Anti-Police Group Fund-Raising “Studies” are Pure Junk Science.

Summary

Why do some people succumb to sudden unexpected and unforeseeable death while encountering law enforcement officers? We all want answers and we all want to blame something. Often, some people seek to blame a single cause temporal to the person’s death, while most often the causation of death is actually multi-factorial and is usually chronic rather than acute. Resisting arrest and consuming illegal drugs, especially over a long period of time, is dangerous and often leads to “excited delirium”-type deaths, which is the most likely explanation for this sad death.

The fact that the TASER device was used in attempts to control someone to save their life is not why they died.

Causation vs. Correlation

Why does the sun come up after the rooster crows? If you think that the rooster’s crow caused the sun to come up you have committed the post hoc ergo propter hoc logical fallacy. The statement “post hoc ergo propter hoc” is Latin for “after this therefore because of this.” You put your coat on before you go out on a winter day. Do you think your coat caused the air to turn cold? That is why some reporters lacking both scientific training and an understanding of statistics may see causations where there is none.[i]^,[ii]^,[iii] 

About 20,000 Americans die annually of drug-related causes according to the Center for Disease Control.[iv]  A cocaine overdose death is not a peaceful sleepy death like one from heroin – especially if the individual is a chronic abuser. It is violent, disturbing, and with bizarre behavior.[v] It is also ugly, sad and tragic. The methamphetamine epidemic is also causing a rapidly increasing number of stimulant deaths which may top those of cocaine. The end-stage of chronic cocaine or methamphetamine usage is a fairly consistent sequence of events typically referred to “excited delirium.”[vi]^,[vii]^,[viii] These same symptoms can also be seen in violent struggle deaths triggered by a psychiatric episode.[ix]^,[x] This has been recognized as far back as before the American Civil War.[xi]  

A decade ago, these in-custody-deaths were blamed on pepper spray. “Pepper Spray: A Magic Bullet under Scrutiny.”[xii] In that report, the American Civil Liberties Union (ACLU) of Southern California documented seven fatalities after the use of pepper spray in a nine-month period. Now the TASER devices are being seen as a simple, “obvious” scapegoat for these tragic deaths.

If a person with normal mental function has excessive exertion, that individual’s brain will recognize the signals that the blood is getting acidic and will force the body to slow down. If someone’s mental functioning is such that this feedback signal is ignored, the person may struggle until they die.[xiii] Thus, excited delirium can kill by making the blood so acidic that nothing can function.[xiv]^,[xv] The typical features of excited delirium are agitation, incoherence, hyperthermia, paranoia, displays of public nudity, violent aggression, attraction to glass and lights, constant motion, and feats of incredible strength right up to death.[xvi] The main causes are chronic, illicit stimulant abuse, presence of certain mental health conditions, and also use of certain mental health medications.[xvii]^,[xviii] Sadly, some cases are also due to severe mental illness and the refusal to take prescribed medications.

When someone is dying this horrible death described as excited delirium, they usually exhibit bizarre, unusual, and violent resistive behavior which often attracts attention. Law enforcement personnel are then called and they have to deal with this syndrome for which no good or accepted protocols or treatment have been agreed upon.[xix]

Studies of excited delirium deaths show that the majority of the cases have no TASER device involvement.[xx]  Citizen Down, another law enforcement “watchdog” group, estimates that 1,000 American citizens die in law enforcement custody each year. About 50% of the U.S. law enforcement agencies have at least some TASER devices. If the TASER device-carrying officers were to be always called to deal with these violent cases then one would estimate 500 “TASER-related” deaths per year. Consider a much more conservative estimate and take just the 12% of officers, across the country, who carry TASER devices on their belts. That would give a very conservative estimate of 120 “TASER-related” deaths per year. The clear and inescapable conclusion is that the TASER devices are being blamed for less than their theoretical share of “related” deaths and thus may well be reducing the incidence of in-custody-deaths.

In fact, every study by law enforcement agencies adopting TASER devices has shown that the arrest-related death and injury rate goes down — not up![xxi] 

Examining the Examiners

Why have a few medical examiners indicated that TASER devices were a cause of death, a contributing factor in a death, or could not be ruled out as a cause of death? Even if every death in which the  TASER device is even mentioned —was  assumed to actually be the fault of the TASER device — then it would appear to be an amazingly safe weapon. Around 27 deaths out of about 550,000 estimated uses indicates that the theoretical death rate is about 1 in 20,000. But, even those few cases exaggerate the role of the TASER devices in any deaths.

Medical examiners cannot detect electricity in the body after a shock like they can detect drugs or bullets. So, they sometimes take a politically safe approach and make the meaningless statement that, “The role of the TASER was undetermined,” or “… could not be ruled out.” This can be an honest admission by a medical examiner (ME) of knowing nothing about electricity. They are trained to detect poisons and physical injury and disease.

Also, in many such death cases the ME does not perform the investigation or the tests that could actually assist in proving causality of death. The examiners often do not examine the striatal dopamine transporter levels in the brain,[xxii] nor do they perform hair analysis for indications of chronic drug abuse. Nor do many of the examiners perform psychological autopsies to gain additional information that could lead them to other possible contributors or causations of death. This may be for budgetary reasons or time constraints. Also, there is no great societal pressure to expend large amounts of time and money precisely investigating the death of a drug addict or street criminal.

A death from excited delirium, in the chronic drug abuser, will often occur at a point when the drug itself has been metabolized (processed) and thus is not detectable in the blood.[xxiii] Or, it is detectable at a fairly low level not fatal for an acute usage. The tests to determine chronic drug usage are tricky, expensive, and time consuming. At a minimum they require a quick freezing of the brain so that it can be analyzed for the modifications from long-term drug use. This is generally not done.

Very rarely do the medical examiners affirmatively list the TASER device as a contributing factor. In those rare cases, TASER has presented the autopsy and law enforcement records to cardiac electrophysiologists, experts in excited delirium, and other specialists. In every case analyzed to date, the medical experts have concluded that the medical examiners erred in their conclusions. The most common mistakes made by the examiners were: (1) failure to appreciate the timing of electrocution, and (2) failure to adequately test for excited delirium. Since electrocution is instantaneous (seconds), cases in which death occurred minutes or hours after the TASER application are easy to eliminate by someone understanding fibrillation.

I performed a press search for the years 2001-2005 for cases of an SICD (Sudden in custody death) with a temporal TASER ECD association and obtained the autopsy reports. Working with other experts, we counted the number of errors found in the medical examiner reports.[xxiv]

As discussed above, sudden death from electrical discharge is caused by the induction of ventricular fibrillation (VF) and generally follows this sequence: (1) pulse disappears immediately, (2) there is loss of physical strength for continued resistance, (3) collapse occurs within 5-20 seconds, (4) VF rhythm occurs, and (5) immediate defibrillation is usually successful. Any material failure to appreciate the above facts was scored as an error.

Other errors were counted if the medical examiner report reflected hypotheses not supported by known literature. These included: blaming the ECD for cardiac physical changes, inclusion of a publicity sensitive safe comment (e.g. “we were unable to eliminate the role” of the ECD), assuming prolonged ECD applications are more dangerous than other restraint techniques, claiming that ECDs impair breathing, presumption of a lethal synergy between stimulant drugs and the ECD, use of the ECD in the “drive stun” mode only since this involves current passing between the two very close electrodes and does not create any major body mass involvement. Finally, the use of the metaphorical “last straw” was scored as an error.

We found 27 cases where the autopsy report listed the ECD as a contributory or as an “unknown” factor. As expected, the rate of such reports appears to be growing at 2.6 per year (r²=.74, p = .06) due to increased adoption of the TASER ECDs.  Autopsy reports were reviewed for these cases and errors were tabulated.  The decedents were all male with mean age 35.6 ± 10.7 years (median = 32) which is consistent with recently reported SICD data.[xxv] We found a mean of 3.1 ± 1.2 scored errors per report with a range of 1-6. This rate was very stable across the study period. A sobering finding was the rate at which “last straw” was mentioned as a linkage in lieu of a scientific mechanism. Scored errors are listed in the following table:

Inverse Causation

An additional error is so common that there are riddles based on it. This is the error of the inverse causation. In fact, the best way to introduce this error is with a riddle.

“Why do I always find something in the last place that I look?”  After a brief reflection the answer is obvious: once someone finds sometimes they stop looking. Therefore they will always find that which is being sought in the last place they look. With the inverse causation thinking one would be tempted to ascribe the discovery to the fact that the article was hidden in the very last possible hiding place in the universe.

Lets go back to the rooster example. Why does the sun rise after the roster stops crowing? Does the sun, in fact, listen for a local rooster crowing to stop before it shows its shining face?  Obviously not.  The causation is the exact inverse.  The roster begins crowing with the first hint of sunlight refracted through the atmosphere and then stops.

Inverse causation thinking is often common with the media and others with law enforcement involved in-custody deaths. With excited delirium a person will often have superhuman strength and stamina until they stop breathing.  This is when they have their very short “quiet period” and they then quickly progress to a cardiac rhythm of asystole or (PEA) pulseless electrical activity.  During the quiet period the law enforcement officers are able to cease with restraint techniques and handcuff the person.  However, the person was already programmed to progress to a lethal cardiac arrhythmia of asystole or PEA and they now have a lethal cardiac arrhythmia.