Effects of TASER X26 in Swine R. Walter, A. Dennis, D. Valentino, K. Nagy, J. Winners, F. Bokhari, D. Wiley, K. Joseph, F. Starr, R.

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1 Effects of TASER X26 in Swine R. Walter, A. Dennis, D. Valentino, K. Nagy, J. Winners, F. Bokhari, D. Wiley, K. Joseph, F. Starr, R. Roberts Illinois Surgical Society May 7, 2007

3 TASER - How it Works Under no resistive load: 50,000 volts 19 pulses/sec 0.36 J/pulse or 6.8 J/sec 2.1 ma time averaged 140 µsec/ pulse ma = threshhold for VF > 2A = asystole Under physiologic resistive load: Waveform characteristics uncertain 10/11/2007 copyright 2006 free template from brainybetty.com 3

5 Risks Associated with TASER Use Police: Woman Dies After Police Use Taser On Her; Baltimore, April 25, 2007 Man Dies After Being Stunned By Taser; Three Gastonia police officers on administrative leave after a man dies from stun gun. Brooklyn Man, 38, Dies After Jolt From Police Taser; January 9, 2007 Suspect dies after HPD officers use Taser on him; A man died overnight after police stunned him with a Taser at a southwest Houston apartment. April 24, 2007 Akron, Taser maker oppose ruling, Medical examiner calls death homicide; April 15, 2007 Total 2007 deaths = 27 10/11/2007 copyright 2006 free template from brainybetty.com 5

6 Deaths Associated with TASER Use > 250 TASER related deaths Cause or Coincidence? Risk Factors: Drug interactions (meth, cocaine, alcohol, Rx) For particular individuals For darts in particular anatomic locations For multiple or lengthy discharges 10/11/2007 copyright 2006 free template from brainybetty.com 6

7 TI states: It appears that the TASER device output is incapable of inducing VF in adult human beings. Human studies show that the TASER does not affect the heart Long TASER applications do not affect the heart. There is absolutely zero cardiac effect from TASER applications to the back. This is not to say that there is a risk from using the TASER devices frontally. (last accessed 5/6/07) 10/11/2007 copyright 2006 free template from brainybetty.com 7

8 Existing Peer Reviewed Literature Few studies McDaniel et al 2005, PACE J. (pigs) No dysrhythmias observed Utilized custom TASER-like device Increased power 15x > standard X26 TASER to fibrillate a 30kg pig Ho et al 2006, Levine et al 2005 (human studies) No significant laboratory alterations Included CK, lactate, myoglobin No dysrhythmias were observed on EKG analysis 10/11/2007 copyright 2006 free template from brainybetty.com 8

9 Existing Literature Jauchem et al. 2006, Forensic Sci. Intl. Pigs Significant acidosis 1hr after TASER exposure No fibrillation Nanthakumar et al. 2006, J. Amer. Coll. Cardiol. Wu, Webster et al. 2007, IEEE Trans. Biomed. Eng. Pigs Potential risk for fatal dysrhythmia with TASER exposure 10/11/2007 copyright 2006 free template from brainybetty.com 9

10 Our Hypothesis Prolonged TASER X26 exposure in an animal model, using a trans-cardiac vector, would induce clinically significant metabolic acidosis and cardiovascular disturbances 10/11/2007 copyright 2006 free template from brainybetty.com 10

11 Animal Study / Swine Model 3-5 month-old Yorkshire pigs Weight kg N = 11 Experimental Group: 6 animals Sham Group: 5 animals Anesthesia: IV, ket/xyl with intubation Unmodified TASER X26 device Two discharges, each for 40 sec Reviewed and approved by IACUC 10/11/2007 copyright 2006 free template from brainybetty.com 11

13 Physiologic Parameters All Animals: HR, BP, SaO2 5 Lead ECG Rectal Temp Labs Direct Imaging: Thoracotomy (2) Echocardiography (4) Time Intervals Pre-shock (zero time) 5 min post-shock 15 min post-shock 30 min post-shock 60 min post-shock 24 hrs 48 hrs 72 hrs 10/11/2007 copyright 2006 free template from brainybetty.com 13

14 Laboratory Parameters Troponin I ph pco 2 HCO 3 Lactate Creatinine i-stat po 2 BE SaO 2 Glucose Hb Na +, K +,Ca ++ Myoglobin (ELISA) CK-MB (ELISA) 10/11/2007 copyright 2006 free template from brainybetty.com 14

15 Results 2 animals died immediately from shock-induced VF Surviving Animals A-V dyssynchrony observed in all animals (<30 sec) No dysrhythmias at 5 min post-discharge Increased heart rate: Peaked at 5 min post-shock Normalized at 24 hrs ECGs lost due to noise during shock Electrolytes No significant changes Myocardial capture in all animals (echo) Myocardial capture regardless of animal weight 10/11/2007 copyright 2006 free template from brainybetty.com 15

Direct Visualization - Thoracotomy 10/11/2007

23 Summary Trans-cardiac vector possible worst case scenario Fatal VF in 2 animals Vital signs, blood chemistry were significantly altered Temporary AV dyssynchrony post-discharge TnI elevations NS Reproducible capture of the myocardium Echo and thoracotomy Regardless of weight 10/11/2007 copyright 2006 free template from brainybetty.com 23

24 Conclusions TASER X26 captures myocardial rhythm with a trans-cardiac vector Severe metabolic and respiratory acidosis Resting animal model Risk of VF Further independent investigation needed Define specific risk factors associated with device 10/11/2007 copyright 2006 free template from brainybetty.com 24

25 Acknowledgments Staff of the Hektoen Animal Care Facility Des Plaines, IL Police Department Northern Illinois Police Alarm System Emergency Services Team (NIPAS EST) 10/11/2007 copyright 2006 free template from brainybetty.com 25

27 Electric Current Effects In Vivo Based on 60Hz AC Household Current ma Tetanic contraction ma Respiratory arrest ma Threshhold for VF ~1A Electroporation > 2A Asystole 10/11/2007 copyright 2006 free template from brainybetty.com 27

29 TASER Associated Deaths in Christopher Hernandez, 19, Fort Myers, FL January 3, Daniel Quick,??, Butte, Montana January 3, Calvin Thompson, 42, Gastonia, NC January 5, Douglas Ilten, 45, Fort Pierce, Florida January 6, Blondel Lassegue, 38, Queens, NY January 7, Pete Carlos Madrid, 44, Fresno, CA January 9, Keith Kallstrom, 56, Milan, Michigan January 17, Name not released, 45 Bradenton, FL January 25, Name not released,??, Huntington Park, CA January 29, 2007 Total = Christopher McCargo, 43, Chattanooga, TN February 3, Steven Krohn, 44, Mesa, Arizona February 11, Martin Mendoza, 43, Vista, California February 21, Giant man,??, New Brunswick, Canada February 27, Muszack Nazaire, 24, Collier County, Florida March 16, Randy Buckey, 42, Marion County, Ohio March 15, Ryan Lee Meyers, 40, Middle River, MD March 16, David Brown, 47, Park Forest, Illinois March 17, Andrew J. Athetis, 18, Gilbert, Arizona March 17, Not released, 40s, West Covina, California March 20, Sergio Galvan, 35, San Antonio, Texas March 23, Donjuall Gilliam, 22, Prattville, Alabama April 12, David Mills, 26, Hamden, Connecticut April 23, Jermaine Broomfield, 35, Charleston, NC April 23, Hispanic male?, 25, Houston, Texas April 23, Uywanda Peterson, 43, Baltimore, Maryland April 24, Roy Hamner, 59, Pearl, Mississippi May 1, Daniel Young, 33, Seminole, Florida May 5, /11/2007 copyright 2006 free template from brainybetty.com 29

Cardiac, Physiologic, and Real World Effects of Taser Use

Cardiac, Physiologic, and Real World Effects of Taser Use 1 June 2017 Conducted Energy Device Meeting San Francisco Police Department Zian H. Tseng, M.D., M.A.S. Murray Davis Endowed Professor Associate