Electronic control devices

We are members of the TASER International Scientific and Medical Advisory Board, and we would like to comment on the recent CMAJ editorial on tasers.1 Essentially every implication of the editorial was either erroneous or misleading. Only 4 of the 16 references were from the medical literature; most of the rest were newspaper articles.

The implication that TASER International asserts that a TASER electronic control device has never contributed to a death is erroneous. There are at least 6 cases of deaths from head injuries resulting from falls in which an electronic control device may have contributed to the fall, and TASER International warns of this risk in its training materials. Aside from these cases, we stand by TASER International's position that electronic control devices have never directly killed anyone.

The statement that TASER International has sponsored “just about all” of the research on electronic control devices is erroneous; 12 of the 17 published peer-reviewed human studies had no funding from TASER International. (They cannot be listed here because of the CMAJ's space restrictions.)

The editorial stated that volunteers are almost never shocked in the chest or given sustained shocks. This was true in early studies but not in more recent studies.2^,3

The editorial also stated that members of the TASER International Scientific and Medical Advisory Board attempt to hide their associations with TASER International. This is untrue, as demonstrated by a letter published in the Journal of the American College of Cardiology.4

The statement (referencing a newspaper article) that TASER International has sued researchers for publishing their scientific results is untrue. The newspaper article was about James Ruggieri, who claimed, not in a peer-reviewed journal but in a bulletin of a small trade group of professional expert witnesses, that there would be a 50% fatality rate with use of a TASER electronic control device, on the basis of mysterious measurements and calculations. He also suggested that patients with cardiomyopathy should not comb their hair, remove their clothing or walk across carpeting because a static shock might induce fibrillation.

TASER International and the City of Akron, Ohio, did jointly go to court under a state law that allows for independent judicial review of the opinions of medical examiners. This court case concerned an extreme situation in which the medical examiner consistently (in 3 cases) ruled that the use of an electronic control device constituted homicide, leading to criminal charges against several sheriff's deputies. After a 4-day legal proceeding in which numerous experts testified (including 3 forensic pathologists and 2 cardiac electrophysiologists), the judge ordered striking of the electronic control device as the cause of death and homicide as the manner of death.

The implication that TASER electronic control devices are a risk factor for deaths from excited delirium is erroneous. The editorialist gives no reference for this speculation nor can he, as excited delirium was recognized as a condition long before electronic control devices were invented.5^–7 Even today, electronic control devices are involved in only a small minority of deaths from excited delirium.8^,9

The implication that a defibrillator should be used to treat excited delirium is incorrect. When death occurs with this disorder, with or without the involvement of an electronic control device, the presenting rhythm is characteristically asystole or pulseless electrical activity.9^–11 Defibrillation reverses fibrillation and therefore has no clinical indication in cases of excited delirium.