Wednesday, June 25, 2008

NIJ's Interim Report

An expert panel conducting a taser-related study (called "Deaths following electro-muscular disruption") for the National Institute of Justice (NIJ) has released an interim report on their findings. A full report is expected in 2009.

Expect Taser International to press release this sentence from the NIJ's website:
An expert panel of medical professionals found no conclusive evidence of a high risk of death or serious injury from the direct effects of Conducted Energy Devices (CEDs), such as Tasers.
It's quite a strong sentence given that the rest of their document qualifies the details of that finding with, "in normal, healthy adults." Why that qualifier was left omitted from their introductory sentence is a mystery to me.

For example, this paragraph really doesn't say much except that the collective state of the science based on the literature reviewed by the panel was insufficient to assess the safety of conducted energy weapons in the field, where they're applied to at-risk populations (as defined by the Canadian Inquiry):
There is currently no medical evidence that CEDs pose a significant risk for induced cardiac dysrhythmia when deployed reasonably. Research suggests that factors such as thin stature and dart placement in the chest may lower the safety margin for cardiac dysrhythmia. There is no medical evidence to suggest that exposure to a CED produces sufficient metabolic or physiologic effects to produce abnormal cardiac rhythms in normal, healthy adults.
The interim report goes on to discuss excited delirium. The blog by the same name, Excited Delirium, has plenty of information on this questionable condition that is not in the Diagnostic and Statistical Manual of Mental Disorders.

The term is used in this important paragraph from the report (emphasis mine):
Studies examining the effects of extended exposure in humans to CED are very limited. Preliminary review of deaths following CED exposure indicates that many are associated with continuous or repeated discharge of the CED. The repeated or continuous exposure of CED to an actively resisting individual may not achieve compliance, especially when the individual may be under drug intoxication or in a state of excited delirium. The medical risks of repeated or continuous CED exposure are unknown and the role of CEDs in causing death is unclear in these cases. There may be circumstances in which repeated or continuous exposure is required but law enforcement should be aware that the associated risks are unknown. Therefore, caution is urged in using multiple activations of CED as a means to accomplish subdual.
What the panel is saying there is that over
40% of the time that tasers are used, no one knows if they are safe!

A real tell in this report comes if you exam the panel's composition. The panel's sole emergency medicine representative is someone who published a paper that found a low risk of injury associated with taser use. We know how easy it is to get scientists to seriously consider findings that conflict their own, right? Another member, from the Pathology portion of the panel has quite an interesting conservative blog and offers some pretty interesting statistics on taser injury rates (I think it's him in this thread as well). Those are just two panel members I quickly Googled.

The aknowledgements thank a few Taser International representatives and at least one scientist who has served as a paid consultant for the company. But, the acknowledgments also thank someone from Amnesty International.

Amnesty International's rosier-than-mine take on the interim report is here. Some relevant paragraphs:
Amnesty International today said the interim report of the National Institute of Justice (NIJ) on deaths following police use of conducted energy devices (CEDs) such as Tasers, published earlier this week, underscores the organization’s concerns about the safety of such devices. ...

While the Justice Department’s interim report found “no conclusive medical evidence” of a high risk of death or injury from the direct effects of CEDs, it acknowledged that “Many aspects of the safety of CED technology are not well-known, especially when used on populations other than normal healthy adults”.

The risk of death or serious injury, the report said, could be higher in certain populations, including children, the elderly, pregnant women, people with heart disease and those who show signs of “excited delirium” (the latter described as “a syndrome characterised by psychosis and agitation”). It recommended that police officers should avoid the use of CEDs against these populations unless the situation excludes other options.

The report also noted that many of the deaths are associated with prolonged or repeated CED discharges. While it found research in this area to be limited, it called on law enforcement officers to exercise caution in using multiple activations.

Amnesty International has serious concerns both as regards the safety of such weapons and their potential for abuse – the latter a serious issue not addressed in the Justice Department study. Amnesty International believes that electro-shock weapons are inherently open to abuse as, portable and easy to use, they can inflict severe pain at the push of a button without leaving substantial marks.

The capacity to use such weapons close-up as “touch stun guns”, often when individuals are already in custody, and to inflict repeated or prolonged shock, makes them even more prone to abuse, the organization said.

Amnesty International said it is further concerned that US police often use CEDs as a routine force option against individuals who do not pose a serious threat. Such usage is contrary to international standards which require law enforcement officers to use only the minimum force necessary, in proportion to the threat posed and in a manner designed to minimize damage or injury. ...

Amnesty International hopes that the use of other restraints in arrest-related CED deaths will also be examined in the Justice Department’s ongoing review and believes that some forms of restraint known to carry a risk of death from “positional asphyxia”, such as hogtying, should be banned altogether.

Amnesty International also noted that some of the Justice Department’s interim findings on the safety of CEDs in healthy populations may be subject to revision, pending further research. The report noted, for example, that research showed human subjects maintained the ability to breathe during CED shocks, with little medical evidence of lasting respiratory damage. However, there have been only limited human studies to date, many of them industry-funded.
It will be interesting to see if the panel examines the abuse of CED's. It's hard to imagine this panel giving it more than cursory consideration.

While the panel, in their interim report, found no conclusive evidence of danger in applying tasers to "normal, healthy" adults, they also didn't find any conclusive evidence that CED's are safe in the their relevant milieu.

PostBlog: Be sure to visit Excited Delirium's post on this report. There's a great graphic there that indicates the portions of the population that the NIJ panel needed to neglect in order to find no safety issues with tasers.