Wecht to do second autopsy on man police tasered

August 9, 2008
By Jonathan D. Silver, Pittsburgh Post-Gazette

Let the battle of the forensic pathologists begin.

Dr. Cyril H. Wecht will perform a second autopsy on a man who died after a confrontation with Swissvale police. Howard Messer, a lawyer representing the family of Andre D. Thomas, yesterday confirmed that the noted forensic pathologist and former Allegheny County medical examiner has been retained by the Swissvale man's family.

An autopsy by the county medical examiner's office was inconclusive pending toxicology and other tests. However, both Medical Examiner Dr. Karl Williams and District Attorney Stephen A. Zappala Jr. have said Mr. Thomas' body bore no signs of excessive force.

Mr. Messer said photographs he has seen of Mr. Thomas's body tell a different story. "There is evidence of trauma to the body," Mr. Messer said. He declined to elaborate. Mr. Messer said he believed county officials were acting appropriately to investigate the circumstances surrounding Mr. Thomas's death Tuesday.

Dr. Wecht will likely perform the second post-mortem examination today between Mr. Thomas's funeral service and burial.

Dr. Williams also said it's not uncommon for families to request second autopsies, and he doesn't believe Dr. Wecht's examination will yield any dramatically new information. "We did a complete autopsy," he said. "The findings are the findings."

Mr. Thomas was pronounced dead at 12:46 a.m. Tuesday at UPMC Braddock, less than an hour after scuffling with three Swissvale police officers on Hawthorne Avenue. Police responded to numerous 911 calls of a man pounding on doors saying people were trying to kill him. Officers arrived, believing that Mr. Thomas might be a victim. But things changed when police decided that Mr. Thomas was acting so irrationally he was a danger to himself and others, Mr. Zappala said.

When Mr. Thomas tried to run away, one officer shocked him with her Taser three times until he was incapacitated enough to be handcuffed. Even so, Mr. Zappala said Mr. Thomas demonstrated "almost superhuman" strength in resisting attempts to handcuff him. Several witnesses said they saw police stomp and punch Mr. Thomas. Others told investigators from the Allegheny County Police that officers did not rough him up.

Mr. Zappala said Mr. Thomas's behavior and symptoms -- unusual strength, irrational behavior, dilated pupils, normal breathing that suddenly becomes labored and a normal pulse that rapidly weakens -- were similar to those exhibited in other people who died while in a state of "excited delirium" brought on by acute cocaine toxicity.

Investigators are looking into whether Mr. Thomas was high on the night of his death.

Toxicology tests are still weeks away from being available, but Mr. Zappala indicated that investigators were exploring the possibility that Mr. Thomas bought drugs in Braddock between 9 p.m. and 11 p.m., 50 minutes before his encounter with police. Paramedics at the scene treated him as a possible overdose.

Mr. Messer said Dr. Wecht will not be making any public statements about the results of his examination. "He's under a confidentiality agreement with me not to talk to the media about this case," Mr. Messer said.

However, in an interview Thursday before he was retained, Dr. Wecht expressed skepticism about excited delirium -- especially if there is any indication of excessive force or positional asphyxia. "Excited delirium is a convenient fallback for medical examiners, coroners and their forensic pathologists around the country," Dr. Wecht said. "The convenient thing about that diagnosis is that it's not susceptible to scientific disproof. It's not susceptible to scientific proof, either. It's based on nothing more than anecdotal situations."

In cases of positional asphyxia, prolonged pressure on the back or neck while someone is prone -- such as while they are being handcuffed and restrained -- can cause death.

Mr. Zappala flatly stated this week that Mr. Thomas did not die from positional asphyxia. He said one Swissvale officer did put a knee to the small of Mr. Thomas's back while detaining him, but that Mr. Thomas was then sitting upright.

In addition to setting up the possibility of dueling autopsy reports that reach different conclusions, the hiring of Dr. Wecht puts him squarely at odds with an old nemesis: Mr. Zappala. Dr. Wecht and Mr. Zappala have feuded for years, most significantly over the DA's successful move to end Dr. Wecht's ability to hold open inquests in cases of suspicious deaths. When Dr. Wecht was still county coroner, he would routinely hold fact-finding hearings when people died while in police custody or at the hands of police. Those inquests were conducted as an independent investigation parallel to police probes.

Mr. Zappala effectively outmaneuvered Dr. Wecht and put an end to open inquests. He argued that coroner's inquests were duplicative, illegal and unnecessary and could compromise law enforcement investigations.

Even this week, Dr. Wecht touted the importance of an impartial, transparent fact-finding hearing in the case of a death like Mr. Thomas's.

Pennsylvania man dies

August 5, 2008
Pittsburgh Post-Gazette

Andre Thomas, 37, Swissvale, Pennsylvania, died on August 4th

Ruling in cocaine-related taser deaths splits experts

March 17, 2008
By Mike Wereschagin, TRIBUNE-REVIEW

Traffic screeched to a halt on the Parkway West as Chad Cekas lay on his stomach in an inbound lane, disoriented and bleeding from his nose.

His legs didn't move. The 27-year-old Beechview man struggled weakly and unsuccessfully to rise on his elbows just outside the mouth of the Fort Pitt Tunnel. Headlights illuminated his wide and frightened eyes in the warmth of the late-summer night. A motorist knelt beside him, stroking his back and telling him the help he was pleading for was on its way.

Forty minutes later, at 9:23 p.m. Aug. 23, 2007, doctors at Mercy Hospital pronounced Cekas dead. Allegheny County Medical Examiner Dr. Karl Williams later would say a controversial syndrome and the cocaine in Cekas' blood -- not shocks delivered by a Pittsburgh police officer's Taser -- killed him.

"It says in the autopsy he was a healthy young man. All his organs were the right size. Everything was in good working condition," said Cekas' mother, Joanne Zekas, who uses the traditional Lithuanian spelling of their last name. "He shouldn't have died. There's no way he should have died," she said.

Controversial syndrome

Pathologists, police, stun-gun makers and civil liberties advocates differ on the merits and even the existence of Excited Delirium Syndrome, the cause of death listed for Cekas. Skeptics say the syndrome gets listed as a cause of death only when people die in the custody of police or medical personnel, and only when the person is forcibly restrained. Weapons such as stun guns or pepper spray frequently are involved.

Proponents list as proof the similarities in those who die from it -- erratic and violent behavior, cocaine or other stimulants in the person's blood, disorientation, surges of strength and a final period of calm before the person's heart stops beating.

As many as 1,000 people across the country die from it each year, said Michael Conner, a psychologist who serves as an expert witness in Excited Delirium cases. He added, however, that no one tracks all the deaths, so the number can only be estimated.

Neither the American Medical Association nor the American Psychiatric Association recognizes the syndrome. No physical evidence, such as lesions or microscopic tissue damage, exists to prove it as a cause of death, said former Allegheny County Coroner Dr. Cyril H. Wecht.

"There have got to be tens of thousands, hundreds of thousands (of cocaine users), who from time to time get excited or agitated when police aren't around," Wecht said. "How come there is not one case that I'm familiar with of anyone dying of Excited Delirium with cocaine toxicity in a situation that doesn't involve police?"

Using the word "delirium" causes further skepticism.

"You don't die of delirium. It's a symptom of what a person has," said Dr. William Narrow, director of research for the American Psychiatric Association.

Other cases

Three other deaths in the last year in Allegheny County could be attributed, at least partially, to Excited Delirium, said Williams, the Allegheny County medical examiner.

One involved a 39-year-old man with a history of seizures who died after a struggle with police in McKeesport. Police used a dog and pepper spray to subdue him, Williams said.

Another death involved a man who had a history of seizures and was taking psychiatric medicine. He died after being restrained in a psychiatric ward, Williams said. The third, a man who leaped out of a window and died of blunt-force trauma, might be partially attributable to the syndrome, he said.

Williams declined to release their names.

"I believe these are cases that represent some element of Excited Delirium, but I don't know right now whether that was listed as the immediate cause of death," Williams said. Cocaine intoxication or some other element of the syndrome sometimes is listed on death certificates instead of Excited Delirium, he said.

Williams said he understands criticism of the syndrome, especially in a death such as Cekas', where police used a stun gun. Still, he said, Excited Delirium is real.

"My gut reaction is you can't essentially electrocute somebody, even with low amperage and high voltage, without running the risk that you're going to have some adverse effects. But the case at hand is really different, (because of) the presence of really high levels of cocaine," Williams said. He declined to specify the amount of cocaine in Cekas' system.

Stun gun triggers?

No court, in the 66 lawsuits adjudicated so far, has ever found Scottsdale, Ariz.-based Taser International liable in a death or injury, said Steve Tuttle, the company's vice president of communications.

The electric current discharged from a Taser is designed specifically not to kill, Tuttle said. Measured in joules, the energy of a Taser shock is one five-thousandth as powerful as the defibrillators used to jump-start hearts, he said.

"If a shock were to kill somebody, does it kill them 20 minutes later? No," Tuttle said.

Medical researchers disagree whether stun guns can trigger heart problems. Tuttle said their safety has been "documented year after year in medical journals." But a study published in July, 2006, in the Journal of the American College of Cardiology, said the weapons "may have cardiac risks."

"I have not made up my mind on the Taser aspect of (Excited Delirium), to tell you the truth," Williams said. "I note the fact that (Cekas) has been Tasered."

Excited Delirium began gaining credence with medical examiners in the late 1980s, as cocaine use became more prevalent, said Dr. Jeffrey Jentzen, president of the National Association of Medical Examiners.

The condition wasn't invented to shield police, he said. Research suggests drugs such as cocaine prompt the brain to grow more of a certain kind of neuroreceptor -- the kind that responds to adrenaline. When cocaine users get into a fight, their more-sensitive brains soak up too much adrenaline. They become overstimulated, their body temperatures rise rapidly and their hearts give out, he said.

"The more you push them, the more belligerent and paranoid they become," Jentzen said.

Cekas had a history with police and drugs. He was serving a year of probation after pleading guilty to drug possession about one year before he died. He pleaded guilty to simple assault in 1999 and theft and harassment charges two years later, getting probation both times. When he died, he was awaiting trial on charges of simple assault and making terroristic threats.

In 2006, county courts awarded custody of his daughter, Zarah, then 5, to her mother. The mother, in a protection-from-abuse order she filed against Cekas, alleged he threatened violence against anyone she dated.

"I'm not saying cocaine may not play a contributing role, in terms of a person's behavior or placing a greater demand on the coronary system," Wecht said. "I'm not saying cocaine (levels) are a finding that is to be ignored.

"But to attribute all this to Excited Delirium because you find a little bit of cocaine, when you have someone who has been Tasered, has been beaten, has been physically subdued -- I think, frankly, that is a cop-out."

Cekas incident unclear

Paula Shubock, the motorist who knelt beside Cekas the night he died, said Cekas showed no signs of violence. Why Cekas was lying on the road remains unclear. His car was found on a nearby overpass, but police declined to talk about their investigation into Cekas' death -- even to his mother, who said she still wonders how her son ended up bleeding and frightened at the mouth of the Fort Pitt Tunnel.

Four cars were between Shubock and Cekas when traffic stopped that night. She left her car and walked to him.

"He just kept saying, 'Please help me. Please help me,' " said Shubock of Forest Hills. Three men stood nearby as she stroked his back and told him an ambulance was on the way.

After waiting several minutes, Shubock said she got frustrated and walked back to her car to again call 911. While she was on the phone, she saw a police officer arrive. He and the men who'd been standing near her lifted Cekas and moved him off the highway, out of her sight.

Other witnesses later told police and the Tribune-Review they saw Cekas shaking violently.

The ambulance had not yet arrived, Shubock said.

She ran back toward Cekas and saw him slumped over, being supported by a police officer who was holding a Taser against his back.

Tasers incapacitate people by sending 50,000-volt electrical currents through two small darts. The darts can be fired into a person from as far away as 35 feet, or delivered by touching the stun gun to the person. A typical cycle of short electrical pulses lasts five seconds, according to Taser International's Web site.

"I said, 'What are you doing?' " Shubock said. Another officer warned her to stand back. "The kid wasn't moving. He was never standing up, as far as I could see. He didn't appear to be able to stand up."

It was about 8:44 p.m.

Police said the day after the incident they shocked Cekas several times because he was combative and endangering other motorists.

Williams said he believes Cekas wasn't shocked more than twice, though the autopsy report lists eight puncture wounds that could have been caused by Taser darts.

Police and the District Attorney's Office reviewed the case and found no wrongdoing on the part of police, said Zekas' attorney, Paul Giuffre, with the Downtown firm Meyers Kenrick Giuffre & Evans. Police won't release their report, however, and Giuffre said he's considering asking a court to force them to turn it over.

"The decision not to prosecute is probably correct," Giuffre said. "But why are they forcing a family who just wants to find out what happened to get a subpoena from the court?"

Drugs shadow Taser cases

August 14, 2005
Antigone Barton, Palm Beach Post

Gordon Randall Jones

In July 2002, an Orange County deputy shocked Gordon Randall Jones with a Taser 14 times in four minutes on the day the 37-year-old Orlando man died. Jones had taken cocaine that day and was acting strangely when deputies came to remove him from a hotel where he was a paid guest. But Jones had not been violent and was not being arrested for a crime when the Taser darts hit him in the back, crumbling him to the floor.

A lobby surveillance tape shows Jones lying, sometimes still, sometimes writhing, while a circle of deputies stands near him, some with arms folded, waiting for him to follow orders to put his hands behind his back.

Eventually, deputies discussed another plan to gain control over Jones, who had bloody drool frothing from his mouth. By then, observers in the lobby had begged deputies to stop shocking him. One woman had fled from the smell of burning flesh.

According to depositions, deputies didn't tell paramedics about the repeated Taser shocks as they loaded Jones facedown into an ambulance.

He died on the way to a hospital.

The Orange County deputy chief medical examiner found Jones suffocated, with Taser shocks and cocaine intoxication contributing.

The Taser shocks, Dr. William Anderson said, interfered with the muscles Jones needed to breathe, making him already short of breath when he was eventually handcuffed lying on his chest.

As a result, Anderson said, Jones' blood was starved of oxygen.

Orange County officials hired Pennsylvania-based pathologist Cyril Wecht to take another look. Wecht found Jones' death resulted primarily from cocaine intoxication, with being restrained facedown reduced to a contributing cause. The multiple Taser shocks did not contribute to his death, Wecht said.

"Which doesn't make sense, when you think about it," Anderson said. If being placed in a position that makes breathing difficult contributed to Jones' death, he said, the Taser shocks that interrupted his breathing would have contributed as well.

Taser later hired Wecht as a paid consultant to "independently review" deaths following the weapon's use, according to a letter the company sent to medical examiners.

Is 'non-lethal' taser deadly?

December 1, 2004
By PHUONG CAT LE AND HECTOR CASTRO
SEATTLE POST-INTELLIGENCER REPORTERS

Willie Smith was high on cocaine the night he pinned his wife down and told her he wanted to get the devil out of her. She broke free, crawled out of their bedroom window and called for help. Auburn police say that when they came and tried to arrest Smith, he resisted. So officers used a Taser, subduing him with 50,000 volts of electricity. When Smith finally emerged from the apartment, he was rolled out on a gurney -- hogtied, face down with his hands and ankles cuffed behind him, his wife said. She could hear him whimpering. The 48-year-old man had a heart attack in the ambulance. He died in the hospital two days later.

Willie Smith was the third person in Washington state to die after being shocked with a Taser. Smith was the third person in Washington to die after being shocked with a Taser; others died in Silverdale and Olympia. Nationwide, there have been 69 such deaths since 2000, raising concerns about a new breed of electric shock devices in widespread use by law enforcement.

In dozens of cases nationwide, autopsies showed the victims died of a heart attack, cocaine intoxication or underlying causes such as heart disease. But autopsies in at least five cases found Tasers were a contributing factor in the deaths.

The company that manufactures Tasers insists they are safe and non-lethal, and some medical professionals think some of the deaths may be the result of a combination of physical restraint and drug-induced agitation. But Amnesty International and other groups say such deaths are troubling and shouldn't be overlooked as more law enforcement officers use Tasers in a wide variety of situations.

In a report issued yesterday, Amnesty International said Tasers couldn't be ruled out as a factor in seven of 74 deaths in the United States and Canada it asked a forensic pathologist to review. That underscores the need to ban such non-lethal weapons until it is known whether they're responsible for the deaths, it said.

Across the country, 6,000 law enforcement agencies have equipped some or all of their officers with the tools. According to the manufacturer, Taser International, Houston police last month placed a $4.7 million order to buy Tasers for all 3,700 of its officers.

Company says they're safe

Taser International, a publicly traded company with nearly $50 million in sales this year, says the devices have never directly caused a death. The company points out that many of the people died hours, even days, after they were shocked, and of other reasons, such as cocaine overdose or heart disease.

Steve Tuttle, a company spokesman, said a study showing Tasers did not cause ventricular fibrillation in 10 pigs has been accepted for publication in Pacing and Clinical Electrophysiology, a peer-reviewed journal. The study will be published in January. Ventricular fibrillation is a condition in which the heart's electrical activity becomes disordered, which could lead to cardiac arrest in minutes.

He said the company has offered to provide funding for more medical studies using standards agreed upon with Amnesty International, but that the group has not responded. "We're not saying Tasers kill people," said Mike Murphy, coroner of Clark County, Nev., where two men have died after being shocked by Las Vegas police officers. "We appear to be seeing some issues that need to be addressed."

The Taser was one of several methods used to restrain William Lomax, a 26-year-old who was under the influence of PCP when he fought with security guards and a Las Vegas police officer earlier this year. He died after being handcuffed, shocked several times and held down, Murphy said. The forensic pathologist who performed the autopsy said the Taser played a role in Lomax's death, but couldn't say how big a role.

The Taser, powered by batteries, fires two darts that hook into a person's skin, then deliver an electrical charge that temporary subdues them. It can also be pressed against a person's body in a stun mode.

Seattle police Chief Gil Kerlikowske said an in-custody death isn't unusual, so "it's a huge leap to say the Taser caused the death. It's natural to expect, whether it's a huge ingestion of drugs or alcohol or from some other type of injuries, that there are going to be some deaths that are also associated with Taser use," he said.

Chief Sue Rahr, who has been named to replace King County Sheriff Dave Reichert, said she believes the tools are safe and give officers better options than wrestling or fighting someone with a baton or nightstick. She said she wants every deputy to have one. About 250 of 700 deputies now carry them.

"If there were a case where the Taser was shown as the direct cause of death, absolutely we would reconsider," she said. "But I haven't seen any information that directly correlates the Taser with the death."

But while law enforcement officers have accepted the devices as safe, relatives of those who have died aren't convinced.

"A Taser gun did the same harm that a regular gun would have done," said Tammie Smith, who believes the tool helped bring about her husband's heart attack in July. "I don't understand why he had to be Tasered."

The King County Medical Examiner Office last week ruled the 48-year-old machine operator died of "a combination of acute cocaine intoxication and physical restraint," but declined to offer more details. An inquest into Smith's death is pending.

The Auburn Police Department completed its investigation this week and forwarded the case to the King County Prosecutor's Office, which is standard procedure. Cheryl Price, department spokeswoman, said the investigation was focused on Smith's "felony assault," not any issue with the officers' involvement in his death. "He was resistant to arrest and we utilized different levels of force to subdue him, and he happened to have a cardiac episode," she said. She said she couldn't say why the department was still investigating Smith after his death.

Coroners in the two other Washington fatalities ruled that the Taser did not contribute to the deaths of:

Stephen L. Edwards, 59, of Shelton, who fought with a security guard outside a grocery store before an Olympia police officer arrived and shocked him four times in less than a minute and a half;

Curt Lee Rosentangle, 44, a Silverdale business owner, who was high on cocaine and reportedly pounding on doors at an apartment complex when a Kitsap County sheriff's deputy shocked him at least twice.

Some see deadly combination

Some say that for those already agitated, high on cocaine or other drugs or have existing heart problems, the Taser can inhibit breathing and become lethal. Dr. William Anderson, a private forensic pathologist in Florida, believes those people may be particularly vulnerable. Although the Taser is generally safe for most people, he said, the company hasn't done the scientific study to conclude it's safe for everyone. "If you're in that particular situation at the time you get Tasered, it may be the straw that breaks the camel's back," said Anderson, who added that it can be a good tool.

As deputy medical examiner in Orlando two years ago, he ruled that the Taser contributed to the death of Gordon Jones, who was cocaine-intoxicated when he was Tased multiple times. Another pathologist contradicted Anderson's ruling.

Amnesty International's report raised similar questions about whether the devices could exacerbate breathing difficulties caused by violent exertion, drug overdose or other restraint devices, triggering heart attacks.

A British government report warned "excited, intoxicated individuals or those with pre-existing heart disease could be more prone to adverse effects from the M26 Taser, compared to unimpaired individuals." But it also concluded that the risk of serious injuries was "very low" and it wasn't medically necessary to hold off using them until more was known.

"Testing that we've done hasn't identified any groups of people at risk," said Taser's Tuttle, who added that the company supports continued research on the device. "There's no use of force that's risk-free. But studies continue to show that this is one of the safest uses of force that's out there on the street."

The company has cited both the British report and a report sponsored by the Department of Defense to bolster its claims. In September, the DoD released an abstract of the report concluding that the device "does not appear to pose significant risk" and wasn't the primary cause of reported deaths. It recommended more research into how such tools affect "sensitive populations."

But the Air Force Research Laboratory, which conducted the DoD study, released a statement last week saying the devices could be dangerous in certain circumstances and that there wasn't enough data to evaluate it. The need to rely on case reports from the manufacturer and the lack of laboratory data "generate uncertainty in the results," the report said. "There's a huge gap in the scientific data that has been performed," said Larry Farlow, a spokesman with the Air Force Research Laboratory at Brooks City-Base in San Antonio.

'Very little controlled research'

Kenneth Foster, who was on the independent panel that reviewed the U.S. report, said there is no indication the Taser is unsafe, though there has been "very little controlled research." "If a medical device company wanted to put a device on the market, they have to prove the safety and effectiveness using rigorous tests and to get federal approval," said Foster, a bioengineering professor at the University of Pennsylvania. "The Taser doesn't have that requirement, so there's been rather little systematic study as far as I can tell."

Yet, he and others say any significant hazard would have been obvious by now, given the thousands of times they've been used.

Although some Taser supporters feel more research is needed, they say Tasers shouldn't be pulled from the streets. Doing so would remove a valuable less-lethal option, they say. "I can't overemphasize (that) the value of the Taser is it allows us to gain control of somebody without injuring them. That's huge," said Rahr, of the Sheriff's Office. "What better way to protect the public than to not have to wrestle with them or hit them with a nightstick or shoot them?"

The company cites animal studies it funded, as well as tests on older versions of electric shock devices, as evidence of the product's safety. In a study in 1996, Dr. Robert Stratbucker shocked an anaesthetized pig 48 times with an older lower-powered Taser and found that it didn't affect the pig's heart.

In a later study at the University of Missouri, he and another researcher, Wayne McDaniel, shocked five dogs 236 times in the chest area with no episodes of ventricular fibrillation. McDaniel later repeated the study on 10 anesthetized pigs, and determined the device could be used safely even at 15 times its standard power.

Kerlikowske said police agencies are left to their own devices when determining the safety of new policing tools, but his agency didn't buy Tasers as a knee-jerk reaction. A citizens group researched the options and compared notes with other police agencies. "There are some departments that have a controversial shooting and, within a month, they buy 500 Tasers and issue it to every officer," he said.
"We went into this as methodically and thoroughly as any agency as I've ever seen."

Taser says the device operates at a fraction of the electricity used to resuscitate heart attack victims -- 1.6 joules. A joule is a unit of energy. "That amount of energy applied to the chest, probably only a fraction ends up going to the heart," said Dr. Peter Kudenchuk, professor of medicine at the University of Washington. "Simply the pain created by a shock of 1.6 joules might make the heart rate faster, but I'd be surprised if much of the energy reaches the heart itself," he said. "In terms of causing a cardiac arrest, the risk is probably low."

Some medical experts believe the common denominator in the publicized deaths is not the Taser, but how officers restrain out-of-control, agitated people. Some of those who died while in custody were hogtied, handcuffed or held down, which compressed their chests and restricted their ability to breathe. A person's delirious, excited state combined with the way he or she is restrained plays a more significant role in a fatal outcome, they say.

In a British Columbia report this fall, a group of medical professionals said the deaths of four people there may have been because the individuals were restrained while in an excited, delirious state and that the Tasers didn't cause their deaths.

Tasers cited in five deaths

But Tasers played a part in at least five deaths nationwide, according to medical authorities. A county coroner in Indiana ruled that electric shock contributed to the death of James Borden, who died in an Indiana jail after being shocked several times while handcuffed. The jail officer faces two counts of felony battery. "People who carry these should be warned," said David Brimm, an attorney representing the Borden family in a wrongful death suit against the county and Taser.

Pathologist Ronald Kohr ruled Borden died of cardiac dysrhythmia, or disorder of the heartbeat. He listed an enlarged heart, pharmacological drug intoxication and electric shock as contributing factors. But a pathologist working for the jail officer's defense, Dr. Cyril Wecht, wrote in a memo that there was no basis to conclude the Taser contributed to Borden's death.

Electric shock was also listed as one of four causes of death for Jacob Lair, a 29-year-old who died last June after a struggle with police officers in Sparks, Nev. The autopsy report said methamphetamines combined with delirium, the Taser and restraint combined to kill him. "There's not a single one of those that you can make the sole cause of death, and not one that you can ignore," Washoe County Coroner Vernon McCarty said of Lair's case.

A coroner in South Carolina also ruled the Taser contributed to the death of William Teasley, who died in August after he was shocked at the county jail. "The Taser gun was a last straw because he was Tased and he collapsed to the floor," said Charlie Boseman, a forensic pathologist who conducted the autopsy. Teasley died of cardiac arrhythmia, with the Taser and health problems, including an enlarged heart and heart and liver diseases, contributing. Boseman said two Taser representatives called him and asked him "could we not use the Taser as part of the man's death." "I told them that we could not change the report and leave the Taser out, because the Taser was used to bring the man down to the floor," Boseman said.

Tuttle said the company has never pressured any medical professional to alter a report involving a death in which a Taser was involved. Rather, they called Boseman's office to offer technical information on Tasers that the pathologist requested, he said.

Smith, who has been waiting for her husband's death certificate, is convinced the shock played a role in her husband's death. She said she hoped police would "take responsibility for their part in it."