TASER Electronic Control Devices and Cardiac Arrests: Coincidental or Causal?Response to Kroll et al
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Being arrested is a highly emotional event and can result in a fatal, adrenergically supercharged physiological state.1 The exertion of arrest-related struggle is several-fold greater than that seen with normal exercise and leads to numerous extreme metabolic and electrolytic derangements, including elevated levels of lactate, CO2, potassium, creatine kinase, and myoglobin.2 Only 1.6% of US law-enforcement interactions involve the use or threats of force, and annually there are ≈700 000 cases in which force is used or threatened.3 There are ≈700 arrest-related deaths per year in the United States, yielding a mortality rate of ≈1 in 1000 for a law-enforcement interaction associated with force.4
Response by Zipes on p 100
The electronic control device (ECD) has gained widespread acceptance as the force option for law enforcement because of its dramatic reduction in both suspect and officer injury. At the same time, advocacy groups post statements on the Internet listing the hundreds of arrest-related deaths after ECD use with the implication that the ECD involvement was causal. Studies covering a total of >48 000 forceful arrests have consistently found suspect injury rate reductions of ≈65%.5,6 Of the 250 000 annual ECD field uses in the United States, only 1 in 4000 is involved in an arrest-related death. This reduction in fatality rate is consistent with published data showing that 5.4% of ECD uses “clearly prevented the use of lethal force by police.”7
Of the >3 million total ECD applications, there have been 12 published case reports suggesting a potential cardiac arrest link, giving an incidence of 4×10−6 per application.8–13 In most cases, those authors did not consider important factors that are now better understood. These include separating postural from cardiovascular collapse, the latency of electrically induced ventricular …