BACKGROUND:Conducted Electrical Weapons (CEWs) are widely used worldwide by law enforcement as an intermediate less-lethal force option. While CEW direct electrical effects are generally transient, and direct significant injuries are rare but sometimes severe, secondary effects from associated falls related to neuromuscular effects while rare, may also be severe. OBJECTIVE:To characterize the frequency, severity, and injury patterns of permanent paralysis associated with CEW deployments, with emphasis on fall-related and law-enforcement force related trauma. METHODS:We analyzed a curated case series of 17 incidents (2004-2024) in which individuals sustained paraplegia or tetraplegia associated with CEW use by law enforcement. We judged 13 of these falls to have been caused by the CEW while 4 may have been only temporally related. Demographics, circumstances, injury mechanisms, and neurological outcomes were summarized descriptively. RESULTS:Of the 17 cases we found, 15 were in the USA and 2 were in the UK. Permanent tetraplegia occurred in 8 cases and paraplegia in 8 cases; there was a single recovery. The mean age was 37 years (range 17-65). All cases involved subjects actively resisting or attempting to flee law enforcement interaction. Elevated falls with head-first impacts, generating thoracic or cervical spine trauma, predominated as causes. CONCLUSIONS:Subject paralysis following CEW deployment is a rare but severe complication of attempted electrical weapon control by neuromuscular effects.

It is accepted that congenital and acquired heart disease increase the risk of sudden cardiac death. To our knowledge, there are no published studies on the types of heart disease in cases of arrest-related deaths. The goal of this study, therefore, was to consider a large body of autopsy reports of non-firearm arrest-related deaths to analyze the presence of heart disease with regard to numerous decedent variables and toxicology findings. We analyzed 1650 autopsy reports covering the years 2005-2024 and classified cardiac findings into larger subgroups. Most of the cases (95%) were men, and the mean age was 38 years, with a range of 14 to 95. The racial classification was black (40.2%), Hispanic (17.8%), and non-Hispanic white (38.8%). There was some type of cardiac abnormality described in 61% of the group. The most common were cardiomegaly (35.8%), cardiac hypertrophy (23.6%), moderate to severe coronary disease (15.0%), cardiomyopathy (14.5%), and hypertensive cardiac disease (12.2%). At 61%, the rate of any heart disease is significantly higher than the expected rate of 1% to 2% for this age group in living patients. The rates of specific heart diseases were also significantly higher. For example, the general population rate of dilated cardiomyopathy is estimated to be 0.4% and contributes to 0.2% of deaths, whereas in this group of autopsy-diagnosed young men, the prevalence was 4%. Our findings show a high rate of subclinical heart disease in people experiencing non-firearm arrest-related deaths. It is possible that these findings show an increased clinical risk in this population. The incidence of heart disease is increasing with time for this population.

Our present understanding of electrocution followed a long path of detours and speculation. It is now hard to appreciate how mysterious was an unexpected sudden death—without visible trauma—and we should be sympathetic to the surprising theories that came from well-intentioned attempts to find something in the autopsy of an electrocution victim. The early hypotheses (1880s) tended to favor effects on the central nervous system, but the emphasis switched to arterial and hematological mechanisms as well as respiratory arrest (ie, asphyxia) along with a widespread publication debate. While careful animal experimentation slowly established that electrocution was due to the induction of VF (ventricular fibrillation), the older hypotheses held sway for many decades. Even today, the neurogenic and asphyxial explanations reappear occasionally. Despite 170 years of research, the phenomenon of electrocution continues to generate new hypotheses for its mechanism.

Attempted copper theft from power stations causes many fatalities and is an increasing concern. There is a trend towards using electric security fencing to protect power stations. However, capacitive and inductive coupling into fence wires from the power lines above has not been studied previously. Therefore, we calculated the capacitively and inductively coupled voltages and currents for different power line heights, angles, voltages, and currents. We restricted the analysis to 3-phase power grids. Varying levels of current imbalance between the 3 phases were included. We concluded that under typical fence placements (i.e. angled with respected to power lines) the induced voltages were less than 15 V, the human perception threshold at AC frequencies. This level is much lower than the AC magnitudes expected to raise cardiac safety concerns. As a result, the use of electric security fences around power substations is safe. We recommend that fence lines should be temporarily connected to ground during installation. The grounding should be removed only after the connection to the low-impedance output of the electric fence energizer.Clinical Relevance— This study addresses the electrical safety of fence wires placed around power distribution lines.

The role of sickle cell trait (SCT) in sudden exertional death is well-recognized in sports and military training. However, it is not yet studied for non-firearm arrest-related death (NF-ARD). With extensive multi-pronged searches, a large database (n = 1389) of NF-ARDs was established. For the years 2006-2021 (inclusive) there were 50 NF-ARDs of Black persons in which postmortem evidence of SCT was found. A control cohort consisted of 414 NF-ARDs of Black persons with no reported SCT. The mean age for SCT cases was 33.1 +/- 10.4 years versus 37.0 +/- 10.4 years for the control group (p = 0.01). The body-mass index for SCT cases was 28.3 +/- 6.6 kg/m2 versus 30.7 +/- 7.6 kg/m2 for the control group (p = 0.03). The prevalence of cardiomegaly was 21% for SCT cases versus 39% in the control cohort (p = 0.008). The postmortem prevalence of SCT in NF-ARDs of Black persons (n = 50, 10.7%) was higher than the prevalence of SCT in the US Black population, which is 7.1% (p = 0.003). In this study of NF-ARDs in Black persons, the prevalence of SCT and the differences between the SCT cases and the control cohort suggest that exertional collapse associated with sickle cell trait may be a contributory factor in NF-ARDs.

Although the post-mortem descriptor of cardiomegaly is an important component of understanding a sudden death, there is no unified definition. A recent survey reported the usage of heart weight correction models of Molina or Kitzman, for example, or simple step cutoffs such as 350, 400, 450, or 500 g in common use. The goal of the present study was to determine how a diagnosis of cardiomegaly relates to these definitions and heart weight using a database of sudden deaths using 1071 autopsy reports from across the USA in which the heart weight and the presence (n = 373) or not (n = 698) of cardiomegaly were recorded. We found that medical examiners appear not to use corrections for body weight but instead rely on step weight cutoffs, predominantly of 350, 400, 450, and 500 g. The decedent's age, weight, ethnicity, and toxicology did not tend to influence a diagnosis of cardiomegaly. The term cardiomegaly is being used with increasing frequency with an average increase of 3.6% per year. Consistency in the post-mortem use of cardiomegaly is lacking.

The effects of electrical "stun guns" for civilian self-defense are incompletely investigated. Advertising often suggests significant central and peripheral nervous system and musculoskeletal effects.We purchased 3 samples of each of the 10 best-selling stun-gun models. We measured their outputs to compare them to relevant requirements of standards for nerve stimulators and for law enforcement electrical weapons.The average charge perm pulse was 0.91 ± 0.75 µC. All delivered less than the minimum 7 µC required for classification as a nerve stimulator. The equivalent utility-frequency outputs were 0.64 ± 0.52 mArms. This is in the range of perception but not pain. The open-air arcing gaps were 7.2 ± 1.5 mm with sharp points to facilitate arcing at low voltages. They correspond to breakdown voltages of 1.13 ± 0.16 kV. We found that as a result of this, the sound pressure levels were extremely high from the arcing across the electrodes (108.1 ± 2.8 dBA).Popular "stun guns" sold for civilian self-defense do not appear to be capable of nerve stimulation but are capable of generating very loud arcing sounds suggesting that the "stunning" effect is primarily aural. ∗

ABSTRACT:Spit hoods are used by law enforcement, officers in correctional facilities, and medical personnel during the restraint of agitated subjects that are actively spitting to prevent the transmission of droplet-transmitted pathogens. We could find no studies reporting on the time course of normal breathing to clear saliva from such a saturated spit hood. We purchased samples of 3 popular spit hood models and applied a section over the output of a pneumatic test system. We used a digital anemometer, digital manometer, and an inline controllable fan for back pressure and flow. The pressure was 3 mm Hg to match quiet breathing. The tested area was saturated with artificial saliva, and air pressure was applied while we recorded the pressure and airflow. Within 5 seconds, the spit hoods all cleared sufficient artificial saliva to allow 1 m/s of airflow, which exceeds that of an N95 mask with similar pressure. Commonly used spit hoods offer very low resistance to breathing even after being initially saturated with artificial saliva. Our results do not support the hypothesis that a saliva-filled spit hood might contribute to death.

ABSTRACT:Our present understanding of electrocution followed a long path of detours and speculation. It is now hard to appreciate how mysterious was an unexpected sudden death-without visible trauma-and we should be sympathetic to the surprising theories that came from well-intentioned attempts to find something in the autopsy of an electrocution victim.The early hypotheses (1880s) tended to favor effects on the central nervous system, but the emphasis switched to arterial and hematological mechanisms as well as respiratory arrest (ie, asphyxia) along with a widespread publication debate. While careful animal experimentation slowly established that electrocution was due to the induction of VF (ventricular fibrillation), the older hypotheses held sway for many decades. Even today, the neurogenic and asphyxial explanations reappear occasionally.Despite 170 years of research, the phenomenon of electrocution continues to generate new hypotheses for its mechanism.

Multiple studies have documented various factors that influence or determine forensic pathologist classification of manner of death. There do not appear to be any published studies on manner of death classification specifically regarding arrest-related deaths (ARDs). The goal of this study was to consider a large body of cases of nonfirearm ARDs to analyze the homicide classification with regards to numerous decedent and practitioner (medical examiner/coroner [ME/C]) variables. We analyzed 1145 US autopsy reports from the years 2006-2020, inclusive, and considered decedent variables of age, ethnicity, height, weight, body mass index, toxicology, and mention of a conducted electrical weapon and ME/C influence variables of gender, country region, and year. We found that the homicide classification likelihood increased by a factor of 1.04-1.05 per year, 1.34-1.37 for a female medical examiner, and 1.4-1.5 going from Southern states to Western states. There is an increasing trend for ME/C to label nonfirearm ARDs as homicides in the United States. The homicide classification is more common in Western states and less common in Southern states, and it was more common with a female ME/C.

The mass media and legal system possess and promulgate deep misunderstandings of the basic concepts, operation, and effects of the modern Conducted Electrical Weapon (CEW). CEWs are, after all, weapons, and are used in violent and dangerous situations. They have indeed contributed to deaths from head injuries and ignition of flammable fumes. While electrocution remains a theoretical possibility, the notion that an electrical weapon has ever electrocuted anyone is an urban myth. CEW benefits are well established in the peer-reviewed literature and explain why these weapons are so widely adopted throughout the industrialized world. With the use of CEWs, injury rates are reduced by approximately two-thirds. The most misunderstood and exaggerated theoretical risk is that of electrocution or the electrical induction of ventricular fibrillation (VF). This is extremely unlikely as the output of existing CEWs satisfies all relevant world electrical safety standards, including those for the ubiquitous electric fence.

Electrocution is a death caused by an application of electrical current to the human body. Our present understanding of electrocution-as the induction of ventricular fibrillation (VF)-followed a nearly century-long path of misunderstandings and speculation primarily focused on hypotheses of asphyxia as well as central nervous system trauma. It is hard for us today to appreciate the past mystery of an unexpected sudden death usually bereft of visible trauma. Even today, a false dogma exists that direct-current shocks can cause asystole instead of VF. A lightning discharge (up to 500 megavolts) is differentiated because it can cause substantial acute and chronic neural effects leading to other cardiac arrest rhythms. The human heart is exquisitely sensitive to alternating currents, and VF can be induced with currents of one-eighth that required for mere pacing. Because of these low currents, this effect obtains only in the TQ interval, and low-power electrocution does not involve the vulnerable period. If a current is strong enough to electrocute, generally it will do so in 1-2 seconds; longer shocks do not tend to be more dangerous. Regardless of concomitant drug dosing, the electrocution cardiac arrest rhythm is still VF, suggesting that electrocution is a stand-alone cause of death; the electrical current does not potentiate the effects of the drug. The experimental and clinical data supporting VF as the mechanism for electrocution are provided.

INTRODUCTION:Restrained subjects often spit on law enforcement and corrections officers and medical responders. Based on the droplet-transmitted risk of COVID-19, such spitting could be considered a potentially life-threatening assault. Officers commonly use "spit socks" over the head and neck of spitting subjects to reduce this risk. The pneumatic impedance of such socks has not been published, so this remains an open issue for arrest-related death investigation. METHODS:We purchased samples of 3 popular spit sock models, 3 insect-protecting "bug" socks and hats, 3 N95 masks, a standard 3-ply surgical mask, and a common dust mask. We used a BTmeter model BTN8468 digital anemometer, an HTI model HT-1890 digital manometer, and an AC Infinity Cloudline model S6 inline controllable fan to measure air flow versus pressure drop. We compared the curves graphically and also calculated a pneumatic pseudo-impedance by dividing the pressure drop by the air velocity. RESULTS:The spit and bug socks allowed nearly maximum airflow with minimal pressure (≤1 mm Hg), whereas none of the masks allowed greater than 2 m/s of airflow at maximum pressure of 3 mm Hg. All of the spit and bug masks were grouped together with the lowest pneumatic impedances, whereas all of the N95 masks were grouped together with the highest values. The dust mask and surgical mask were in between with the dust mask closer to the spit and bug masks, whereas the surgical mask was closer to the N95 masks in impedance. CONCLUSIONS:Commonly used spit socks offer nearly zero resistance to breathing. The highest resistance spit sock was still 100 times better than the best N95 mask for airflow during inhalation. Our results do not support the occasional hypothesis that spit socks might contribute to an arrest-related death.

Conducted electrical weapons (CEW) have risks including trauma associated with uncontrolled falls, probes penetrating the eye, and fume ignition. A lesser-known risk is weapon-confusion error with officers mistakenly discharging their firearm when they intended to deploy their electrical weapon. We searched for incidents of possible weapon confusion with the TASER® brand CEWs via open-source media, litigation filings, and a survey of CEW law enforcement master instructors. We found 19 incidents of possible CEW weapon confusion in law enforcement field uses from January 2001 to April 2021. We eliminated a case as not meeting our criteria for probable weapons confusion leaving 18 cases, thus giving a demonstrated CEW discharge risk of 3.9 per million with confidence limits (2.4–6.2 per million) by Wilson score interval. Ipsilateral carry of the weapons was historically correlated with increased risk vs. contralateral carry. Officer gender was not a predictor of weapon confusion. The psychological issues behind weapon confusion under stress are discussed. The concurrent carry of electrical weapons and firearms presents a very small but real risk of injury and death from confusion between an electrical weapon and a firearm.

It is difficult to electrocute (induce ventricular fibrillation) with capacitive discharge shocks. With small capacitance values, the high voltages required for the necessary charge are rarely seen in industrial situations (e.g. electric vehicle charging stations). On the other hand, with large capacitance values, the discharge time is so great that the shock couples inefficiently with the cardiac cells. The update to IEC 60479-2 sets the C1 "mostly-safe" charge limit of 3 mC for a short "impulse function" pulse. We calculated the equivalent capacitor stored charge for an arbitrary capacitance value using the simple single membrane time constant model for the cardiac response. The peak membrane response was set equal to that of the 3 mC impulse function response to calculate the safe values for stored charge, voltage, and energy. The total stored charge, per se, cannot be used simplistically to estimate the danger of a capacitive discharge shock. A capacitive-discharge shock cannot be accurately compared to a rectangular shock with a duration equal to the shock time constant. The greater the capacitance, the larger the fraction of wasted charge in coupling to the heart and thus the shorter equivalent duration compared to the shock time constant. For a capacitive discharge shock this translates to a stored charge of 3 mC increasing up to 9 mC for a 10 capacitor using the assumed 575 load for an electric-vehicle (EV) charging station. In the area of interest for 1 - 10 the safe voltage ranges from 1300 to 4700 V, which includes the 1500-VDCscope of EV charger standard IEC 61851-23. For C > 100 the voltage asymptote is 700 V.

Introduction Restrained subjects often spit on law enforcement and corrections officers and medical responders. Based on the droplet-transmitted risk of COVID-19, such spitting could be considered a potentially life-threatening assault. Officers commonly use “spit socks” over the head and neck of spitting subjects to reduce this risk. The pneumatic impedance of such socks has not been published, so this remains an open issue for arrest-related death investigation. Methods We purchased samples of 3 popular spit sock models, 3 insect-protecting “bug” socks and hats, 3 N95 masks, a standard 3-ply surgical mask, and a common dust mask. We used a BTmeter model BTN8468 digital anemometer, an HTI model HT-1890 digital manometer, and an AC Infinity Cloudline model S6 inline controllable fan to measure air flow versus pressure drop. We compared the curves graphically and also calculated a pneumatic pseudo-impedance by dividing the pressure drop by the air velocity. Results The spit and bug socks allowed nearly maximum airflow with minimal pressure (≤1 mm Hg), whereas none of the masks allowed greater than 2 m/s of airflow at maximum pressure of 3 mm Hg. All of the spit and bug masks were grouped together with the lowest pneumatic impedances, whereas all of the N95 masks were grouped together with the highest values. The dust mask and surgical mask were in between with the dust mask closer to the spit and bug masks, whereas the surgical mask was closer to the N95 masks in impedance. Conclusions Commonly used spit socks offer nearly zero resistance to breathing. The highest resistance spit sock was still 100 times better than the best N95 mask for airflow during inhalation. Our results do not support the occasional hypothesis that spit socks might contribute to an arrest-related death.

Introduction: Conducted electrical weapons are primarily designed to stop subjects from endangering themselves or others by deploying 2, or more, probes to conduct current via the body to induce motor-nerve mediated muscle contractions, but probe impedance can vary significantly including open circuits from probes failing to complete or maintain a circuit.Methods: We tested 10 units of the TASER ® 7 model with a range of impedances and open circuit conditions. Pulse data (stored in the device’s memory) were used to predict the load resistances and detect arcing conditions. Acoustical data (recorded externally) was evaluated on an exploratory basis as a secondary goal.Results: The average error of predicted resistance, over the physiological load range of 400–1000 Ω, was 8%. Arcing conditions was predicted with an accuracy of 97%. An arcing condition increases the duration of the sound generation.Conclusions: The TASER 7 electronic control device stored pulse-log data for charge and arc voltage yielded forensic analysis of the load resistance with reliable accuracy.