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 Criminal Justice
Recent Scholarship

Edited by
Nicholas P. Lovrich
Copyright © 2015. LFB Scholarly Publishing LLC. All rights reserved.

A Series from LFB Scholarly

Williams, Howard E.. TASERs and Arrest-Related Deaths, LFB Scholarly Publishing LLC, 2015. ProQuest Ebook
Copyright © 2015. LFB Scholarly Publishing LLC. All rights reserved.

Williams, Howard E.. TASERs and Arrest-Related Deaths, LFB Scholarly Publishing LLC, 2015. ProQuest Ebook
 TASERs and Arrest-Related
Deaths

Howard E. Williams
Copyright © 2015. LFB Scholarly Publishing LLC. All rights reserved.

LFB Scholarly Publishing LLC

El Paso 2015

Williams, Howard E.. TASERs and Arrest-Related Deaths, LFB Scholarly Publishing LLC, 2015. ProQuest Ebook
 Copyright © 2015 by LFB Scholarly Publishing LLC

All rights reserved.

Library of Congress Cataloging-in-Publication Data

Library of Congress Cataloging-in-Publication Data

Williams, Howard E., author.

TASERs and arrest-related deaths / Howard E. Williams.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-59332-788-0 (hardcover : alk. paper)
I. Title.
[DNLM: 1. Autopsy--methods--United States. 2. Forensic
Pathology--methods--United States. 3. Conducted Energy Weapon
Injuries--mortality--United States. 4. Death, Sudden--etiology--United
Copyright © 2015. LFB Scholarly Publishing LLC. All rights reserved.

States. 5. Police--United States. W 825]

RB57
RA1063.4--dc23
2014039078

ISBN 978-1-59332-788-0

Manufactured in the United States of America.

Williams, Howard E.. TASERs and Arrest-Related Deaths, LFB Scholarly Publishing LLC, 2015. ProQuest Ebook
 Table of Contents

List of Tables ........................................................................................ vi

List of Figures ...................................................................................... vii
List of Acronyms and Abbreviations .................................................... ix
Acknowledgements .............................................................................xiii
Preface .......................................................................................... xv
Chapter 1: Arrest-Related Sudden Death and High-Risk Group
Theory ................................................................................ 1
Chapter 2: What We Know About Arrest-Related Sudden Death ...... 19
Chapter 3: What We Know About TASER Technology .................... 39
Chapter 4: Testing High-Risk Group Theory...................................... 87
Copyright © 2015. LFB Scholarly Publishing LLC. All rights reserved.

Chapter 5: Research Findings ........................................................... 105

Chapter 6: Implications and Conclusions ......................................... 137
Appendix A: Search Terms ................................................................ 157
Appendix B: Coding Instrument ....................................................... 159
Appendix C: Coding Instrument Instructions ................................... 163
Appendix D: STATA Regression Model Tables .............................. 169
Glossary ........................................................................................ 173
References ........................................................................................ 181
Cases Cited ........................................................................................ 207
Index ........................................................................................ 209

Williams, Howard E.. TASERs and Arrest-Related Deaths, LFB Scholarly Publishing LLC, 2015. ProQuest Ebook
 List of Tables

Table 1. Ratio of ECD Arrest-Related Sudden Deaths by Year......... 107

Table 2. Logistic Regression Analysis of Attribute Data................... 109
Table 3. Age Data for Arrest-Related Sudden Deaths ....................... 111
Table 4. χ2 Contingency Table for Sex .............................................. 112
Table 5. χ2 Contingency Table for Race/Ethnicity ............................. 113
Table 6. χ2 Contingency Table for Cardiovascular Disease ............... 114
Table 7. χ2 Contingency Table for Drugs Present .............................. 116
Table 8. χ2 Contingency Table for Amphetamines Present................ 117
Table 9. χ2 Contingency Table for Cocaine Present........................... 118
Copyright © 2015. LFB Scholarly Publishing LLC. All rights reserved.

Table 10. χ2 Contingency Table for Marijuana Present ..................... 119

Table 11. χ2 Contingency Table for Opiates Present.......................... 119
Table 12. χ2 Contingency Table for PCP Present............................... 120
Table 13. χ2 Contingency Table for History of Drug Abuse .............. 121
Table 14. χ2 Contingency Table for Excited Delirium ....................... 122
Table 15. χ2 Contingency Table for Alcohol Present ......................... 123
Table 16. χ2 Contingency Table for Chronic Alcohol Abuse............. 124
Table 17. χ2 Contingency Table for Mental Illness ............................ 126
Table 18. χ2 Contingency Table for Psychotropic Medications ......... 127
Table 19. csQCA Case Configurations by Cell Frequency ................ 129
Table 20. Summary of Findings......................................................... 136

vi

Williams, Howard E.. TASERs and Arrest-Related Deaths, LFB Scholarly Publishing LLC, 2015. ProQuest Ebook
 List of Figures

Figure 1. Total Arrest-Related Sudden Deaths by Year..................... 106

Figure 2. Non-ECD versus ECD-Proximate Arrest-Related
Sudden Deaths by Year...................................................... 106
Copyright © 2015. LFB Scholarly Publishing LLC. All rights reserved.

vii

Williams, Howard E.. TASERs and Arrest-Related Deaths, LFB Scholarly Publishing LLC, 2015. ProQuest Ebook
Copyright © 2015. LFB Scholarly Publishing LLC. All rights reserved.

Williams, Howard E.. TASERs and Arrest-Related Deaths, LFB Scholarly Publishing LLC, 2015. ProQuest Ebook
 List of Acronyms and
Abbreviations

AED Automatic external defibrillator

AH History of amphetamine use
AP Amphetamine present
BJS Bureau of Justice Statistics
BPM Beats per minute
C Centigrade
CH History of cocaine use
CI Confidence interval
cm Centimeter
CO2 Carbon dioxide
Copyright © 2015. LFB Scholarly Publishing LLC. All rights reserved.

Con Consistency
CONS Constant
CP Cocaine present
csQCA Crisp set Qualitative Comparative Analysis
CT Computed tomography
CVD Cardiovascular disease
d Cohen’s d
DAP Drugs present
DCRP Deaths in Custody Reporting Program
dL Deciliter
DOMILL Defence Scientific Advisory Sub-Committee on
Less-Lethal Weapons
ECD Electronic control device
ETOH Alcohol present
ExDS Excited delirium syndrome
F Fahrenheit
FBI Federal Bureau of Investigation

ix

Williams, Howard E.. TASERs and Arrest-Related Deaths, LFB Scholarly Publishing LLC, 2015. ProQuest Ebook
 x List of Acronyms and Abbreviations

Freq Frequency
fsQCA Fuzzy set Qualitative Comparative Analysis
HCAA History of chronic alcohol abuse
HDA History of drug abuse
HPA Hypothalamus-pituitary-adrenal
ICD Implantable cardioverter-defibrillator
j Joule
K Kappa
kg Kilograms
L Liter
LH History of LSD use
LP LSD present
LR Likelihood ratio
m Minute
mA Milliamp
MDMA 3,4-methylenedioxy-4- methamphetamine
mg Milligram
MH History of marijuana use
MI Myocardial infarction
mL Milliliter
mm Millimeter
MNIL Mental illness plus psychotropic medications
Copyright © 2015. LFB Scholarly Publishing LLC. All rights reserved.

MP Marijuana present
ms Millisecond
MT Mental illness
mvQCA Multiple value Qualitative Comparative Analysis
µC Microcoulomb
µs Microsecond
ng Nanogram
NVDRS National Violent Death Reporting System
O2 Oxygen
OC Oleoresin capsicum
OH History of opiates use
OP Opiates present
O.R. Odds ratio
pCO2 Partial pressure of carbon dioxide
PEA Pulseless electrical activity
PERF Police Executive Research Forum
PH History of PCP use

Williams, Howard E.. TASERs and Arrest-Related Deaths, LFB Scholarly Publishing LLC, 2015. ProQuest Ebook
 List of Acronyms and Abbreviations xi

PMED Psychotropic medications

pO2 Partial pressure of oxygen
PP PCP present
PPS Pulses per second
QCA Qualitative Comparative Analysis
r Effect size correlation
RR Respiration rate
SAM Sympathetic-adrenal-medulla
TdP Torsade de pointes
UCR Uniform Crime Reports
V Volt
VF Ventricular fibrillation
VT Ventricular tachycardia
WISQRS Web-Based Injury Statistics Query and Reporting
System
WODER Wide-Ranging Online Data for Epidemiologic Re-
search
χ2 Chi-square
Copyright © 2015. LFB Scholarly Publishing LLC. All rights reserved.

Williams, Howard E.. TASERs and Arrest-Related Deaths, LFB Scholarly Publishing LLC, 2015. ProQuest Ebook
Copyright © 2015. LFB Scholarly Publishing LLC. All rights reserved.

Williams, Howard E.. TASERs and Arrest-Related Deaths, LFB Scholarly Publishing LLC, 2015. ProQuest Ebook
 Acknowledgements

I wish, first, to thank Joycelyn Pollock, J. Pete Blair, Brian Withrow,

and Michael D. White for their assistance in designing and developing
this research. I sincerely appreciate their diligence, their thoroughness,
their candor, and their patience as I conceptualized and then conducted
the study reported here. Additionally, Kelly Williams and Nick
Icossipentarhos volunteered many hours of their valuable time to code
reports.
Most importantly, I thank my wife, Kelly, for thirty years of love
and support. She sacrifices much to accommodate my careers in law
enforcement and academics. I could not succeed in either endeavor
without her, and I am forever indebted to her.
Copyright © 2015. LFB Scholarly Publishing LLC. All rights reserved.

xiii

Williams, Howard E.. TASERs and Arrest-Related Deaths, LFB Scholarly Publishing LLC, 2015. ProQuest Ebook
Copyright © 2015. LFB Scholarly Publishing LLC. All rights reserved.

Williams, Howard E.. TASERs and Arrest-Related Deaths, LFB Scholarly Publishing LLC, 2015. ProQuest Ebook
 Preface

TASER electronic control devices (ECDs), manufactured by TASER

International, Inc. in Scottsdale, Arizona, have become a popular tool
for law enforcement. TASER International has sold more than 710,000
devices to 16,880 agencies in 107 countries. Although other manufac-
turers produce comparable types of electro-shock weapons, TASER
products are the most commonly used in the United States and world-
wide.
Unfortunately, more than 900 people worldwide have died unex-
pectedly following law enforcement officers’ uses of TASER ECDs.
Currently, there is no research definitively establishing a causal rela-
tionship between the use of an ECD and the death of a person exposed
to it. However, some recent studies suggest that application of TASER
Copyright © 2015. LFB Scholarly Publishing LLC. All rights reserved.

technology is responsible for sudden unexpected deaths. The ever in-

creasing number of deaths following application of TASER ECDs and
the growing number of cases wherein a coroner or medical examiner
attribute the use of an ECD as a cause of death or as a significant con-
tributing factor to the death raise legitimate concerns about the safety
threshold of the devices.
Researchers have proposed and tested many theories of why peo-
ple die following the application of ECDs, including direct electro-
stimulation of cardiac muscle, interference with breathing, and meta-
bolic changes resulting in acidosis. Thus far, human model experi-
ments have produced no evidence to support these theories. Another
theory, which has recently appeared in the literature, has received no
empirical testing—the theory of high-risk groups. High-risk group
theory postulates that elderly people, young children, people with pre-
existing cardiovascular disease, people with pacemakers and implanta-
ble cardioverter-defibrillators, people under the influence of drugs (am-
phetamines, cocaine, lysergic acid diethylamide, marijuana, opiates,

xv

Williams, Howard E.. TASERs and Arrest-Related Deaths, LFB Scholarly Publishing LLC, 2015. ProQuest Ebook
 xvi Preface

and/or phencyclidine) or with a history of drug abuse, people intoxicat-

ed from alcohol or with a history of chronic alcohol abuse, people un-
der extreme psychological distress or who exhibit signs of excited de-
lirium, people who are mentally ill or taking psychotropic medications,
people subjected to repeated or multiple applications, and pregnant
women are at a heightened risk of serious injury or death following
application of a TASER ECD.
What the current literature fails to consider is that the same physio-
logical attributes that are presumed to render members of high-risk
groups more vulnerable to serious injury or death following application
of a TASER ECD might render these same people more vulnerable to
serious injury or death regardless of the tactics or weapons that officers
use to subdue them. If that hypothesis is correct, the use of TASER
ECDs on people in high-risk groups might be irrelevant to arrest-
related sudden deaths.
The potential for fatal adverse effects on high-risk groups when us-
ing other less lethal tactics and methods versus the potential for fatal
adverse effects on high-risk groups following the use of a TASER ECD
is currently unknown. Thus far, research has not directly addressed that
question. By examining autopsy and toxicology reports of the deceased
and comparing differences in the physiological attributes of arrest-
related sudden deaths, one can then estimate whether a difference exists
Copyright © 2015. LFB Scholarly Publishing LLC. All rights reserved.

in high-risk group attributes between deaths proximate to the use of a

TASER ECD and deaths not involving the use of an ECD.
This study examines physiological attributes in arrest-related sud-
den deaths. An arrest-related sudden death is a death that occurs fol-
lowing a collapse within 24 hours after the initial arrest or detention.
The death must be unexpected, must not be the result of trauma or inju-
ry that a layperson could readily discern needs medical attention, and
must follow a sudden change in clinical condition or the beginning of
symptoms from which the deceased does not recover. It does not in-
clude ovious trauma deaths, police shootings, or suicides.
This work was a retrospective open source research study of pub-
licly available autopsy and toxicology reports designed to compare the
physiological attributes of high-risk group theory to two groups of ar-
rest-related sudden deaths, TASER ECD-proximate deaths and non-
ECD deaths. A non-proportional stratified random sample of 300 pub-
licly available reports was obtained for study and coded for physiologi-
cal attributes of high-risk groups. Descriptive and inferential quantita-

Williams, Howard E.. TASERs and Arrest-Related Deaths, LFB Scholarly Publishing LLC, 2015. ProQuest Ebook
 Preface xvii

tive statistics, specifically Student’s t-test, Pearson’s chi-square, and

bivariate logistic regression (logit) were used to analyze the data and
compare attributes for any significant differences observed. Addition-
ally, crisp set Qualitative Comparative Analysis (csQCA) was used to
examine whether any configuration of causal conditions described a
unique path to arrest-related sudden death following application of a
TASER ECD.
The study included data on 1,060 arrest-related sudden deaths that
occurred in the United States between January 1, 2006 and December
31, 2011. The results indicate that the physiological attributes of
TASER-proximate deaths look much like the attributes in non-ECD
deaths. The one notable exception was the statistically significant dif-
ference in deaths involving excited delirium syndrome.
Copyright © 2015. LFB Scholarly Publishing LLC. All rights reserved.

Williams, Howard E.. TASERs and Arrest-Related Deaths, LFB Scholarly Publishing LLC, 2015. ProQuest Ebook
Copyright © 2015. LFB Scholarly Publishing LLC. All rights reserved.

Williams, Howard E.. TASERs and Arrest-Related Deaths, LFB Scholarly Publishing LLC, 2015. ProQuest Ebook
 CHAPTER 1

Arrest-Related Sudden Death and

High-Risk Group Theory

TASER® electronic control devices, manufactured by TASER Interna-

tional, Inc. in Scottsdale, Arizona, have become a popular tool for law
enforcement since Jack Cover patented and sold the first device in 1974
(Smith, 2006).1 Almost 40 years of technological development have
produced several generations of TASER products. Earlier generation
devices included the TF-76TM, the TASERTRONTM, the AIR TASER
34000TM, the M18TM, the ADVANCED TASER® M26TM, and, briefly,
the XREPTM. Only the later generation models, the X26TM, the X2TM,
the X3TM, and the C2TM, were in production at the end of 2012.2 By the
Copyright © 2015. LFB Scholarly Publishing LLC. All rights reserved.

end of that year, TASER International had sold more than 710,000 de-
vices to 16,880 law enforcement and corrections agencies in 107 coun-
tries (Kukowski, 2012). Terrill, Paoline, and Ingram (2012), in a na-
tional survey of police agencies, found that approximately 80 percent of
the 662 responding agencies in the United States reported that they
were using electronic control devices.
Although other manufacturers produce comparable types of elec-
tro-shock weapons, TASER products are the most commonly used in
the United States and worldwide, and TASER technology has under-
gone the most extensive domestic and international scientific testing

1
TASER® and ADVANCED TASER® are trademarks of TASER Internation-
al, Inc., registered in the United States. All rights reserved.
2
TF-76TM, TASERTRONTM, AIR TASER 34000TM, M18TM, M26TM,
XREPTM, X26TM, X2TM, X3TM, and C2TM are trademarks of TASER Interna-
tional, Inc.
1

Williams, Howard E.. TASERs and Arrest-Related Deaths, LFB Scholarly Publishing LLC, 2015. ProQuest Ebook
 2 TASERs and Arrest-Related Deaths

related to its safety, efficacy, and risk utility (Peters, 2006). Conse-
quently, because other manufacturers use different electro-shock tech-
nologies, because so few deaths have followed the application of other
manufacturers’ products, and because there is so little research on the
effects of other electronic control technologies, this study examines
only the effects of TASER-brand name devices. Any death involving
another brand name device will not be a death related to a TASER elec-
tronic control device, although, depending on the circumstances, it
might be an arrest-related sudden death.
Researchers and authors have used many terms to describe TASER
products, including neuromuscular incapacitating devices, conducted
energy weapons, conductive electrical devices, electronic control
weapons, and electronic control devices. For the sake of simplicity, the
term electronic control device and its acronym ECD are used here.
The TASER X26, the X2, and the X3 are the models that law en-
forcement agencies now use almost exclusively. These devices deliver
a five-second electrical charge of 19 pulses per second (PPS), each
pulse lasting approximately 100 microseconds (µs). The average peak
loaded voltage over the duration of the main phase is 1200 volts (V),
with an average over the full phase of about 350 V. The electrical cur-
rent averages 2.1 milliamps (mA) and delivers about 0.07 joules (J) of
energy into the load. The device also generates an open-circuit voltage
Copyright © 2015. LFB Scholarly Publishing LLC. All rights reserved.

of up to 50,000 V to arc through air or through thick clothing, but the

ECD does not deliver 50,000 V to the body (Kroll, 2009; Kunz, Zinka,
Fieseler, Graw, and Peschel, 2012).
TASER ECDs operate in three ways: probe mode, drive-stun
mode, and a hybrid mode. The probe mode uses compressed nitrogen
to propel two electrodes toward a target. A pseudo-monophasic wave-
form electrical signal transmits through connected wires to where the
probes make contact with the body or with clothing. A pseudo-
monophasic pulse is a biphasic pulse in which the second phase dura-
tion is much greater than the first. Optimal results of the probe mode
include immediate loss of neuromuscular control and loss of the ability
to coordinate muscular actions for the five-second duration of the elec-
tric impulse (Panescu, Kroll, and Stratbucker, 2009).
The drive-stun mode results from pressing the electrodes of the
ECD directly to the skin, thus stimulating A-δ neural fibers to produce
a sensation of sharp pain and, thereby, to promote compliance. In the

Williams, Howard E.. TASERs and Arrest-Related Deaths, LFB Scholarly Publishing LLC, 2015. ProQuest Ebook
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