Natasha McKenna was being held at the Fairfax County jail in Virginia this past February for allegedly assaulting a police officer. She weighed just 130 pounds, had been diagnosed with schizophrenia at age 12, and was the mother of a young girl.
When a half dozen sheriff's deputies in protective gear came to transfer the 37-year-old from her county cell to a jail in Alexandria where she would receive appropriate mental health treatment, she put up a struggle. The officers slapped handcuffs and leg shackles on her, and forced her into a restraining chair. When she resisted, one of the officers pulled out a Taser and shocked her four times.
After the fourth shock, McKenna stopped breathing. She was transported to the hospital, where she was pronounced dead three days later.
The April 28 autopsy report listed the cause of death as "excited delirium associated with physical restraint including use of conductive energy device, contributing: Schizophrenia and Bi-Polar disorder." It referred to the manner of death as an "accident."
Following a recent spate of high-profile deaths in police custody — including those of Freddie Gray in Baltimore and Sandra Bland in Waller County, Texas — the autopsy's ruling in McKenna's death was met with public skepticism, and many have wondered if the four shocks delivered by a Taser device had a larger part to play in her death than the report indicated.
Last week, the US Department of Justice announced that it would conduct its own investigation into McKenna's death.
'Too often Tasers feature as the punch line to a joke, which makes them seem like they're not much of a big deal when really they're a huge deal.'
As law enforcement agencies come to rely more and more on Tasers as a less lethal alternative to guns, Taser-related deaths are on the rise. With few regulations surrounding the devices and such scant independent research on the effect they can have on the human heart, they are becoming an increasingly controversial weapon in the police officer's arsenal.
When a person dies after being shocked by a Taser, Taser International, Inc. — the multi-million dollar weapons manufacturer behind the product — often denies responsibility by suggesting that the device hadn't been used properly, or by citing "excited delirium syndrome" as the cause of death. The syndrome is a contentious collection of various anxiety-related symptoms that can result in respiratory or cardiac arrest.
According to a study by Amnesty International, there were more than 500 Taser-related deaths in the United States between 2001 and 2012. Some states are considering higher regulatory standards for Taser devices amid growing public concern over their safety.
Data recently compiled by VICE News showed that there were more than 49 Taser-related deaths as a result of officer-civilian interactions since August 2014. Of those 49, two victims were armed with crossbars and one with a pair of scissors. The rest were reportedly unarmed.
Jack Cover, an aerospace scientist, invented the Taser in the 1970s. He intended the weapon to be used by law enforcement in emergency settings, such as hijackings, as a nonlethal alternative to guns. "TASER" is an acronym for "Thomas A. Swift's Electric Rifle," a reference to an early 20th Century adventure series in which a character named Tom Swift invents a weapon that he calls "the electric rifle" with the intention of traveling to Africa to kill "cannibals," "pygmies," and big game.
Taser devices were initially classified as firearms by the Bureau of Alcohol, Tobacco, Firearms, and Explosives because they originally used gunpowder to discharge electrified darts at a target. Taser International asked Cover to modify the devices in 1993, and he replaced gunpowder with compressed nitrogen — an adjustment that exempted the device from firearm regulations and government oversight.
Between 2000 and 2011, the number of US agencies purchasing Tasers rocketed from 500 to more than 16,000.
The Taser X26, which is the model issued to law enforcement officers, looks like a gun — so much so that in April a volunteer sheriff's deputy in Oklahoma apparently mistook his .357 Magnum for his Taser and shot Eric Harris, a black man, dead. In the past decade, there have been at least 11 other instances in which this has happened.
Tasers have two modes: "dart mode" and "drive-stun mode." In dart mode, a Taser device shoots two electrified darts at a target with enough force to penetrate about two inches of clothing, delivering an electric pulse of 50,000 volts. The electrical current will pulse through the target's body for however long the officer chooses to hold the trigger. The current overwhelms the body's nervous system, inhibiting coordinated movement by causing uncontrollable muscle spasms.
In drive-stun mode, the Taser device is pressed against the target's body. This causes a painful current to run through the specific body area that the device is pressed to, but won't necessarily immobilize the subject.
In 2007, following a sudden spike in Taser-related deaths, a report from a meeting of the United Nations Committee Against Torture noted that the committee "was worried that the use of Taser X26 weapons, provoking extreme pain, constituted a form of torture, and that in certain cases it could also cause death, as shown by several reliable studies and by certain cases that had happened after practical use."
Experts called by lawyers have successfully convinced jurors that victims die not from the effects of being Tasered but by the crazed state described by the phrase "excited delirium syndrome."
That was the argument Taser International used in court after a medical examiner ruled the death of 18-year old Richard Holcomb a homicide. The district attorney declined to prosecute the officers involved, and Taser International sued the medical examiner.
The night Holcomb died sometime before 1:00 AM on May 28, 2005, a resident of Springfield Township near Akron, Ohio, called the local police to report a disturbance on her property. Officer Kristina Albrecht responded, calling for backup when she thought she heard a scream in the vicinity.
She encountered Holcomb standing in a fenced-in horse pasture, shirtless and "gesturing as though swinging a baseball bat."
"He had a look on his face that was almost indescribable," Albrecht later testified in court in the case against the medical examiner. Albrecht asked Holcomb if he was intoxicated. He admitted he'd been drinking and had taken drugs. Albrecht said he told her "somebody was going to die" before he turned around, sat on the ground by the barn, and started to rap.
When Holcomb got up and walked toward her again, Albrecht says that she fired her Taser and shocked him four times.
Holcomb was incapacitated, lying face down on the ground, but "breathing, moaning, making other noises" and "moving on his own free will," Albrecht testified in court.
Eight minutes after the Albrecht fired the Taser, her backup arrived and placed Holcomb in handcuffs. Albrecht said that Holcomb then became unresponsive. By 2:05 AM, he was dead.
A toxicology report showed that Holcomb had taken the drug ecstasy, but the Summit County medical examiner, Lisa Kohler, ultimately ruled his death a homicide — "sudden death incurred during restraint." "Contributing to his death," her report stated, "were the electrical impulses delivered by the Taser."
Three years after Albrecht encountered Holcomb in that horse pasture, Taser International filed a civil lawsuit against Kohler for ruling that Holcomb's death, and two others, was related to the officer's use of a Taser.
A number of experts testified in court on behalf of the company, saying that the victims had likely died from "fatal cardiac arrhythmia" due to drug intoxication or acute psychiatric conditions consistent with excited delirium syndrome, and arguing that Tasers had nothing to do with their deaths.
Judge Ted Schneiderman ruled in favor of Taser International, and Kohler was ordered to change her description of the death in all three autopsy reports from "homicide" to "accidental."
At the time of the ruling, Jeffrey Jentzen, president of the National Association of Medical Examiners, voiced concern over the judge's decision, describing Taser's law suits as "dangerously close to intimidation."
When contacted recently by VICE News, Kohler said that she "still stands by" her original ruling of homicide — that the use of Tasers by police officers caused the deaths of the three men, adding that she had "nothing else to say," and that all the details of the case are available online.
In 2003, Taser International also sued Vigo County medical examiner Roland Kohr in Indiana for ruling a man's death a homicide caused by the six electric shocks he received from a Taser at the hands of police.
"Taser has sued a number of medical examiners for making informed medical opinions in an attempt, I think, to both protect their product and send a threatening message to medical examiners," Jentzen said, referring to the actions taken against Kohler and Kohr.
In fact, Lisa Kohler's finding of homicide in those three cases was unusual. Many Taser related deaths are found by medical examiners across the country to be caused by excited delirium syndrome, which is not recognized by the American Medical Association, the American Psychological Association, the American Psychiatric Association, or the World Health Organization.
Nevertheless, Amnesty International found that the syndrome had been cited as cause of death in 75 of 330 Taser-related incidents between 2001 and 2008.
The combination of symptoms associated with excited delirium — fear, violence, paranoia, incoherence, unexpected strength and respiratory arrest, which can lead to sudden death — were first described in the 1800s as part of a disorder called Bell's Mania.
Excited delirium syndrome is believed to be brought on by psychiatric illness like mania or schizophrenia, or more commonly by stimulant drug use in which a person's nervous system becomes flooded with adrenaline, causing their heart to beat faster and faster.
'Anyone who has been to a music concert where there's rampant drug use or worked in emergency care has seen someone in this state.'
The first modern mention of excited delirium syndrome was in the 1980s, linked to the booming popularity of cocaine in the United States at that time. But the legitimacy of excited delirium divides medical experts. Some contend that it is a scapegoat to justify instances of police brutality. Others are convinced of its validity and estimate that it is responsible for around 500 sudden deaths each year.
Dr. Vincent Di Maio, a forensic pathologist from Texas who provided expert witness testimony in favor of Taser International in its lawsuit against Kohler, is convinced that excited delirium syndrome is a valid condition. Di Maio, who has previously testified on behalf of the defense in the trials of George Zimmerman, Phil Spector, and Drew Peterson, and who has written two books on excited delirium syndrome, told VICE News, "There is no concrete evidence that Tasers can kill you."
He said that excited delirium is an "umbrella term" to describe the physiological symptoms associated with drug use or psychosis, though he acknowledged that Tasers and pepper spray might have the effect of making a person exhibiting symptoms of the syndrome even more excitable.
Subduing a person in this condition isn't easy, Di Maio said, noting that they can often exhibit almost "superhuman" strength.
"You need six people to get them down," he remarked. "When EMS workers arrive, you should administer cold packs and oxygen, and then get them off to the hospital with the sirens going as quickly as possible." At the hospital, they should be administered a sedative.
According to Di Maio, a person with excited delirium syndrome has an extremely high risk of sudden death. He suggested that in many cases, regardless of the introduction of a Taser into the equation, such people were probably going to die anyway.
In 2011, the Police Executive Research Forum updated its guidelines on Taser use, noting as an aside: "Let's be clear, subjects in excited/agitated delirium are at higher risk of sudden death REGARDLESS of what police tool or tactic is employed, and regardless of whether police are even present."
Dr. Douglas P. Zipes, an expert on electrophysiology and the impact of electrical impulses on heart rhythms, produced a study for the American Heart Association that focused on the relationship between Tasers and sudden death. Zipes contends that Tasers can cause cardiac arrest in humans.
Zipes, who often serves as an expert witness for plaintiffs in cases regarding Taser-related deaths, told VICE News that he believes that the classification of a Taser-related death as excited delirium syndrome is simply "a way to exonerate" Taser International from lawsuits.
"A medical examiner has a dead body before them, and is making the diagnosis of how that body got to be dead by looking at its anatomy," he explained. "Well, 'excited delirium' is a functional state — it exists as an awake, agitated, delirious individual. How can a medical examiner make that diagnosis? They can only do it based on what someone else has written down."
But Dr. Corey Slovis, professor and chair of emergency medicine at Vanderbilt University Medical Center, says that despite the controversy surrounding the classification, almost all emergency physicians regard excited delirium as a legitimate condition. He told VICE News that organizations like the American Medical Association don't recognize excited delirium because there's currently no lab test for it. It's a clinical diagnosis made for a "wild uncontrollable person," whose symptoms include acute agitation, dehydration and high fever.
"Anyone who has been to a music concert where there's rampant drug use or worked in emergency care has seen someone in this state," Slovis said, while noting that the likelihood of excited delirium leading to sudden death is compounded by whether an individual receives "appropriate care."
Officers don't always initially recognize that an individual is in the throes of excited delirium, and will instinctually fire their Taser to subdue them. Slovis said that discharging a single Taser shock is appropriate, but stressed that "multiple electrical discharges into the same patient, especially in rapid succession, increase the likelihood of sudden death."
Tasers are generally safe, he added, but they aren't always safe to use on someone with excited delirium syndrome, whose heart rate is already running very high.
Other studies have produced even more graphic evidence of the fatal effects that can be produced by Tasers. In 2006, a team of doctors and scientists at Chicago Cook County hospital stunned 11 pigs using Tasers, hitting their chests with 40-second jolts of electricity at 10- to 15-second intervals.
Two of the pigs died, one of them just three minutes after being stunned. The surviving animals were left with heart rhythm problems, the researcher said. Taser International refuted the study, and said that pigs provided an "unreasonable model" to test the safety of their devices.
In response to a VICE News request for comment on the issue of deaths following the use of their product, Taser International's head of communications, Steve Tuttle, replied in an email, "The key issue about TASER and arrest related deaths is that we get cleared on the vast majority of these high profile and often controversial cases."
A search on LexisNexis using the keywords "wrongful death" and "Taser International" indicates that the company has been involved in at least 125 wrongful death cases over the last 10 years, among which there were only two jury trial losses.
Taser guidelines recommend that law enforcement officers avoid using the devices on "pregnant females," "elderly individuals or obvious juveniles," "individuals who are handcuffed or otherwise restrained," anyone who is near flammable material, and anyone who might be injured badly by falling. The guidelines instruct users to avoid firing Tasers at the subject's chest area, citing a risk of "potential cardiac consequences."
The company also warns that people who exhibit "extreme agitation" or "violent irrational behavior," among other symptoms associated with excited delirium syndrome, may be "at an increased risk of sudden death" and should be "examined by qualified medical personnel as soon as practicable" after being shocked with a Taser.
Despite these guidelines, a study by the New York Civil Liberties Union (NYCLU) said that more than one in four Taser incidents involved shocks directly to the subject's chest area.
Corey Stoughton, who led the NYCLU study, told VICE News that the real problem with Taser devices is how they are misused by law enforcement. Beyond the corporation's aggressive marketing, Stoughton wonders if pop culture has contributed to the lack of seriousness with which Tasers are regarded.
In cartoons, TV shows, and commercials, she said, "too often Tasers feature as the punch line to a joke, which makes them seem like they're not much of a big deal when really they're a huge deal."
"That pop culture reality seeps into the minds of law enforcement," Stoughton added.
The Police Executive Research Forum writes in its 2011 guidelines that Tasers "should not be seen as an all-purpose weapon that takes the place of de-escalation techniques and other options," but rather should only be used when there's a demonstrable risk of physical harm or death to another person.
The NYCLU study showed that this justification was missing in 60 percent of incidences of Taser use. It concluded that the devices are often adopted by law enforcement departments with little consideration given to their potential risks, and that standards vary between agencies.
A 2006 study by the Louisville Courier found that Tasers were often used in instances where the subject showed "verbal non-compliance" and "when subjects showed no active resistance or aggression or were handcuffed."
Earlier this year, footage captured by a Texas state trooper's dash cam showed a white officer threatening Sandra Bland with a Taser as he ordered her out of her vehicle during a traffic stop. "I will light you up!" the officer shouted at Bland when she questioned why he was trying to remove her from her vehicle. (Bland was later found dead in a county jail three days later from what the authorities described as an apparent suicide, having asphyxiated herself with a garbage bag around her neck — an assessment that remains a matter of controversy.)
Some states and medical examiners are coming around to the idea that Tasers, though "less lethal" than firearms, can still be lethal.
Last week, a district attorney in Georgia indicted two former police officers from East Point on charges of homicide for killing Gregory Towns, an unarmed black man, with a Taser. In April 2014, Towns left his mother's apartment building in East Point after an argument with his girlfriend.
Two officers approached the 24-year-old Towns, who bolted. Chris Stewart, the attorney representing Towns' family, told VICE News that they chased him into the woods. As he was running, he tripped over a tree branch and fell.
He was tired from running, Stewart said, and surrendered. Officers caught up with him and used a Taser on him, "like a cattle prod," Stewart said, to make him stand up and walk.
They used the Taser on him so many times — "at least 10," according to Stewart — that Towns became unresponsive. EMTs were called and Towns was pronounced dead at the scene.
"Tasers can kill you if they're used that many times," said Stewart.
The autopsy report from the Fulton County medical examiner's office ruled Towns's death a homicide, having determined that he had died of "hypertensive cardiovascular disease exacerbated by physical exertion and conducted electrical stimulation."
Stewart said that they didn't sue Taser International because they anticipated what their defense would be — that the officers had used the weapon irresponsibly.
Towns's family filed a wrongful death suit against the city and received a $1 million settlement. Stewart said the entire East Point police department was also forced to undergo retraining on how to properly use a Taser.
Similarly, a medical examiner in Connecticut recently ruled the death of David Werblow a homicide, even though he was reportedly having a schizophrenic episode when he was Tasered.
"What matters here is that medical examiners are recognizing that Tasers can be part of the cause of death," David McGuire of the ACLU said at the time of the ruling, adding that "the next step, which is equally important, is to make sure that investigations done by prosecutors into these deaths are meaningful."
Werblow's death in March prompted Democratic State Sen. Ted Kennedy Jr. to explore the possibility of establishing a statewide standard for Taser use in Connecticut. Kennedy said it was his "obligation" following Werblow's death to investigate the state's current policies on Taser use.
Last year, Connecticut became the first state to approve a bill requiring police to file a report every time they use a Taser device. The law went into effect in January this year, meaning an officer has to provide information regarding a person's race, age, height, and weight in addition to noting how the Taser was used, what mode they used it in, how many times they used it, whether the person was injured and needed medical assistance, and whether than assistance was provided. Police will also have to attach the electronic data from the Taser device to their report.
Even Taser International's critics don't want the weapon removed entirely from the arsenal of law enforcement. Many just want their users to better understand that a Taser is a dangerous weapon.
"In no way am I saying that the Taser is not a good weapon, not a useful weapon, not a weapon to use in preference to a gun," Zipes explained. "What I'm saying is, educate the users. Make them aware that this is not a benign instrument. Make them treat it with respect. This instrument can kill."
Follow Tess Owen on Twitter: @misstessowen
Editor's note: This piece has been updated.