices and eye injuries

TASER electronic control devices and eye injuries

The effect of an electronic control device on muscle injury as determined by creatine kinase enzyme

The medical literature on the effect of electronic control devices (ECD) on muscle injury is sparse. In this paper, we examine pooled data from five human studies that used creatine kinase (CK) as a marker for muscle injury. CK was measured in five separate studies involving four TASER ECDs with different exposure durations and number of circuits or contact points. Device type, exposure duration, number of circuits or contact points, and CK values at baseline and 24 h after exposure were pooled from these previous studies. Data were analyzed to determine the correlation of CK to duration of exposure, number of contact points, and distance between the probes. The pooled results contained 163 subjects. Seven were withdrawn due to incomplete data, leaving 156 subjects for analysis (median age 36, range 19-67, 93.6% male). 121 (77.6%) subjects had 2 contacts points, 10 (6.4%) had 3 contact points, 18 (11.5%) had 4 contact points, and 7 (4.5%) had 6 contact points. 81 (51.9%) subjects had a 5-s exposure, 64 (41.0%) a 10-s exposure, and, 11 (7.1%) a 30-s exposure. Median baseline CK (145 U/l, IQR 104-217, range 12-1956) did not differ between groups (P = 0.213 for number of contact points, 0.124 for duration). For the number of contacts, the median change in CK for 2 points of contact was 32 (IQR -1 to 1513, range -205 to 1821), for 3 was 1456 (IQR 634-1868, range 101-25452), for 4 was 887 (IQR 285-7481, range -1054 to 7481), and for 6 was 846 (IQR 57-1149, range -8 to 2309), (P < 0.001). For duration, the median change in CK for 5 s was 26.5 (IQR -8 to 109, range -1054 to 2309), for 10 s was 303 (IQR 34.5-1073, range -205 to 25452), and for 30 s was 47 (IQR 23-82, range -140 to 364), (P < 0.001). There was a relationship between the number of points of contact and the change in CK (P < 0.001) but not a relationship between the duration and the change in CK (P = 0.496). The median spread between the probe pairs for our pooled data was 40 cm, with a range from 18 to 70 cm (n = 76). The correlation between the change in CK and spread between the probe pairs was 0.16 at baseline (P = 0.18), and 0.24 at 24 h (P = 0.04) by Spearman's rank correlation. ECD exposure can cause a modest increase in CK. Although we cannot draw conclusions about the individual devices included in this analysis, our findings indicated that multiple contact points or exposures may result in a larger increase in CK, but the duration of the exposure does not appear to have a significant effect on CK. There is a correlation between the distance between the probes and the change in CK.

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

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. 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. 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). 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.

Sensitive Swine and TASER Electronic Control Devices

Sensitive Swine and TASER Electronic Control Devices

Crafting The Perfect Shock

The paper presents the " Thomas A. Swift electric rifle". The Taser electronic control device uses microprocessor control. The device temporarily and harmlessly immobilizes the suspect with a carefully engineered electric signal that is specifically designed with human physiology in mind. The operation of this device was also presented in the paper.