1
|
Aulino G, Giannuzzi F, Carlà MM, Guarnieri G, Spagnolo D, Lepore D, Cittadini F, Rizzo S. Taser-Related Ocular Injuries: A Review of the Literature and Medico-Legal Implications. Semin Ophthalmol 2024; 39:334-339. [PMID: 38502067 DOI: 10.1080/08820538.2024.2322452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 02/14/2024] [Indexed: 03/20/2024]
Abstract
PURPOSE Electric weapons have dangers associated with their use, such as burns and trauma related with the impacts of uncontrolled falls, even though they often minimize morbidity and mortality. The exact visual outcome of the damage inflicted is unknown, even though numerous studies have been documented in the literature about the ocular damage induced by the use of these tools. METHODS We present a narrative review of types of eye damage associated with the use of the Taser. The following search terms were used to identify eligible articles through the PubMed database: "TASER", "Conducted Electric Weapons", "CEWs". RESULTS A total of 15 articles were included with information about 38 patients with eye damage associated with the use of taser. The majority of patients were males. In most cases the mechanism of injury was the penetration of the probe inside the eye. Clinical manifestations of ocular damage were present in only 18 out of 38 cases and varied according to the type of damage mechanism. Indeed, the cases in which the probe had penetrated the eye showed more severe clinical manifestations with a poor visual outcome. CONCLUSION In conclusion, the introduction of taser use for law enforcement requires serious consideration and adequate training for officers.
Collapse
Affiliation(s)
- Giovanni Aulino
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Rome, Italy
- Graduate School, Catholic University of the Sacred Heart, Rome, Italy
| | - Federico Giannuzzi
- Graduate School, Catholic University of the Sacred Heart, Rome, Italy
- Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli, IRCCS", Rome, Italy
| | - Matteo Mario Carlà
- Ophthalmology, Universita Cattolica del Sacro Cuore - Campus di Roma, Roma, Italy
| | - Giorgia Guarnieri
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Rome, Italy
- Graduate School, Catholic University of the Sacred Heart, Rome, Italy
| | - Domenico Spagnolo
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Rome, Italy
- Graduate School, Catholic University of the Sacred Heart, Rome, Italy
| | - Domenico Lepore
- Graduate School, Catholic University of the Sacred Heart, Rome, Italy
- Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli, IRCCS", Rome, Italy
| | - Francesca Cittadini
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Rome, Italy
- Graduate School, Catholic University of the Sacred Heart, Rome, Italy
| | - Stanislao Rizzo
- Graduate School, Catholic University of the Sacred Heart, Rome, Italy
- Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli, IRCCS", Rome, Italy
| |
Collapse
|
2
|
Willoughby L, Peyton K, Gorgas D, Li-Sauerwine S. Leveraging Resources to Remove a Taser Barb Embedded in Bone: Case Report. Clin Pract Cases Emerg Med 2022; 6:29-31. [PMID: 35226843 PMCID: PMC8885210 DOI: 10.5811/cpcem.2021.10.54196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 10/16/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction Conducted electrical weapons, commonly known by their proprietary eponym,
TASER, are frequently used by law enforcement. A review of the literature
yielded descriptions of taser barb removal from soft tissue and surgical
intervention for barbs lodged in sensitive areas such as the eye and head,
but not from other osseous sites. Case Report We report the case of a 30-year-old male transferred from another hospital
with a taser dart embedded in his clavicle. Prior attempts at bedside
removal had been unsuccessful. We describe bedside removal of the taser barb
from bone using local anesthesia and simple fulcrum technique. Conclusion We describe a novel fulcrum technique for removal of a taser dart embedded in
bone. This is a reasonable technique to attempt in patients with involvement
of superficial osseous structures to avoid operative intervention.
Collapse
Affiliation(s)
- Lauren Willoughby
- The Ohio State University, Department of Emergency Medicine, Columbus, Ohio
| | - Kelee Peyton
- The Ohio State University, Department of Emergency Medicine, Columbus, Ohio
| | - Diane Gorgas
- The Ohio State University, Department of Emergency Medicine, Columbus, Ohio
| | | |
Collapse
|
3
|
Plenzig S, Verhoff MA, Gruber H, Kunz SN. Aspiration-related pneumonia after Taser exposure - A multiple causations mechanism. Forensic Sci Int 2021; 326:110906. [PMID: 34298206 DOI: 10.1016/j.forsciint.2021.110906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/17/2021] [Accepted: 07/11/2021] [Indexed: 11/23/2022]
Abstract
Arrest-related deaths in the context of Conducted Electrical Weapon (CEW) deployment are rare. The evaluation of such complex events is a challenge for the forensic scientist. We present a case of a 49-year old man, who was exposed to a Taser X26P during a confrontation with the police. He lost consciousness, vomited, aspirated and died after having been hospitalized for several days at the ICU. Based on the patient´s medical history, autopsy findings, witness testimonies, and reliable clinical and toxicological blood parameters, the most probable cause and mechanisms of his death are discussed. The present work demonstrates, based on one case report, the possibilities as well as limitations of forensic assessment in CEW-related deaths.
Collapse
Affiliation(s)
- S Plenzig
- Institute of Forensic Medicine Frankfurt, Germany; Goethe, Universität Frankfurt, Germany
| | - M A Verhoff
- Institute of Forensic Medicine Frankfurt, Germany; Goethe, Universität Frankfurt, Germany
| | - H Gruber
- Institute of Forensic Medicine Frankfurt, Germany; Goethe, Universität Frankfurt, Germany
| | - S N Kunz
- Institue of Forensic Medicine, Ulm University Hospital, Germany; Ulm University, Germany.
| |
Collapse
|
4
|
de Courcey C, Jones MA. Taser barb penetration causing phalangeal fracture. BMJ Case Rep 2021; 14:14/5/e240953. [PMID: 33962924 PMCID: PMC8108659 DOI: 10.1136/bcr-2020-240953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We present an unusual case of phalangeal fracture resulting from direct penetration by the barb of a conducted electrical weapon (Taser). When a Taser is triggered, compressed gas propels two barbs with trailing insulated wires which deliver a pulsed electrical discharge on contact. A 51-year-old man presented with a single barb of the Taser embedded in the diaphysis of the proximal phalanx and an associated open fracture. The barb was removed under local anaesthesia. The fracture was stable and was mobilised in a flexible splint. Oral antibiotics were commenced in recognition of the risk of flexor sheath and bone inoculation. While the most severe complications associated with Taser are related to the electrical component, the most common injuries are associated with falls and barb penetrations. Clinicians must be mindful of the risk of fracture, infection and soft tissue injury when such a foreign body penetrates a phalanx.
Collapse
Affiliation(s)
- Cynthia de Courcey
- Department of Plastic Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Matthew A Jones
- Trauma and Orthopaedics, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| |
Collapse
|
5
|
Hallett N, Duxbury J, McKee T, Harrison N, Haines A, Craig E, O'Brien AJ. Taser use on individuals experiencing mental distress: An integrative literature review. J Psychiatr Ment Health Nurs 2021; 28:56-71. [PMID: 31957217 DOI: 10.1111/jpm.12594] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 12/25/2019] [Accepted: 01/13/2020] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN ABOUT THE SUBJECT?: People experiencing mental distress have a high rate of contact with police in community crisis events. Police use a continuum of responses when managing situations involving agitation, aggression and behavioural problems. People experiencing mental distress have been subjected to Tasers as part of the police response. Following a number of deaths and numerous reports of injuries, concerns have been raised about the safety of Tasers. WHAT THIS PAPER ADDS?: Police use of Tasers in mental health crises is relatively common. Tasers are used in a range of settings including public places, private residences and healthcare facilities. People experiencing mental distress may be subjected to more use of Tasers than the general population. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health professionals need to work with police towards greater understanding of the needs of people experiencing mental distress and to promote the use of non-coercive interventions in mental health crisis events. Mental health researchers need to explore the qualitative experiences of people who are Tasered, to provide an evidence base for Taser use with people experiencing mental distress. ABSTRACT: Introduction Conducted electrical weapons, or "Tasers," are currently used by over 15,000 law enforcement and military agencies worldwide. There are concerns regarding the effectiveness, potential for harm and overuse with people experiencing mental distress. Aim To explore the literature about police use of Tasers with people experiencing mental distress. Method An integrative review was undertaken, and qualitative and quantitative analytical approaches were used. Results Thirty-one studies were included. Of all recorded usage, overall prevalence of Taser use on people experiencing mental distress was 28%. This population appears to experience higher Taser usage than the general population. Discussion There are substantial gaps in the research literature particularly with respect to the decision-making processes involved in deploying Tasers on this population and the physical and psychological consequences of Taser use in this context. Implications for practice Police use of Tasers in mental health crises is relatively common and occurs in a variety of environments including mental health settings. Mental health professionals need to work with police towards greater understanding of the needs of people with mental illness and to promote the use of non-coercive interventions in mental health crisis events.
Collapse
Affiliation(s)
- Nutmeg Hallett
- Department of Nursing, Manchester Metropolitan University, Manchester, UK
| | - Joy Duxbury
- Department of Nursing, Manchester Metropolitan University, Manchester, UK
| | - Tina McKee
- Lancashire School of Law and Social Sciences, University of Central Lancashire, Lancashire, UK
| | - Natalie Harrison
- Department of Psychology, Birmingham City University, Birmingham, UK
| | - Alina Haines
- Department of Nursing, Manchester Metropolitan University, Manchester, UK
| | - Elaine Craig
- Department of Nursing, Manchester Metropolitan University, Manchester, UK
| | - Anthony J O'Brien
- Auckland District Health Board, University of Auckland, Auckland, New Zealand
| |
Collapse
|
6
|
Mattei E, Censi F, Calcagnini G. Electrical Stun Gun and Modern Implantable Cardiac Stimulators. HEALTH PHYSICS 2019; 116:18-26. [PMID: 30489364 DOI: 10.1097/hp.0000000000000942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The aim of the study is to investigate systematically the possible interactions between two types of stun guns and last-generation pacemakers and implantable defibrillators. Experimental measurements were performed on pacemakers and implantable defibrillators from five leading manufacturers, considering the effect of stun gun dart positioning, sensing modality, stun gun shock duration, and defibrillation energy level. More than 300 measurements were collected. No damage or permanent malfunction was observed in either pacemakers or implantable defibrillators. During the stun gun shock, most of the pacemakers entered into the noise reversion mode. However, complete inhibition of the pacing activity was also observed in some of the pacemakers and in all the implantable defibrillators. In implantable defibrillators, standard stun gun shock (duration 5 s) caused the detection of a shockable rhythm and the start of a charging cycle. Prolonged stun gun shocks (10-15 s) triggered the inappropriate delivery of defibrillation therapy in all the implantable defibrillators tested. Also in this case, no damage or permanent malfunction was observed. For pacemakers, in most cases, the stun guns caused them either to switch to the noise reversion mode or to exhibit partial or total pacing inhibition. For implantable defibrillators, in all cases, the stun guns triggered a ventricular fibrillation event detection. No risks resulted when the stun gun was used by a person wearing a pacemaker or an implantable defibrillator. This work provides novel and up-to-date evidence useful for the evaluation of risks to pacemaker/implantable defibrillator wearers due to stun guns.
Collapse
|
7
|
Electrical weapons and excited delirium: shocks, stress, and serum serotonin. Forensic Sci Med Pathol 2018; 14:478-483. [PMID: 30099702 DOI: 10.1007/s12024-018-0005-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2018] [Indexed: 01/31/2023]
Abstract
It has been suggested that a CEW (conducted electrical weapon) exposure could elicit a stress response that could cause ExDS (excited delirium syndrome). There are some parallels between the signs of ExDS and serotonin syndrome (SS). Electroconvulsive therapy raises serotonin levels and therefore provides a plausible link between CEW applications and elevated serotonin levels. This study was designed to determine whether a CEW exposure elevates serum serotonin. A total of 31 police academy cadets were exposed to a very broad-spread 5-s CEW stimulus from a TASER brand X26 CEW. Blood was drawn before and after the exposure and at 24 h post exposure to measure serum serotonin levels. Lactic acid and cortisol levels were also compared. Median serum serotonin levels were 30 IQR (21,46), 36 IQR (22,50), and 32 IQR (21,45) ng/mL before exposure, after exposure, and 24 h after exposure (NS by pooled comparisons). The increase from baseline to post-test serotonin (∆ median = +6, ∆ mean = +2.7) ng/mL was not significant by a paired T-test (p = .29) but was significant by the Wilcoxon signed-rank test (p = .037). The increase to post-test log serotonin was not significant by a paired T-test (p = .13) but was significant by the Wilcoxon test (p = .049). All serotonin levels remained within the normal reference range of 0-200 ng/mL. Post-hoc analysis demonstrated that the study was powered to detect a ½ SD change, in log serotonin, with a 90% likelihood. With a very-broad electrode spread, CEW exposure did not significantly raise serum serotonin levels.
Collapse
|
8
|
A comparative brief on conducted electrical weapon safety. Wien Med Wochenschr 2018; 169:185-192. [DOI: 10.1007/s10354-018-0616-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 01/05/2018] [Indexed: 10/18/2022]
|
9
|
Abstract
The Conducted Electrical Weapon is a weapon often used by law enforcement agencies as a method of less lethal means to subdue a suspect. Injuries to the eye with these devices are usually due to the projectile force of the metal probes that are released when these devices are engaged. The authors report what may be the first case of an impaled orbital TASER probe that required primary enucleation for globe perforation.
Collapse
|
10
|
White MD, Ready JT, Kane RJ, Yamashiro CT, Goldsworthy S, Bonds McClain D. Examining Cognitive Functioning Following TASER Exposure: A Randomized Controlled Trial. APPLIED COGNITIVE PSYCHOLOGY 2015. [DOI: 10.1002/acp.3128] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Michael D. White
- School of Criminology and Criminal Justice, Center for Violence Prevention and Community Safety; Arizona State University; Phoenix USA
| | - Justin T. Ready
- School of Criminology and Criminal Justice; Arizona State University; Phoenix USA
| | - Robert J. Kane
- Program in Criminal Justice; Drexel University; Philadelphia USA
| | | | | | - Darya Bonds McClain
- College of Nursing and Health Innovation; Arizona State University; Phoenix USA
| |
Collapse
|
11
|
Strote J, Maher P. Civilian use of a conducted electrical weapon. Am J Emerg Med 2015; 33:606.e1-2. [DOI: 10.1016/j.ajem.2014.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 10/02/2014] [Indexed: 11/30/2022] Open
|
12
|
Lésions induites par les pistolets à impulsion électrique de type Taser®. ANNALES FRANCAISES DE MEDECINE D URGENCE 2015. [DOI: 10.1007/s13341-014-0487-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
13
|
Jauchem JR. Exposures to conducted electrical weapons (including TASER® devices): how many and for how long are acceptable? J Forensic Sci 2014; 60 Suppl 1:S116-29. [PMID: 25443856 DOI: 10.1111/1556-4029.12672] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 01/28/2014] [Accepted: 02/03/2014] [Indexed: 01/04/2023]
Abstract
TASER(®) conducted electrical weapons (CEWs) are an important law-enforcement tool. The purposes of this study are a) to review recent literature regarding potential pathophysiological responses to applications of CEWs, and other related issues and b) to evaluate whether enough data exist to determine the acceptability of longer-duration (or repeated) exposures. This is a narrative review, using a multidisciplinary approach of analyzing reports from physiological, legal-medical, and police-strategy literature sources. In general, short-duration exposures to CEWs result in limited effects. Longer-duration or repeated exposures may be utilized with caution, although there are currently not enough data to determine the acceptability of all types of exposures. Data examined in the literature have inherent limitations. Appropriateness of specific types of CEW usage may be determined by individual police agencies, applying risk/benefit analyses unique to each organization. While more research is recommended, initial concepts of potential future long-duration or repeated CEW applications are presented.
Collapse
Affiliation(s)
- James R Jauchem
- Bio-effects Division, Human Effectiveness Directorate, 711th Human Performance Wing, U.S. Air Force Research Laboratory, Fort Sam Houston, TX, 78234
| |
Collapse
|
14
|
O'Brien AJ. Health effects of TASER™ electronic control devices. J Emerg Nurs 2014; 40:415. [PMID: 25194649 DOI: 10.1016/j.jen.2014.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 04/03/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Anthony J O'Brien
- Centre for Mental Health Research, University of Auckland, Grafton, New Zealand.
| |
Collapse
|
15
|
O'Brien AJ, Thom K. Police use of TASER devices in mental health emergencies: a review. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2014; 37:420-426. [PMID: 24656744 DOI: 10.1016/j.ijlp.2014.02.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The proliferation of TASER devices among police forces internationally has been accompanied by concerns about injuries and health effects, and about the use of TASER devices on vulnerable populations such as people with mental illness. TASER devices have generated a flood of research studies, although there remain unanswered questions about some of the key issues. This paper outlines the introduction of TASER devices to policing and their subsequent widespread adoption. The paper considers the role of police in mental health emergencies with a particular focus on use of TASER devices. Some factors contribute to the special vulnerability of people with mental illness to the effects of TASER devices. The paper also reviews research into use of TASER devices and raises issues about conflict of interest in research into TASER devices. We conclude that TASER devices look set to play a significant role in policing in the future. We make suggestions for a future research programme, and suggest guidelines for publication of papers in which there may be a conflict of interest.
Collapse
Affiliation(s)
- Anthony J O'Brien
- Centre for Mental Health Research, University of Auckland, Private Bag 92019, Auckland, New Zealand.
| | - Katey Thom
- Centre for Mental Health Research, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| |
Collapse
|
16
|
|
17
|
Maher PJ, Beck N, Strote J. Pneumomediastinum and pulmonary interstitial emphysema after tracheal taser injury. Emerg Med J 2013; 32:90. [DOI: 10.1136/emermed-2013-203160] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
18
|
Cheek S, Shifflette V, Dunn E. Foreign Body Removal: A Shocking Story. Am Surg 2013. [DOI: 10.1177/000313481307900119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | | | - Ernest Dunn
- Methodist Dallas Medical Center Dallas, Texas
| |
Collapse
|
19
|
Bozeman WP, Teacher E, Winslow JE. Transcardiac Conducted Electrical Weapon (TASER) Probe Deployments: Incidence and Outcomes. J Emerg Med 2012; 43:970-5. [DOI: 10.1016/j.jemermed.2012.03.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Revised: 12/21/2011] [Accepted: 03/20/2012] [Indexed: 10/28/2022]
|
20
|
Penders TM, Gestring RE, Vilensky DA. Excited delirium following use of synthetic cathinones (bath salts). Gen Hosp Psychiatry 2012; 34:647-50. [PMID: 22898445 DOI: 10.1016/j.genhosppsych.2012.06.005] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Revised: 06/11/2012] [Accepted: 06/12/2012] [Indexed: 02/04/2023]
Abstract
Synthetic analogs of the cathinone molecule have seen increasing recreational use as substitutes for cocaine, 3,4-methylenedioxymethamphetamine (ecstasy) and methamphetamine. Repeated use of these drugs is associated with a paranoid hallucinatory delirium. A subset of patients using these substances develops a syndrome of extreme agitation and violent behavior that has been reported following the use of other stimulant drugs that also produce rapid changes in brain monoamines. This syndrome, characterized as "excited delirium," presents to the acute care setting with a challenging combination of paranoia, severe agitation and violent behavior. These patients frequently suffer from dehydration, skeletal muscle damage and renal failure that may lead to multiorgan failure and death. Management of these individuals requires careful consideration of the consequences of interventions commonly implemented in medical settings to control dangerous aggressive behavior.
Collapse
Affiliation(s)
- Thomas M Penders
- Department of Psychiatric Medicine, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA.
| | | | | |
Collapse
|
21
|
Kunz S. Author's Response. J Forensic Sci 2012. [DOI: 10.1111/j.1556-4029.2012.02226.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Sebastian Kunz
- IFFB Gerichtsmedizin und Forensische Neuropsychiatrie; Paris-Lodron Universität Salzburg-Linz; Ignaz-Harrer-Str. 79 5020 Salzburg Austria
| |
Collapse
|
22
|
Ben Ahmed H, Bouzouita K, Selmi K, Chelli M, Mokaddem A, Ben Ameur Y, Boujnah MR. [Myocardial infarction after conduction electrical weapon shock]. Ann Cardiol Angeiol (Paris) 2012; 62:124-6. [PMID: 22551781 DOI: 10.1016/j.ancard.2012.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Accepted: 03/22/2012] [Indexed: 11/17/2022]
Abstract
Controversy persists over the safety of conducted electrical weapons, which are increasingly used by law enforcement agencies around the world. We report a case of 33-year-old man who had an acute inferior myocardial infarction after he was shot in the chest with an electrical weapon.
Collapse
Affiliation(s)
- H Ben Ahmed
- Service de cardiologie, CHU Mongi Slim La Marsa, 2046 Sidi Daoud La Marsa, Tunis, Tunisie.
| | | | | | | | | | | | | |
Collapse
|
23
|
Zipes DP. Sudden cardiac arrest and death following application of shocks from a TASER electronic control device. Circulation 2012; 125:2417-22. [PMID: 22547671 DOI: 10.1161/circulationaha.112.097584] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND 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. METHODS AND RESULTS 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. CONCLUSIONS 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.
Collapse
Affiliation(s)
- Douglas P Zipes
- Krannert Institute of Cardiology, Indiana University School of Medicine, 1800 N Capitol Ave, Indianapolis, IN 46032, USA.
| |
Collapse
|
24
|
Vilke GM, Sloane CM, Chan TC. Clarification of funding sources in "Electronic control device exposures: a review of morbidity and mortality". Ann Emerg Med 2012; 59:336. [PMID: 22449355 DOI: 10.1016/j.annemergmed.2011.11.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Revised: 11/03/2011] [Accepted: 11/03/2011] [Indexed: 11/29/2022]
|
25
|
Kunz SN, Grove N, Fischer F. Acute pathophysiological influences of conducted electrical weapons in humans: A review of current literature. Forensic Sci Int 2012; 221:1-4. [PMID: 22421323 DOI: 10.1016/j.forsciint.2012.02.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Revised: 01/06/2012] [Accepted: 02/17/2012] [Indexed: 11/25/2022]
Abstract
Conducted electrical weapons (CEWs) deliver short high-voltage, low current energy pulses to temporarily paralyze a person by causing muscular contraction. The narrative of this article is a methodical analysis on acute pathophysiological changes within the central nervous system, cardiovascular, neuroendocrine, sympatho-adrenergic and muskuloskeletal system which can occur after application of conducted electrical weapons on human subjects. The results are based on wide-ranging literature analysis and source studies. The majority of the recent scientific publications on humans classify the health risks of an appropriate use of the CEWs device as minor. However, there still is an uncertainty about possible side-effects of these devices. Therefore medical supervision with human application is advised.
Collapse
Affiliation(s)
- S N Kunz
- Department of Forensic Medicine, Ludwig-Maximilians-University, Munich, Germany.
| | | | | |
Collapse
|
26
|
Vilke GM, Sloane CM, Chan TC. "Funding source and author affiliation in TASER research are strongly associated with a conclusion of device safety". Am Heart J 2012; 163:e5; author reply e9. [PMID: 22424027 DOI: 10.1016/j.ahj.2011.12.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
27
|
Kroll MW, Fish RM, Lakkireddy D, Luceri RM, Panescu D. Essentials of low-power electrocution: established and speculated mechanisms. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2012; 2012:5734-5740. [PMID: 23367232 DOI: 10.1109/embc.2012.6347297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Even though electrocution has been recognized--and studied--for over a century, there remain several common misconceptions among medical professional as well as lay persons. This review focuses on "low-power" electrocutions rather than on the "high-power" electrocutions such as from lightning and power lines. Low-power electrocution induces ventricular fibrillation (VF). We review the 3 established mechanisms for electrocution: (1) shock on cardiac T-wave, (2) direct induction of VF, and (3) long-term high-rate cardiac capture reducing the VF threshold until VF is induced. There are several electrocution myths addressed, including the concept--often taught in medical school--that direct current causes asystole instead of VF and that electrical exposure can lead to a delayed cardiac arrest by inducing a subclinical ventricular tachycardia (VT). Other misunderstandings are also discussed.
Collapse
Affiliation(s)
- Mark W Kroll
- Biomedical Engineering Dept., University of Minnesota, Minneapolis, MN, USA.
| | | | | | | | | |
Collapse
|
28
|
Kunz SN, Adamec J, Zinka B, Münzel D, Noël PB, Eichner S, Manthei A, Grove N, Graw M, Peschel O. Wound ballistic evaluation of the Taser® XREP ammunition. Int J Legal Med 2011; 127:119-26. [PMID: 21984167 DOI: 10.1007/s00414-011-0628-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Accepted: 09/26/2011] [Indexed: 11/30/2022]
Abstract
The Taser® eXtended Range Electronic Projectile (XREP®) is a wireless conducted electrical weapon (CEW) designed to incapacitate a person from a larger distance. The aim of this study was to analyze the ballistic injury potential of the XREP. Twenty rounds were fired from the Taser®X12 TM shotgun into ballistic soap covered with artificial skin and clothing at different shooting distances (1-25 m). One shot was fired at pig skin at a shooting distance of 10 m. The average projectile velocity was 67.0 m/s. The kinetic energy levels on impact varied from 28-52 J. Depending on the intermediate target, the projectiles penetrated up to 4.2 cm into the ballistic soap. On impact the nose assembly did not separate from the chassis, and no electrical activation was registered. Upon impact, a skin penetration of the XREP cannot be excluded. However, it is very unlikely at shooting distances of 10 m or more. Clothing and a high elasticity limit of the target body area can significantly reduce the penetration risk on impact.
Collapse
Affiliation(s)
- Sebastian N Kunz
- Institut für Rechtsmedizin, Ludwig-Maximilians-Universität München, Munich, Germany.
| | | | | | | | | | | | | | | | | | | |
Collapse
|