Dr. Douglas Zipes Warns of Cardiac Hazards Associated With TASER
Practice Update: What is a TASER electronic control device?
Dr. Zipes: A TASER is a handheld device similar in form to a gun. It has a trigger, which, when pulled, shoots two barbs that are propelled by compressed nitrogen. The barbs look much like small fishhooks, and they impale the clothes and/or skin. The TASER transmits over very fine wires connected from the handheld device to the barbs a series of very rapid electrical stimuli—19/sec or 1140/min, which, essentially, paralyze the individual by causing tetany. The muscles contract so rapidly in response to the stimuli that individuals basically lock up and fall, if upright, allowing police to handcuff them or do whatever they feel they need to do. The device can also be used in “drive–stun mode,” in which it is held directly against the skin, like a cattle prod, primarily producing pain but without the muscles locking up.
Practice Update: Are TASERs safe?
Dr. Zipes: We need to define safe. The company estimates that the TASER has been used almost 3,000,000 times. The number of sudden deaths associated with TASER use is very small in comparison, but my position is that if the barbs are in the chest, particularly the left chest near the heart, they have the potential to take control of the heartbeat. Because the device delivers such rapid rates of stimuli, it can rev up the heart rate to a degree that is unsustainable, which can provoke cardiac arrest due to ventricular fibrillation. The TASER people disagree with me and say that their device is safe, although it now carries warnings that, basically, parrot what I have said. But, the company maintains that it does not cause cardiac arrest, or, if it does, it is very infrequent.
Practice Update: How can TASERs interfere with cardiac function, and what is the best way to avoid this?
Dr. Zipes: Don’t shoot in the chest! In fact, based in part on the article I published in Circulation,1 the Cincinnati police have banned chest shots with a TASER except in self-defense or in defense of another person. The police are ordered to aim for the belt, back, or buttocks. Also, long or frequent trigger pulls must be avoided. Pulling the trigger delivers a 5-second shock, unless the trigger is held down, which can override that 5 seconds. I dealt with one case in which there were 13 trigger pulls, for a total of 62 seconds.
Practice Update: How are these devices regulated?
Dr. Zipes: Because they don’t use gunpowder, TASERs are not regulated by the Bureau of Alcohol, Tobacco, Firearms, and Explosives (ATF), and there is, basically, no oversight. TASERs are sold in almost every state and can be purchased by ordinary citizens.
Practice Update: What kind of training is required for using a TASER?
Dr. Zipes: Basically, individual law enforcement groups have their own regulations on training. TASER International—the company that manufactures the device—will provide educational materials. And, of course, anybody can just buy a TASER and use it, with no training whatsoever.
Practice Update: What changes would you recommend in TASER regulation and training?
Dr. Zipes: I maintain that there is potential harm associated with these devices and recently gave a lecture to a hundred or so chiefs of police and other interested individuals about the potential for cardiac arrest and how to avoid it.
Certainly, avoiding chest shots, I think, is mandatory, and I would emphasize that to law-enforcement individuals. Obviously, that’s not always easy to do. If an assailant is coming directly at you with a knife or something, the instinct is to shoot at the center of mass, which is, basically, the chest. So, it can’t always be avoided.
However, very importantly, when an individual who has been tased becomes nonresponsive, think of cardiac arrest! Do not disregard that diagnosis because you thought you felt a pulse, that the individual was breathing, or there seemed to be movement. All of those things can happen for a certain time, despite the presence of cardiac arrest−ventricular fibrillation. Even well-trained medical people often mistake feeling a pulse for their own pulse—when you put your fingers on the wrist or on the neck, you’re actually feeling the pulsations from your fingers, rather than the individual. So, there may actually not be a pulse, but you think there is one, and, therefore, you think that there is no cardiac arrest. It can be very deceptive.
In addition, agonal respirations, in which an individual gasps reflexively, may occur during a cardiac arrest. There may be movement despite the initial onset of ventricular tachycardia going to ventricular fibrillation. Apply CPR. Certainly, call 911. If there’s an external defibrillator available, put it on the individual. In the course of the litigation that I’ve done, I’ve seen police videos of individuals being tased, losing consciousness, and the police doing nothing because they’ve been told that the TASER is safe and has no lasting effects. Meanwhile, that individual is dying with ventricular fibrillation. It is just horrible to watch a vibrant 22-year-old dying with no one doing anything about it.
Practice Update: It seems reasonable that the police might just go ahead and pull the trigger again, to try to make sure this guy doesn’t get up and do anything else.
Dr. Zipes: You’re exactly right, and, at least in two of the cases that I’ve seen, where the individual goes down nonresponsive, one police officer says to the other, “Tase him again. He’s faking.”
The individual is totally unconscious and nonresponsive and gets tased again. One of the points that I’ve made is that the heart is not locked in a position in the chest. In other words, the heart can move within the pericardial sac, and the heart in a prone individual is closer to the chest wall—consequently, closer to the TASER barbs. In one of the cases I’ve looked at, an individual was tased, went down, initially, I think on his side, and then rolled over onto his chest, looked up and said to the police officer, with some profanity, “Why did you do that to me?” He was obviously fully conscious at that point, but then the police officer pulled the trigger again, and the individual died. My interpretation is that he died because he was in a prone position. The barbs, being closer to the heart, facilitate capture, and then provoke ventricular fibrillation.
We also know, based on 30 or 40 years of electrophysiologic studies, that it’s easier to provoke ventricular fibrillation with electrical stimuli if the heart is abnormal, the result of a previous heart attack or if there are certain drugs or alcohol in the system. Obviously, a police officer trying to subdue an individual doesn’t take a history and do a physical exam first and has no way of knowing the individual’s cardiac status.
And, basically, what I’ve told them is to handle the TASER like they would a firearm. There shouldn’t be a difference. There was a YouTube video, just in the past several weeks, of a woman, drunk, handcuffed behind her back, in a police station, and she is mouthing off at the policeman and spits in his face and the policeman pulls his TASER and shoots her in the chest. She does not die, and I can understand him being angry, having been spit in the face, but he would not have pulled his .38 out or his Glock and shot her in the chest with it. Yet, he did it with a TASER, and he is now under investigation for a felony for doing that.
Practice Update: Does the device record information?
Dr. Zipes: Yes. The TASER records the deployment information, so the number and duration of the trigger pulls are available. The more recent TASER iterations actually have video capability, so the response to the trigger pulls can be recorded. This, in itself, is a revelation, because the officer is not always aware of the response to how he or she actually used the device.
Often, the police, after an event, will say, “Yeah, I just pulled the trigger once and it was just for 5 seconds.” But when the information is downloaded from the TASER, you find out that the trigger was pulled three times and for 8 or 10 seconds each time. In no way am I blaming the police officer. In that sort of situation, where there is such tumult, you can’t expect people to remember exactly what transpired.
Practice Update: It sounds as if there is no protocol where that information gets downloaded. It’s really left up to the individual department and depends on the circumstance.
Dr. Zipes: Exactly.
Practice Update: My last question. Is there any indication that some kind of a national registry to compile electronic control device deployments and outcomes is in development?
Dr. Zipes: No.
Practice Update: No such thing?
Dr. Zipes: No such thing. I think it’s essential, but no. There is nothing underway.
At times, I’ve felt like Erin Brockovich going up against the establishment, but there is some movement. Obviously, the cases I’ve reviewed as an expert witness have all involved cardiac arrests, and most of the victims, with the rare exception, died. Two individuals were resuscitated and have some residual brain damage.
Note: Dr. Zipes has been in the past, and will be in the future, a plaintiff expert witness against TASER, International, Inc.
Reference
Zipes DP. Sudden cardiac arrest and death following application of shocks from a TASER electronic control device. Circulation 2012;125(20):2417-2422.
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