Study suggests tasers pose substantia​l risk to the heart

April 30, 2012
Erica Goode, New York Times

The electrical shock delivered to the chest by a Taser can lead to cardiac arrest and sudden death, according to a new study, although it is unknown how frequently such deaths occur.

The study, which analyzed detailed records from the cases of eight people who went into cardiac arrest after receiving shocks from a Taser X26 fired at a distance, is likely to add to the debate about the safety of the weapons. Seven of the people in the study died; one survived.

Advocacy groups like Amnesty International have argued that Tasers, the most widely used of a class of weapons known as electrical control devices, are potentially lethal and that stricter rules should govern their use.

But proponents maintain that the devices — which are used by more than 16,700 law enforcement agencies in 107 countries, said Steve Tuttle, a spokesman for Taser — pose less risk to civilians than firearms and are safer for police officers than physically tackling a suspect. The results of studies of the devices’ safety in humans have been mixed.

Medical experts said on Monday that the new report, published online on Monday in the journal Circulation, makes clear that electrical shocks from Tasers, which shoot barbs into the clothes and skin, can in some cases set off irregular heart rhythms, leading to cardiac arrest.

“This is no longer arguable,” said Dr. Byron Lee, a cardiologist and director of the electrophysiology laboratory at the University of California, San Francisco. “This is a scientific fact. The national debate should now center on whether the risk of sudden death with Tasers is low enough to warrant widespread use by law enforcement.”

The author of the study, Dr. Douglas P. Zipes, a cardiologist and professor emeritus at Indiana University, has served as a witness for plaintiffs in lawsuits against Taser — a fact that Mr. Tuttle said tainted the findings. “Clearly, Dr. Zipes has a strong financial bias based on his career as an expert witness,” Mr. Tuttle said in an e-mail, adding that a 2011 National Institute of Justice report concluded there was no evidence that Tasers posed a significant risk of cardiac arrest “when deployed reasonably.”

However, Dr. Robert J. Myerburg, a professor of medicine in cardiology at the University of Miami Miller School of Medicine, said that Dr. Zipes’s role in litigation also gave him extensive access to data from medical records, police records and autopsy reports. The study, he said, had persuaded him that in at least some of the eight cases, the Taser shock was responsible for the cardiac arrests.

“I think when we put together the preponderance of what we know about electrical shocks with his observations, there’s enough to say that the phenomenon occurs,” he said. But he added, “I suspect the incidence of these fatal events is going to be low and can be minimized by the precautions.”

Police officers, he said, should take precautions when using the weapons and avoid multiple shocks, prolonged shocks and shocks to the chest.

“I’d rather see Tasers out there than bullets flying around,” Dr. Myerburg said. “But if you have a choice, if the circumstances allow you to avoid either, then physical restraint should be considered.”

Answer on Taser danger depends on who's asking

August 19, 2011
Frederik Joelving, Reuters

NEW YORK (Reuters Health) - A new study adds a cynical note to the highly charged debate over Tasers, the American-made stun gun that has made its way quickly into law enforcement across the globe.

As it turns out, people looking to settle arguments about the weapon's safety may not get much help from scientists.

That's because the answer they get from published studies seems to depend on who paid for the research, according to a report in the American Heart Journal.

Looking at 50 human or animal studies on Taser safety, researchers found that 23 of them had been funded by the manufacturer, Taser International, Inc, or done by scientists with financial ties to the company.

Twenty-two of those studies, or 96 percent, concluded the stun guns were safe or at least unlikely to be harmful. By contrast, only about half of the research not linked to Taser International reached that conclusion.

"When you read articles that are very favorable to the device, invariably you will see that one of authors is affiliated with the company making Tasers or sitting on the board," said Dr. Byron K. Lee, who worked on the new study.

"I'm not necessarily saying the research is done dishonestly and they lied and twisted their conclusions, it could very well be they designed their research to give favorable results," added Lee, a cardiologist at the University of California, San Francisco.

According to the Scottsdale, Arizona-based company, its weapon has conquered the market rapidly, and is now used by law enforcement agencies in 107 countries.

With a pull of the trigger, two darts fly out of the gun and lodge in the skin or clothes of the target. The darts set up a high-voltage electric circuit that causes both sensory nerves and motor nerves to go haywire. The result is excruciating pain and violent muscle spasms that immobilize even the feistiest suspect.

NOT SO HARMLESS?

But critics say the powerful jolts, which in rare cases have caused broken bones, could also hijack the heart, causing it to enter a deadly flutter called ventricular fibrillation.

They worry particularly about the cases in which police have used the Taser on children and the elderly, as well as mentally ill people and drug addicts, who may be more vulnerable.

To dispel those fears, scientists have conducted scores of experiments, including an outlandish Taser-funded study published last year, in which sheep were doped up on methamphetamine and then shocked with a Taser X26 gun.

But the studies can't seem to agree.

"Both sides have research to back their claims that the Taser is safe or unsafe," Lee told Reuters Health.

If you Taser very close to the heart, he said, you might trigger a fatal heart rhythm in some animals. But if you aim further away, or use different animals, you might not.

Of course, Lee added, it is also possible that independent scientists might be biased toward finding harm.

"It is much more interesting to say that there is something wrong here, that there are harms," he explained.

When asked if that could have happened in his own study, he acknowledged that the researchers who rated the 50 articles knew where the funding for each had come from. Still, he said he felt their assessments would hold up to scrutiny.

ACCUSATIONS OF BIAS

Steve Tuttle, vice president of communications for Taser International, told Reuters Health that there was no bias in Taser-funded studies.

In an email, Tuttle argued that in most cases, there are three degrees of separation between the scientists doing Taser-backed research and the company.

"The doctors are only paid their normal salary for the research and receive no extra compensation and no moneys from TASER," he said.

"It is worth noting that Dr. Lee has been a paid expert in litigation against TASER and this fact is not mentioned in the conflict of interest section of this report," Tuttle added.

While acknowledging this, Lee countered that it was more than a year ago and that the journal did not require disclosures that far back.

He also said that after he started doing Taser research in 2008, he had removed himself from the case and paid back all the moneys he'd received.

Debates about conflicts of interest and corporate funding biasing research are nothing new, and happen throughout the medical community.

For instance, a study from 1998 in the Journal of the American Medical Association found that scientists from the tobacco industry rated secondhand smoking harmless more than 90 percent of the time. Only 13 percent of researchers without industry ties came to that conclusion, however.

"When you come to a research question with predetermined bias because of funding that you get, you can very much design a study to further the company's interests," Lee said. "I think that is a very real danger of biomedical research."

His fix?

"The first step is to be aware of it, and then look really critically at the article's methods," Lee said.

Researchers Zap Industry-Funded Studies on Stun Gun Safety

May 16, 2011
Christine Young, Fair Warning

Plenty of studies suggest that the stun guns that police sometimes use to subdue suspects are safe. But a new analysis questions the credibility of at least some of that research.

That analysis, by cardiologists at the University of California, San Francisco, was based on a review of 50 published studies on Taser guns. According to a university news release, 23 of the studies either were financed by Taser International Inc., the leading maker of electrical stun guns, or were written by an author affiliated with the company.

The other 27 studies were conducted by independent researchers.

In findings delivered at a conference this month, the UC researchers said all but one of the manufacturer-backed studies said stun guns were either not harmful or not likely to be harmful. Yet among the independent assessments, only slightly more than half — 15 of the 27 studies — came to similar conclusions.

“When you look at the research, you find out a lot of the articles that are touted by police departments are funded by the company,” Dr. Byron Lee, an associate professor at the university and senior author of the study, told The New York Times.

The potential hazards of stun guns were demonstrated last week when a 43-year-old man died after being stun-gunned by deputies in Southern California’s San Bernardino County, according to the Los Angeles Times.

Deputies tried to stop the man after he allegedly ran a stop sign. Cindy Bachman, a sheriff’s department spokeswoman, said the suspect, who had no prior criminal record, had become “combative and uncooperative.” The victim’s father said he was told that his son was Tasered about eight times.

In 2009, five men in San Bernardino County and neighboring Riverside County died after being shot with stun guns, Inland News Today reports. In response, Taser issued an advisory that aiming the device at a suspect’s chest could cause an “adverse cardiac arrest.”

Truth, Not Tasers, a website that tracks stun guns deaths, says 19 people have died so far this year, and 65 were killed last year, in U.S. stun gun incidents.

UCSF doctor questions Taser studies

UCSF Heart Doctors Uncover Significant Bias in Taser® Safety Studies

OfficialTASER on Twitter:

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@phxbizjournal #TASER studies repeated by independent orgs (UCSD & Wake Forest) validated results & directly refute any claim of bias.
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@ucsf #TASER studies repeated by independent orgs (UCSD & Wake Forest, etc) validated our results & directly refute any claim of bias.
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Of the 50 articles studied, 23 were funded by TASER International, Inc. or written by an author affiliated with the company. Nearly all (96 percent) of the TASER-supported articles concluded the devices were either “unlikely harmful” (26 percent) or “not harmful” (70 percent). In contrast, of the 27 studies not affiliated with TASER International, 55 percent found that TASERs are either “unlikely harmful” (29 percent) or “not harmful” (26 percent).

Louise Vance
louise.vance@ucsf.edu
415-502-6397

May 6, 2011

The ongoing controversy surrounding the safety of using TASER® electrical stun guns took a new turn today when a team of cardiologists at the University of California, San Francisco announced findings suggesting that much of the current TASER®-related safety research may be biased due to ties to the devices’ manufacturer, TASER International, Inc.

In a research abstract presented at the Heart Rhythm Society’s 32nd Annual Scientific Sessions at the Moscone Center in San Francisco, study author Peyman N. Azadani, MD, research associate at UCSF’s Department of Medicine, Division of Cardiac Electrophysiology, and senior author Byron K. Lee, MD, associate professor of medicine in UCSF’s cardiology division, set out to gauge the accuracy of 50 published studies on the potential dangers of using TASER® products. Lee directs the Electrophysiology Laboratories and Clinics in UCSF’s Cardiology Division, and first published research on the safety of law enforcement use of TASERs in 2009.

The new study’s authors report that among the product safety studies they analyzed, the likelihood of a study concluding TASER® devices are safe was 75 percent higher when the studies were either funded by the manufacturer or written by authors affiliated with the company, than when studies were conducted independently.

Azadani, Lee and three colleagues divided TASER® safety study outcomes into four categories: harmful, probably harmful, unlikely harmful and not harmful. Of the 50 articles studied, 23 were funded by TASER International, Inc. or written by an author affiliated with the company. Nearly all (96 percent) of the TASER-supported articles concluded the devices were either “unlikely harmful” (26 percent) or “not harmful” (70 percent). In contrast, of the 27 studies not affiliated with TASER International, 55 percent found that TASERs are either “unlikely harmful” (29 percent) or “not harmful” (26 percent).

TASERs are the most popular brand of electrical stun guns, used primarily by law enforcement agencies to incapacitate combative suspects. The devices, also marketed for home use, deliver electrical pulses that stimulate the nervous system and cause involuntary muscle contractions. Advocates of using such conductive energy devices, or CEDs, say that they are effective and cause only temporary physical symptoms. Critics and scientists have raised concerns about the potential dangers of using TASER® devices, particularly on pregnant women, the elderly and very young, and individuals with underlying medical conditions.

The UCSF-led research findings have been submitted for publication but are not yet published in a peer-reviewed scientific journal. The study’s other authors are Zian H. Tseng, MD and Gregory M. Marcus, MD, both assistant professors of medicine at UCSF School of Medicine, Division of Cardiology, and Simon Ermakov, BA. The scientists conclude that when reading about TASERs, the public should consider the funding source and author affiliation when evaluating an article’s safety conclusions.

UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.

Marin sheriff defends use of Taser on 64-year-old in his home

September 1, 2010
Vic Lee, ABC 7 News, San Francisco

Watch the video here.

If you have the stomach for it.

San Francisco Police Commission warned on Taser risks

March 4, 2010
Jaxon Van Derbeken, San Francisco Chronicle

Researchers and experts warned the San Francisco Police Commission on Wednesday about the lethal risk of Tasers and urged the panel either to strongly limit or reject their use in dealing with unruly suspects.

The seven-member panel, which had already heard a number of experts speak in favor of Tasers as a way to reduce deaths and injuries, was expected to vote late Wednesday on whether to draw up a policy for their use by the San Francisco Police Department.

But Zian Tseng, a UCSF researcher, cited a sixfold increase in deaths in custody during the first year of their use in 50 Taser-fielding agencies surveyed in California. He could not say if Tasers had a role in any of those deaths. Tseng also noted that officer-involved shootings went up as well, but those shootings and in-custody deaths dropped back to previous levels following the first year of Taser use.

"There is a risk, but there's a smart way of using the Tasers," he said. He cautioned that officers should not fire at the chest or multiple times and that they need to keep heart defibrillators at hand to revive suspects. Dr. Byron Lee, a UCSF cardiology professor, warned against "usage creep" by officers, who are more inclined to use a Taser as they see how easily the device stops suspects. "That's where the risk happens, where you don't realize these are potentially lethal and they are used in a haphazard manner."

Most cities use Tasers

San Francisco is one of only a few major cities in the United States whose officers are not equipped with the weapons, which incapacitate suspects by stunning them with an electrical charge.

The seven-member commission, made up of four mayoral appointments and three members appointed by the Board of Supervisors, was considering Chief George Gascón's request to equip officers with Tasers. On Feb. 17, the panel decided unanimously to delay a decision so it could study Taser research after voting 4-3 against moving forward immediately.

After becoming chief in July, Gascón commissioned a study of officer-involved shootings in San Francisco over five years that found that as many as one-third could have been avoided had police been able to use Tasers.

Critics, however, cite studies that indicate a possible connection between the stun guns and the risk of sudden heart attack in people hit with them. They note that manufacturer Taser International warned police last year not to fire the devices at suspects' chests, after one of the company's scientific advisers concluded that at least one fatal heart attack in an otherwise healthy person had been caused by the device.

John Burton, a lawyer who won a $5 million judgment against Taser International in the case of a man who died after being Tased by a police officer in Salinas, urged the commissions to reject Tasers as "very dangerous" and largely untested and unregulated.

"Departments are relying on training and representations of the manufacturer, which has a built-in conflict of interest," he said, adding that Taser had "covered up a real health risk."

Burton said the company has known since 2005 that the devices could stop the hearts of animals and, later, humans, but failed to warn officers until late last year about not firing at the chest and against multiple uses.

"This is a company that simply refuses to sell its product with advice about how it could be used most safely" he said, adding that the "hidden dangers" outweigh the utility of the device.

ACLU weighs in

Kelli Evans, associate director of the American Civil Liberties Union of Northern California, urged the panel to reject the proposal as ill conceived and premature. "The first step is to back up," Evans said. "You've got the cart before the horse."

She said the department should first reach out to community groups, particularly mental health experts, before the matter goes to the commission.

"What needs to happen is a community dialogue - does this really make sense in San Francisco right now?" she said, suggesting that the community distrusts the police and the department's use-of-force tracking.

Evans said Memphis has developed an alternative to using Tasers, creating a mental health response team rather than use the device on mentally ill suspects. She said that if the city does deploy Tasers, it is "important not to do it carte blanche."

But 38-year SFPD veteran Vince Repetto, who joined a contingent of officers waiting to speak in favor of Tasers, said before the meeting that the Taser proposal is literally "a life-or-death decision."

"It's not if, but when, a Taser is used to stop a knife-wielding suspect and a life is saved," he said. "Then you will see the results of your decision. Let us hope that same suspect is not shot dead because an officer lacked a valuable option to deadly force."

Roughly 400 people in the United States have died since 2001 after being hit with stun guns, but Taser and its proponents, including Gascón, say most had existing heart conditions or had been using drugs.

An important vote

It appeared the Police Commission's decision could hang on the vote of commissioner Jim Hammer, a former San Francisco prosecutor who was among the majority voting against immediately drawing up a policy Feb. 17. He said then that he supported a delay so fellow commissioners could ponder the issue.

Hammer signaled before the meeting Wednesday that he supported giving Tasers to officers, but only if rules are put in place restricting their use to extreme circumstances.

Police agencies not much moved by UCSF Taser study

February 3, 2009
By Robert Salonga, Contra Costa Times

A UC San Francisco study cautioning about the dangers of police use of Tasers has been coolly received by Contra Costa law enforcement authorities who say the device has bolstered the safety of both officers and suspects in violent situations.

The Taser has been proffered as a nonlethal alternative to firearms. But the statistical study found that the devices did not significantly increase officer safety or decrease officer-involved shooting deaths in the first year of use.

The UCSF research team conceded important limitations of the study, particularly the size of the data pool. Fifty of 126 California law enforcement agencies sent complete data to researchers, and the country's 10 largest cities were contacted but did not respond. Researchers, who estimate that Tasers are used by 12,000 law enforcement, military and correctional agencies worldwide, declined to comment specifically on which agencies responded.

The other key limitation of the study is that in the case of non-firearm in-custody deaths, it is not clear how many involved the use of a Taser. At best, the figures can be associated only with the availability of Tasers to officers.

"Since this is an observational study, it's hard to make definitive conclusions. But it definitely raises questions about its safety," said Byron Lee, author of the study and an assistant clinical professor in cardiology.

Except for the Sheriff's Office, law enforcement officers on patrol in Contra Costa County use a model of the Taser, the most popular brand of electric stun gun that shoots probes with electric current to briefly incapacitate a person. The Sheriff's Office only uses Tasers in county jails.

Local law enforcement agencies agreed that Taser use carries risks, but no more than any other means of force. But they said the study seemed to downplay the safety benefits Tasers provide for officers and suspects.

"Prior to it coming along, there was ... a big gap between intermediate force options like batons and pepper spray, and lethal force," said Concord police Sgt. Dave Hughes, who oversees his department's Taser training.

Three of the police agencies interviewed by the Times — Antioch, Concord and the Sheriff's Office — have not had Tasers in wide circulation long enough for the study. Brentwood police Lt. Tom Hansen said his department has had Tasers in place for about five years, but said he wasn't aware of his department being contacted by researchers.

The study, posted online in late January and set for publication in the American Journal of Cardiology, compared non-firearm suspect deaths, firearm deaths, and officer injuries in the five years before Taser deployment and five years after. Cardiologists led the study in part because Tasers have been demonstrated to cause rapid irregular heartbeat, and adrenaline from a struggle and multiple shocks near the heart can make a person more susceptible to death or injury.

In the first of year of Taser use, study data showed a sixfold increase in non-firearm, in-custody deaths of police suspects, from 0.93 per 100,000 arrests to 5.96. In the same period, the study found the frequency of suspect deaths involving the use of a firearm more than doubled from 6.66 per 100,000 arrests to 15.1. Researchers did not get comparable data to track officer injuries in the same period, but observed no significant change linked to Taser use.

But after the first year — which varies, though police departments started adopting Tasers in the late 1990s — the study suggested that police adjusted their use and deaths and injuries returned to levels before Taser implementation.

Hughes offered statistics from his own department refuting the study's observations. In Concord, figures from 2006 — the first full year Tasers were used — show a 21 percent decrease from 2005 in "use of force" events, which include police dogs, physical restraint, batons and pepper spray. Those figures include one on-duty firearm discharge in 2005 and none the following year.

Officer injuries in 2006 decreased 35 percent from 2005, from 26 to 17. Hughes said that can be largely attributed to an increase in Taser uses, with 47 recorded discharges in 2006, up from 17 in 2005, when officers also used other forms of stun guns.

There have been no recorded in-custody deaths in Contra Costa County directly linked to Taser use. In one instance, however, a Taser was one of several measures used on Uriah Dach, a 26-year-old mentally ill man who died after a violent struggle with police April 22 at a Richmond boardinghouse. Dach had ripped out the Taser prods police used on him during the fracas.

Local police agencies said officers undergo routine Taser training. Antioch police Sgt. Tammany Brooks, whose department started using Tasers in 2006, oversees a 10-hour training session on the device. Officers must recertify each year.

The training covers areas such as the optimal spots on the body to aim Taser shots that incapacitate without causing injury. That includes larger muscles, such as the back and legs. Officers also learn to stand far enough from the target — between 10 feet and 15 feet — to ensure the Taser probes create a circuit large enough to stop someone.

When used properly, Hughes said, suspects who are Tasered avoid serious injury.

Researcher Lee stressed that the study does not advocate for the abandonment of Tasers. Its larger purpose is to show that Tasers may not be completely safe and need more third-party study.

"It's definitely better than shooting somebody," he said, but "there may be some inherent dangers and more research needs to be done to find out how safe or unsafe the device is."

Adoption of stun guns spikes the risk of in-custody death in the first year

January 30, 2009
Michael O'Riordan, Heartwire

San Francisco, CA - The rate of in-custody sudden death increases more than sixfold in the first year after the adoption of electrical stun guns in police and sheriff departments, a new study has shown [1]. Moreover, in this first year, the use of the stun guns, the most popular of which is Taser (Taser International, Scottsdale, AZ) did not reduce the rate of firearm-related deaths, despite the devices being marketed as an alternative for reducing the use of lethal force.

"We speculate that early liberal use of Tasers may have contributed to these findings, possibly escalating some confrontations to the point where firearms were necessary," write Dr Byron Lee (University of California, San Francisco) and colleagues in a report published online January 21, 2009 in the American Journal of Cardiology.

The subsequent decrease in sudden deaths and firearm-related deaths to levels before the adoption of the stun guns likely reflects the recognition of the adverse consequences of the Taser, according to researchers, leading to an adjustment of their use or changes in techniques.

"These deaths come back to baseline in the years two to five," senior investigator Dr Zian Tseng (University of California, San Francisco) told heartwire. "That finding is supportive of the fact that the Taser might be causing excess mortality in the first year. As police learn to use the weapon, as they start to recognize that there might adverse outcomes with the gun, they would no doubt adjust their techniques or change their policies. It suggests that this excess mortality is preventable."

Commenting on the study for heartwire, Dr Hugh Calkins (Johns Hopkins University School of Medicine, Baltimore, MD) said the use of stun guns in the law-enforcement community is an important issue, one that needs to be studied further. However, he is critical of the conclusions reached by Lee and colleagues, stating that more than 13 000 police departments worldwide are using the technology, and many of these departments independently tested their safety and effectiveness.

"If you look at the Taser device in particular, it's been about 10 years since it was first introduced, and in those 10 years, it's been subject to intense and critical scrutiny by every law-enforcement body that adopts it," he said. "If this were really causing people to die, if it were not having a favorable impact, it wouldn't be so widely adopted."

Taser use in California

Electrical stun guns, also known as neuromuscular incapacitating devices, are controversial alternatives for subduing prisoners and suspects in police custody. Existing data, the researchers note, are inconclusive on the cardiac and physiologic effects of stun guns. Those with concerns about their use, including Amnesty International, say that the devices could cause ventricular tachyarrhythmias in real-world conditions where police suspects may be under heightened physiological, pharmacological, and environmental stress.

In an attempt to gain a better understanding of the safety of devices in the real world, the researchers surveyed 126 police and sheriff departments in California cities, of which only 50 replied with sufficient data on the rates of death before and after the adoption of stun guns. They requested information on the rates of in-custody deaths in the absence of lethal force, firearm-related deaths, and officer injuries requiring emergency-department visits. Annual arrest data per city was obtained from the California Department of Justice.

The researchers obtained data for the five years prior to deployment of Tasers and in the following five years in which they were used. In the first year after Tasers were introduced to the departments, the risk of in-custody sudden death was 5.96 per 100 000 arrests, a sixfold increase over the five years prior, when Tasers weren't used. In years two to five after deployment, however, the in-custody death rate declined to 1.44 per 100 000 arrests, a number that was not significantly different when compared with the predeployment period.

Among 37 departments that provided sufficient data, the rate of firearm-related deaths increased from 6.66 per 100 000 arrests in the years before Tasers were used to 14.1 per 100 000 arrests in the first year of deployment. This rate declined to 9.1 per 100 000 between years two and five, a rate not statistically different from rates observed in the five-year period before Tasers were used.

"Based on this study, further epidemiologic research on the effect of Taser deployment on real-world outcomes is warranted," write the researchers. "Transparency by law enforcement agencies with regard to Taser use and in-custody sudden-death outcomes is critical for future studies by independent investigators."

Lee, who has provided expert medical testimony in two legal cases against Taser, told heartwire that he was surprised by the findings and that he had initially thought the group was likely to publish a negative paper, especially since in-custody deaths predate the use of electrical stun guns. Tseng added that the study was not designed to answer the question of whether the Taser causes death but rather to look at what happens when it is introduced in a real-world setting.

Safer than other weapons

Calkins, who serves on the medical advisory board of Taser International, noted that only 50 departments of the 126 surveyed provided data on in-custody deaths, and only 40 of these departments provided data in the first year after the Taser was deployed. The absence of responses in this first year of deployment—there were data from 47 departments in the year prior to deployment and 50 responses in year two—could have skewed the findings to show an increase in in-custody deaths. The survey also did not determine whether the Taser had been deployed in subjects who died. Other cities, including Cincinnati, OH, and Phoenix, AZ, have used the Taser and shown that it decreases the use of lethal-force deaths and reduces officer and suspect injuries without increasing the risk of in-custody deaths, said Calkins.

Dr Jared Strote (University of Washington Medical Center, Seattle), who was not part of the study, told heartwire that the findings by Lee et all were interesting but, like Calkins, pointed out the study was observational in nature and hindered by missing data. Along with Dr H Range Hutson (Harvard Medical School, Boston, MA), he has recently studied the use of Tasers over five years with Seattle police department and found no deaths within the first 24 hours of Taser use and a low number of injuries.

"In general, I think they are a safer weapon than many of the other weapons police officers have, and in many circumstances they have the potential to save suspects' and bystanders' lives, as well as the lives of police officers," said Strote. "But I think there are certainly some individuals who are being restrained for whom safety of Tasers is really unclear."

Strote added that the jury is still out on the physiological impact of the Taser.

Calkins told heartwire that there have been approximately 300 in-custody deaths with 650 000 applications of the Taser, but the time sequence of these deaths is not consistent with a ventricular arrhythmia during all of these deaths. Patients who die as a result of ventricular fibrillation caused by the Taser would die within the first minute, and not several hours later in custody, as is often the case, he said. A recent US Department of Justice-sponsored study of more than 1200 subjects who were Tasered found the weapon to be safe, with just three subjects reporting significant injuries [2]. Two subjects died in police custody, but the stun gun was not deemed by medical examiners to be cause or contribute to the death.

Calkins serves on the medical advisory board of Taser International and is compensated for his work. Lee has provided expert medical testimony on behalf of the plaintiffs in two lawsuits filed against Taser and received compensation for his work. Tseng and Strote report no conflicts of interest.

UCSF study raises doubts about stun gun safety

January 24, 2009
Elizabeth Fernandez, San Francisco Chronicle

The number of in-custody sudden deaths rose dramatically during the first year California law enforcement agencies began using stun guns, raising questions about the safety of the devices, according to a new study at UCSF.

The electronic weapons are intended to be a nonlethal alternative to the gun.

"Tasers are not as safe as thought," said Dr. Byron Lee, one of the cardiologists involved in studying the death rate related to Tasers, the most widely used stun gun. "And if they are used, they should be used with caution."

The researchers analyzed sudden death data from 50 law enforcement agencies in the state that use Tasers. They compared the death rate pre- and post-Taser deployment - analyzing data for five years before each agency began using Tasers and five years afterward.

They found a sixfold increase in sudden deaths during the first year of Taser use - amounting to nearly 6 deaths per 100,000 arrests.

"I didn't expect what we found," said Lee. "I thought we would find no difference in the rate of sudden death. But there was a rather dramatic rise."

After the first year, the rate of sudden deaths dropped down to nearly pre-Taser levels, suggesting that police and others in law enforcement altered the way they were using the devices to make them less lethal.

"Sudden deaths are extremely rare events, but it is important to look into why these events happen and whether law enforcement agencies are fully informed of the real-world risks," Lee said.

California does not have a statewide training standard for stun guns, which have been used in the state for decades.

"The manufacturer provides introductory training, then law enforcement agencies do supplemental training," said Robert Stresak, a spokesman for the California Commission on Peace Officer Standards and Training, which sets minimum training standards. "It's on an agency by agency basis. The content of the course could vary widely as to what is taught."

Tasers, known as "conducted energy" devices, send out high-frequency pulses which can cause a very rapid, dangerous heart rhythm, said senior author Dr. Zian H. Tseng, an assistant clinical professor in cardiology.

"Maybe a simple change of technique is what is necessary," he said. "The longer you hold the trigger, the higher the danger to the heart. ... The fewer pulses the better."

San Francisco, which does not use the devices, was not part of the study. Tseng declined to give specifics about local jurisdictions involved in the research but said that "Oakland did not give us data. San Jose did give us data."

Two years ago, Amnesty International reported 156 stun gun-related deaths of people in the United States during the previous five years.

The weapons have generated controversy, but a report last year which suggested a sweeping slate of reforms to the San Francisco Police Department said that allowing the use of Tasers may reduce injuries to officers and suspects.

Tasers are used by more than 12,000 law enforcement, military and correctional agencies in the U.S. and abroad, said UCSF's Lee.

More intensive research is needed, particularly within law enforcement agencies that show a high sudden death rate, said Samuel Walker, one of the nation's top police practices experts.

"We need good studies on the physiological impacts," said Walker, an emeritus professor of criminal justice at the University of Nebraska in Omaha. "I'd want to know more about the deaths, interview the officers to find out if they self-corrected."

The study's findings were published online this week by the American Journal of Cardiology.

Study tests REAL-WORLD effects of stun gun use

January 22, 2009
Digital Journal

University of California: San Francisco researchers have completed the first study to test real-world effects of stun gun use. Click here to read the abstract.

A University of California: San Francisco (UCSF) study states the rate of sudden deaths increased six-fold in the first year that California law enforcement agencies deployed the use of stun guns.

The findings also showed a two-fold increase in the rate of firearm-related deaths during the same time period.

The most widely used brand of stun gun is the Taser, and the team surveyed for outcomes related to the deployment of this device.

While some industry-funded controlled human studies have shown Tasers to cause no harm, this study suggests that their real-world effects pose greater medical risk and more danger than previous reports, said study author Zian H. Tseng, MD.

Although the device has been advertised to decrease the number of shooting deaths and officer injuries, study outcomes showed an increase rather than a reduction in the rate of shooting deaths and no change in officer injuries following Taser deployment, he added.

Researchers found that rates of sudden and firearm-related deaths declined back to near pre-deployment levels after the first year of Taser usage. The team postulated that law enforcement agencies self-corrected, likely adjusting their usage protocol or technique after the first year.

Study findings are published online today (Jan. 22, 2009) by the American Journal of Cardiology. The journal will also publish the study in an upcoming print edition.

“Physicians and law enforcement agencies need real-world knowledge of the effects of Taser use so that risks can be weighed in establishing appropriate policies and techniques,” said Tseng, who is senior author on the paper and assistant clinical professor in cardiology at UCSF.

“There have been a number of animal and controlled human studies, but none that test how Tasers are used in the real world, where subjects may have pre-existing medical conditions or be under the influence of narcotics.”

Researchers, under the Public Records Act and the Freedom of Information Act, mailed surveys to 126 police and sheriff departments in California cities and the 10 largest cities in the U.S. The survey requested three types of information: the rates of in-custody sudden deaths in the absence of lethal force, firearm-related deaths, and officer injuries requiring emergency room visits.

Fifty cities provided data on the rates of sudden death pre- and post-Taser deployment , while 21 cities reported firearm deaths and four cities reported officer injuries. None of the 10 largest U.S. cities returned surveys. The team used total annual arrest data per city as reported by the Department of Justice.

For each law enforcement agency that responded, researchers gathered data for the five years prior to the deployment of Tasers and for five years after. This allowed the research team, which included epidemiologists, cardiologists and statisticians, to observe how device deployment impacted the number of emergency events that a law enforcement agency experienced.

“Sudden deaths are extremely rare events, but it is important to look into why these events happen and whether law enforcement agencies are fully informed of the real-world risks of Taser deployment,” said Byron Lee, MD, first author on the paper and assistant clinical professor in cardiology at UCSF.

Stun guns like the Taser deliver a high-frequency, high-voltage current to incapacitate victims by causing momentary neuromuscular incapacitation. They are in use by over 12,000 law enforcement, military and correctional agencies in the U.S. and abroad, according to reporting by Taser International Inc.

Tasers were not examined in this study, but have been demonstrated to cause fatal ventricular tachyarrhythmias, or rapid irregular heartbeat, by capturing the heart at a higher, more dangerous rate. The increased adrenaline state resulting from a struggle and multiple, prolonged device applications near the heart may also make a person more vulnerable to sudden death.

“If law enforcement agencies using Tasers understood the risks and were trained to recognize cardiac arrest, sudden death events could be averted with timely deployment of external fibrillation or by knowing where not to apply the device’s current, such as near the heart,” Tseng said.

The research team noted limitations in its study, which was observational, such as a lack of information about reported sudden death events and the possibility that survey responses could be inaccurate. Also, the analysis only included a portion of cities known to be using the Taser. Several California cities and all of the largest U.S. cities surveyed were unwilling to release information.

“Further epidemiologic research is clearly needed. Without full transparency by law enforcement agencies, it is possible that our observed outcomes may actually be an underestimation of the real risks of Taser use,” Tseng added.

The study was funded by the National Center for Research Resources, a component of the National Institutes of Health and the NIH Roadmap for Medical Research.

Additional co-investigators on the study were Eric Vittinghoff, PhD, Dean Whiteman and Minna Park of UCSF; and Linda L. Lau of Loyola University Chicago School of Medicine.