Conducted Energy Weapons and Selected Police Complaints Audits — Issue No. 13

SPECIAL COMMITTEE TO INQUIRE INTO THE USE OF CONDUCTED ENERGY WEAPONS AND TO AUDIT SELECTED POLICE COMPLAINTS

Present: Murray Coell, MLA (Chair); Kathy Corrigan, MLA (Deputy Chair); Ron Cantelon, MLA; Eric Foster, MLA; Gordon Hogg, MLA; Leonard Krog, MLA; Joe Trasolini, MLA

3. Resolved, that the Committee meet in-camera to consider its draft report. (Leonard Krog, MLA)

The following electronic version is for informational purposes only.
The printed version remains the official version.

REPORT OF PROCEEDINGS
(Hansard)

SPECIAL COMMITTEE TO
INQUIRE INTO THE USE OF CONDUCTED ENERGY WEAPONS AND TO AUDIT SELECTED POLICE COMPLAINTS


CONTENTS
Page
Restoring Public Confidence: Restricting the Use of Conducted Energy Weapons in British Columbia	177
J. Ho

M. Coell (Chair): Thank you, Dr. Jeff Ho, for your presence here today. Dr. Ho is the medical director and CEW researcher for Taser International.

We have an in-camera portion for report deliberation after the presentation. If there are no questions, I'll turn it over to Dr. Ho.

Restoring Public Confidence:
Restricting the Use of Conducted
Energy Weapons in British Columbia

J. Ho: Good morning, Mr. Chair and committee members. It's nice to be here. I appreciate the opportunity to address the group.

I was given the charge of coming here to discuss medical research surrounding CEWs and, I guess, to ask or answer any questions you may have of that. I put together a short outline, which I believe you have in front of you, with a sample of the papers that have come out of my lab.

I'd like to start off my piece here by telling you a little bit about who I am and by giving you my disclosure as well.

I am a full-time emergency medicine physician. I practise in Minneapolis, Minnesota, at a trauma centre. I provide medical direction to many public safety agencies, including police, fire and governmental sectors. I also hold an academic appointment at the University of Minnesota, where it is expected that we will do a certain amount of research to maintain our credentials there. The other hat that I wear is I'm also a licensed, sworn peace officer in the state of Minnesota, so on my days off I practise in the field as a deputy sheriff.

Based on all of that, over the last decade or so my research has surrounded usage of force and CEWs and those types of human factors that we're discussing today.

By way of disclosure, I'm also the medical director for Taser International, which is a manufacturer of CEWs. I'd like to explain how that relationship works, because I've had the chance to read some prior testimony by other individuals here who have called into question that relationship.

What I can tell you about it is that I do not work for Taser as an employee. My hospital actually holds a contract with Taser International. Taser International pays my hospital for medical direction, and my hospital appoints me as the medical director. I get my standard salary from my hospital. I do not take dollars from Taser. I do not take stock options or anything like that.

When we talk about things such as the research that we're dealing with today, while it is true that a fair amount of it has been funded by Taser International as well as other entities, I've tried to mitigate that conflict as much as I can by not being an employee of them or taking any special benefits. I just wanted to say that up front.

Also, if you have any questions as I'm going along or if I'm going too fast, please interrupt.

Really what I wanted to do today was…. As I understand it, I was asked to come and provide an opinion based on what is known about human research on the CEWs and also what my opinions are just from my expertise in this area.

What I've done…. I wanted to take a walk with you over about the last decade when I started a research team to begin looking at these devices. This was sometime in the late 2003 or early 2004 era. At the time, the only CEWs that were really out there were Taser devices. There weren't any other companies out there. As we'll get to later, there are starting to be some other companies manufacturing these devices now. But at the time, there was very little known about them from a human research perspective.

The way I got started in this was that we simply were asking the question of, you know: "We really don't know what happens when you apply these to a human." So our very first study, which is the first human study in all of the published literature, came out in 2006. It was actually conducted in 2004 and 2005, but it takes a year to get published.

We simply started with a very broad, open-ended question, and we really tried not to be biased one way or the other. I had no knowledge of these devices, didn't know whether they worked or didn't work. We simply wanted to know: "If you apply these to somebody the way that they're supposed to be used, what happens?"

That very first study, which you have listed as citation 1, was simply taking human volunteers and shooting them with a Taser device in a training setting. What we did before we shot them was we basically did every type of measured instrument analysis you could think of. We checked vital signs before. We did 12-lead cardiac EKGs, which is looking at the rhythm of the heart before. We drew blood on them before. Then we would expose them to the device the way that it's supposed to be used in the field, and immediately afterwards we would check all of those parameters again, including drawing blood work and running that for analysis.

We would then continue to serially check those things, including blood work, for the next 24 hours so that we would have a nice timeline of what has occurred over 24 hours with these people. Really, the reason we did it that way was we simply did not know what to expect. We weren't sure if we were going to see electrolyte abnormalities or vital sign changes, or something like that.

As I've testified to you before and as you can read in the paper, really, we didn't see anything that was remarkable. There were some very, very small changes in
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certain lab values. Some of those changes are within the error of measurement of the lab instrument itself, so we couldn't make a lot of that. Some of the changes that happened were so small that, even though they are reportable, they're clinically insignificant. In other words, as a physician, if we saw that type of change in a lab value in a patient, we would think nothing of it.

Based on that study, which was the first study, we really put that out there as: "Well, here's what we know about CEWs and what they do to human physiology."

From there, between 2005 and 2010 our group really moved into…. I run a lab team of about ten individuals that regularly get together. We dream of ideas on how we can test these things further, what conditions we haven't measured and how we could measure those conditions. So for about the next five years or so, we really did multiple human studies, of which I've included four, but we've probably published somewhere in the range of 12 to 15. I can get you those if you want. I just didn't think anybody would read all of them.

We really tried to examine specific variables of human conditions. What we tried to do is we attempted to examine a single variable that we could modify and then exposed people to a CEW with, really, the goal of: "Okay, if we just check or change this one variable, what happens?" We looked at things such as….

One of our tests was: "Let's get people intoxicated on alcohol." I'll use this because it's actually very germane to the discussion. Most of the time when these devices are used on people that are out of control, often intoxication is a factor in that. Again, this is at the time when people were really debating the safety of these devices and we were taking heavy criticism for our original study because it was done on people who were in a non-intoxicated state. We simply said: "Well, let's make them intoxicated and redo that study and see what happens." So we did that.

We also changed things such as multiple exposures, long-duration exposures. Instead of just five seconds, we went up to 15 seconds and, in some of our studies, even 30 seconds. We checked things like body temperature. The reason we did things like that was because…. You may have heard of excited delirium as a cause of death in some of these arrests. It's noted that people have very elevated temperatures in excited delirium states. We wanted to know, because Taser devices or CEWs cause muscle activation, if it can actually elevate body temperature. So we evaluated for that.

We evaluated for things like exhaustion. We would get people on a treadmill and run them until exhaustion — we would know they were exhausted by checking their blood levels of certain lab values — and then expose them to a CEW. The rationale behind that is that very often, when people are exposed by the police, it's pretty rare that they are at rest. It's usually after they've had some significant chase or a fight, or something like that.

We really wanted to see: "If you get people in these states and then you expose them to a CEW, what happens? Is there some change that we missed on our first study?" The results of that are in those papers that I can show you.

What I can tell you, just to summarize all of that, is that we did not find results that were damaging in any way. We didn't find that it elevated body temperature, for instance. We didn't find that multiple hits were significantly more damaging than a single or a double hit or anything like that. We found that…. Well, I'll get to that in just a minute.

When we compared it to other ways of controlling people, CEWs actually affected the body less than the traditional ways that the police would normally try to control somebody, which would include continued fighting or chasing somebody or something like that.

Around 2007…. In parallel with us there are a number of researchers in North America, including Christine Hall, who I know has testified here. They have also begun to do their own research on these devices in their own way. In my country there's probably a group of five or six individuals that I can think of that have received government funding to do this type of research. At least in my country, anything that is a government project tends to be a few years behind the private sector, which is why they were about three years behind our work.

They basically went back to the lab and did their own types of experiments modelled very closely after ours, although they tweaked a few things that they felt we could have done better. They essentially came up with the same results. I included a couple of their papers as well. There are probably eight or ten papers out now by those groups.

The part that I was really happy about with that was that, to me, that indicates that they basically validated what we found. It wasn't as if we were manipulating data and putting it out there. We have our results, we put them out there, and we have independent researchers coming along behind us and verifying that.

That brings us to about 2008 to 2010, where we have been extensively in the lab, again looking at these CEWs. It was about time for Taser International as a company to manufacture a new-generation device. They were playing around with different circuits, different outputs, different probe types, and things like that.

We actually, in one of our experiments, determined that we had stimulated one of the subjects' hearts. As we were watching it during the exposure — we have the ability to watch it under ultrasound — we found that we could cause extra beats of the heart with this experimental device. I've included that paper for you as well.

Basically, there are a few things I'd like to point out about that. Number one, it was an experimental device. It was never released publicly, so it's actually not in the field anywhere. This was the manufacturer's attempt at seeing if they could improve the product.

We quickly told them that: "I don't think you made an improvement. We think you've made this actually worse. You should go back to looking at what you've done here. Here's what we're finding as the result. I think that this is concerning." They were very diligent about immediately halting that and going back and looking at all of the factors that went into the design of that project.

To my team's credit, we did not hide that data. We actually published the paper, so it's out there. You can read about it. We don't believe in only publishing positive data. We put out the negative along with the positive as well. But that was the first indicator that told us that these devices are not zero risk. These are classified as weapons. They're carried by the police. They're used in violent situations. We know that they're not zero risk, and here's an example of potentially how they could not be zero risk.

So we asked the manufacturer to go back and re-examine the design of that, which they did. They have since come up with several new technology devices with different circuitry, different outputs. We have taken those to the lab as well. We have now actually compared them in the grand scheme of things on an animal model, and we've actually described this animal model, where it's becoming what I believe to be the standard of how you're going to test these things for cardiac excitation. We map out a grid across the animal, and basically, in one- by one-centimetre squares we insert probes from all these different devices and try to figure out which one has the most ability to cause extra cardiac beats, if they cause it all.

What we found with this is that we're not only testing Tasers, CEWs and their new technology; we're also testing competitors'. There are two that I can think of that are available today. We've taken all of those to the lab and systematically put them in these swine models that we've used, and we were able to start creating a map of where the danger zone is, so to say, around the heart with these devices.

What I can tell you is it appears to be a factor primarily of total charge output of the device and also the distance from the tip of the dart to the surface of the heart. So that makes sense. Obviously, the closer you are to the heart, the more risk there becomes.

The other thing I can tell you is that the X26 device, which was the older-generation Taser device…. While it does have a defined window where it could potentially cause this in a swine model, the newer technology that has come out has a very much smaller window. We've done, really as much as we can, refined enhancement to try and map out that window and get that window as small as possible and still have the device be effective for what it needs to do.

I will say that when we've examined competitors' devices, that window is much larger — like significantly larger, where I would be concerned about that. I think that's something for the committee to keep in mind as more and more of these devices come out on the market.

That brings us to, sort of, current day and what my lab team is doing. What I'll tell you that we've sort of switched to doing is…. We have done so many human and animal studies on CEWs that we really have built the library of data around this. We feel like we have a very good handle on how these devices function, how they affect physiology. We've actually started moving to look at problems that are not CEW-specific. We've started looking at other usage-of-force physiology. I've given you a few papers that sort of outline that.

The reason for this. If you take a step back and sort of have the 50,000-foot view of what the problem is here, the problem in my mind is that in interactions with law enforcement sometimes people have bad outcomes. We're very focused on CEWs at the moment, which I think is reasonable, but I think we also need to take a look back and say: "You know, there have been bad outcomes prior to the invention of CEWs."

Even in cases, at least in the United States that I'm very familiar with, where the police are involved in an altercation with someone, the person still has a bad outcome, and a CEW wasn't used. From a commonsense, scientific standpoint, that tells me that if we put all of our focus just on CEWs, we're probably not looking at the entire picture, and we should be.

We have started, with my team, trying to figure out alternative mechanisms of bad outcomes in these types of altercations. We think we've identified several, and I've listed those as citations 11 through 13. We have published all of these papers. One of them received an award from the International Association of Chiefs of Police just for bringing this to light.

Basically, what we've done is comparative studies of different types of restraint techniques — we've compared chasing subjects on foot; we've compared fighting with them for 45 seconds; we've compared releasing a police canine on them — to a CEW exposure, to pepper spray exposures, and we've measured all the physiological parameters that we can surrounding that.

There's actually very good data out there that shows which techniques and tools that police use and what types of activities that go on during these types of altercations are the most dangerous and which are the safest. That is what is included in that paper as well.

I know I'm short on time here, but that is pretty much a summary of how my team has gotten through the decade of looking at all of the research that's out there and sort of generating our thoughts and our processes. Our conclusions on this are, I would have to say, that when we think about CEWs in society…. I'm trying to look at this both as a physician — preventative medicine, injury prevention — as well as a law enforcement officer who needs to have a very certain effect to occur. Otherwise, I get hurt, or somebody else gets hurt.

It's clear to me that CEWs are really, really good tools
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when used as they're supposed to be used by the police for what they're supposed to be used for. We know with very good certainty that the data clearly shows that before CEWs were used, we had a high degree of suspect and officer injuries and deaths because this technology was not available to them. Once this came on line, those injuries and deaths have markedly decreased, so it is a good tool. I want to make sure that message is loud and clear. It's a tool that I think has a place in enforcement in society.

The other thing to point out is that in the context of things, I know that a lot of people would like to think that these things could be zero risk. They'd like to think that the police could do their job without ever having a bad outcome. Unfortunately, in the environment that they work in, those situations are very dynamic. They tend to be very violent. It's not a zero-risk proposition. That's just an unrealistic expectation.

I know that without those types of tools in the hands of the police, we would basically have to reduce ourselves to enforcement going back 15, 20 years, which essentially is either very physical techniques like punching someone, using an impact baton to club somebody, or using a firearm, which I think are all steps in completely the wrong direction, especially given what we know about the physiology that these devices affect.

With that, I'd like to wrap up my conclusion at that point and take questions, if you have any.

K. Corrigan (Deputy Chair): Thank you, Dr. Ho, for coming today. We appreciate you appearing before the committee.

I wanted to ask a few questions. First of all, I just want to be clear. The various studies that have been done — and I'm seeing where they've been published, and so on — are peer-reviewed studies, academic studies. Is that correct?

K. Corrigan (Deputy Chair): Okay, thank you. One of the things I wondered about, generally, was the fairly small sample size in some of the studies. Does that concern you?

J. Ho: It doesn't concern me from the standpoint that…. I mean, I can explain the small sample size. The biggest reason for the small sample size is the methodology that I sort of described to you with what we do. It takes an inordinate amount of time and logistics to get people through these tests — to follow somebody for 24 hours with multiple blood draws, and things like that.

We never came to our studies and said that we're going to have a goal of enrolling 10,000 people or anything like that. We came to our studies and said: "Here's our methodology. Here are the resources and the team we have to work with. We're going to put through as many people as we possibly can within this 72 hours that we have to do it."

Our sample size is limited, yes, primarily by those factors. However, what I would tell you on that is that while you could probably say that they're not powered to be numbered in the thousands like you'd like to see on some big trials, what we did look for was specifically for trends. So if we started noticing that markers were falling off one way or the other, we have gone back to the lab and actually done more of that.

Now, if you look at all of my papers over time…. For instance, the very first paper that I described had, I think, 62 volunteers in it. We have continued to draw things like potassium and EKGs throughout the decade on everybody, so we now have a database of probably just over 1,000 volunteers through all of our studies that we have similar data to. All of that data looks the same, to the point where we don't draw potassium levels anymore on people because there just has never been a change. For us it's a waste of time and energy and money to continue to do that.

I hear what you're saying. On individual studies the N, as we call it, is small, but overall over a decade we've had very consistent results without a trend that's been concerning.

K. Corrigan (Deputy Chair): One of your earlier studies was the 2007 "Respiratory Effect of Prolonged Electrical Weapon Application on Human Volunteers." It was one of the earlier ones, before you did try to incorporate some of the factors that might be happening at the same time as the Taser.

I wanted to read a paragraph, because to me, it sort of gets at the heart of the problem with the studies. I'm not discrediting anything you've said.

"An additional limitation of the study is that it does not exactly reproduce the conditions found in most in-custody death events, ICDs. In the field the majority of ICD subjects are using illicit substances, exhibiting bizarre, agitated behaviour and are presumably acidotic when law enforcement officials encounter them.

"There has been some work done in this area on animal models with regard to cardiac effects of CEW application after illicit stimulant administration, but there is no literature available in this area examining the respiratory effects of these substances when coupled with CEW application.

"We are unable to reproduce these field conditions in our volunteers due to the illegality of the conditions often found in the field subjects."

So we do have events still, and they do seem — the testimony we've had — to be corresponding often with a variety of modalities that may be impossible to replicate. That's the area where we seem to have problems, and I'm wondering what your comment is on that.
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J. Ho: Sure. I have several comments on that. First of all, nobody's ever going to be able to address a research study where you are testing an intervention on somebody that cannot give consent. So when somebody is intoxicated on cocaine, for instance, we cannot set up a study where we would take those people and expose them. There's no research board that would allow you to do that. It's unethical, and it's illegal, etc.

The first point you have to get past is that we have to understand that despite what we talk about here, there's never going to be a perfect human study that says: "We took patients, or subjects, who were high on cocaine and did this to them. Therefore, aha, we know what's going on."

The second thing is that we know that if you were just to isolate that variable of…. Let's, for instance, take cocaine, because I think that was mentioned in there, or some sort of intoxicant.

J. Ho: Illicit, so I'm going to assume it's cocaine or methamphetamine. Let's just take that for the example.

We know that that class of medications, which are both stimulants, cause certain physiologic effects on people. I don't have to do a study to know that if I give you cocaine, your metabolism speeds up; if I give you methamphetamine, your metabolism speeds up.

It's common knowledge, at least in the medical field, that when your metabolism speeds up, other things speed up, such as your respiratory drive. That's basic physiology.

I don't think anybody's really questioning the physiology behind that. Where I think a lot of the questions do come in when people criticize and say, "Well, you've never tested these on somebody who's been high on methamphetamine or cocaine.…" That's a very easy academic argument to make, simply because the answer is: "You know it can never be done." So I think that is not a helpful way to approach this.

The third comment that I would say on that is that we have done our best to approach this in looking at the mechanism by which cocaine intoxication would kill somebody. That would be severe acidosis and catecholamine excess. If you look at the paper, I think it's listed as No. 11, which is the one that won the award I was talking about.

We specifically looked at those two factors. I don't need to have somebody on cocaine or methamphetamine to get them in a hypermetabolic, hyperadrenergic state. I can get them very excited by doing a number of other things, such as having them run wind sprints, punching a bag, being chased by a police canine dog. All of those things serve the same purpose — to get your physiology to the same level as taking a stimulant type of drug. And that's exactly what we did.

That's why, when I got to that point in my discussion…. What we've tried to do is to re-examine all of those factors that are inherent in some of those arrest-related deaths that come about. We've tried to come about it in a different way.

Honestly, I think we've done a pretty good job at that. It's not perfect. I'll still be the first one to say that yeah, you're right. They weren't under the influence of an illicit substance at the time we did that. But I think you and I both know that that's never going to happen. So we're left with the information that we have, and we have to make our best conclusions off of that.

K. Corrigan (Deputy Chair): Yeah, but we do have deaths associated still. We do have deaths and have had deaths.

J. Ho: We do, but we also have deaths that are not associated with CEWs. Again, the point I was trying to make is that I think there is a common mechanism here that we are probably not fully understanding or not focusing on the correct thing. That's the point I was trying to make with that.

L. Krog: Thank you very much, Doctor, for coming. You've come a long ways to present to the committee.

You used the term "excited delirium." I'm wondering: do you recognize that as a medical term? Do you see that as a bit of a cliché? Is it a misnomer? Is it something we should rely on? Does it exist?

J. Ho: Okay. Well, I'm going to be careful the way I answer that, because I'm in Canada and I'm not a citizen here, so I can't tell you what Canada should rely on or look at. I will tell you that with increasing regularity, the practitioners that actually deal with this type of phenomenon…. Whatever you want to call it, in their minds it exists, and in my mind it exists.

We don't necessarily have to call it excited delirium. We could call it, you know, profound agitation. We could call it metabolic acidosis with significant psychosis. We can call it a number of different things. I happen to use excited delirium because I think it describes it well in what we see clinically.

I've had a lot of debates with panels and experts over time. Most of the people that do not believe in it or say that it's a made-up condition tend to be made up of folks in the psychiatric area of medical practice or the medical examiner–forensic area of practice.

Before I get too far on that, I would say that probably the majority of medical examiners adopt it. The National Association of Medical Examiners actually uses that as a term. The American College of Emergency Physicians uses that as a term. So the practitioners that actually deal face-to-face with these people when they're out of control — we all identify that there is something there that
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exists. We choose to call it that. You can call it whatever you would like.

The discussions that I've had with people like psychiatrists that say it doesn't exist because it's not in their manual of statistical diagnoses…. We could also have that same argument now about things like autism because they've just restricted that diagnosis in their new version of DSM-IV. So that's an ever-changing target. They add things and take things away. It doesn't necessarily mean it doesn't exist. They're just choosing to call it something else.

I would also make the argument that, at least in my country, when someone presents in a violent, agitated rage, they are never seen by the psychiatrist. They are always seen by the emergency physician first, and if we don't do our job correctly, then they're going to get seen by the medical examiner.

By the time they make it to the psychiatrist, they've been medicated, restrained, calmed down. It's days later, so it's very hard to get people to understand what they looked like in the acute-phase reaction of this. I can see why we have our differences in semantics, but I think that anybody who would say that that type of a condition doesn't exist has never really practised in that acute setting.

K. Corrigan (Deputy Chair): I wanted to ask a little bit about your relationship with Taser International. I appreciate that there was disclosure at the beginning. You said that your salary is not paid for; that your salary is paid for by the trauma centre at the University of Minnesota. Is that correct?

J. Ho: Partially correct. It's paid for by the trauma centre I work for, which is not the University of Minnesota. It's Hennepin County Medical Center. The university is where I hold my academic appointment, but the university does not contribute anything to my salary.

K. Corrigan (Deputy Chair): Okay. You talked about Taser having a contract with the hospital. Which hospital is that?

J. Ho: That would be Hennepin County Medical Center. It's actually the Hennepin health system, which is my employer.

K. Corrigan (Deputy Chair): Okay. So you're not getting paid directly, but the reality is that there is a significant amount of money from Taser International going to Hennepin. Do you know how much money that is?

J. Ho: It's an hour-by-hour rate. I don't know what it is, because I don't hold the contract. What they've agreed to do is that the contract basically protects me from 32 hours of a shift that I would otherwise be working in the emergency department seeing patients. Those 32 hours of time are protected so that I can work on these types of issues.

K. Corrigan (Deputy Chair): So essentially, your time to do this work is being paid for by Taser, even though it's not directly coming to you.

E. Foster: Two questions. One, a bit on the lighter side: where do you get people to volunteer for this? I can't imagine anybody doing that to themselves.

The other thing is that you spoke to bad outcomes in situations where Tasers or CEWs were not used. Is there somewhere we can get statistical information on that before-and-after type of…? Is there anywhere that that would be logged?

J. Ho: Sure. Let me take the second question first, because I think it's probably the more important one. There is, to my knowledge, no governmental database that tracks that information. In the United States, at least, the Department of Justice has tried to put up a mandate where all of the states would report in adverse affects to that. But it's an unfunded mandate, and most of the states cannot keep up with that.

Our Department of Justice will admit that it is far from being accurate, but they do have some semblance of a database that looks at deaths in custody. It's not perfect, because they look all deaths in custody. So they'll look at people that die incarcerated in the justice system, something like that. It's not always just the sudden death on the side of the road.

However, the way I tend to look at it — this is not very academic, but it's actually technologically advantageous, though — is to just do a Google search. If you set yourself up on a Google search to every day report to you police deaths, custodial deaths — you give it the search terms you want — it will spit out to you every reported death that occurs that the police were somehow involved in. You might get 15 of them, and as you kind of read through them, some of them don't really apply.

The ones that do…. You basically have: "Okay, I've got four deaths that happened yesterday in the United States, all in police custody. Here's what I know about them by the news reports: this person was apparently high on something; this person had X, Y or Z going on; on this one a CEW was used; on this one it wasn't."

That's the way that I have been tracking these. Admittedly, it's far from perfect. It doesn't guarantee that I see every single one of them that comes across anywhere in the country, but right now it's the best that I've got. That's how I can say with certainty that these are occurring.
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Then to the first question you had, we actually have no problems getting volunteers. We have a waiting list for volunteers on these. The reason is that most of them are law enforcement or corrections people who realize that if we don't do this type of research to understand how to use these things properly, they're going to get taken away from them. They know that they need this to do their jobs correctly.

A quick follow-up, then. In the bit of unofficial research that you're doing on it, the deaths in custody — eliminating the people that had a heart attack or for whatever reason you eliminate — would you say there are more from CEWs or another way, non-CEW — chokes or whatever?

J. Ho: Two things on that. One, we don't really eliminate people that have a heart attack, because if you're fighting with the police and you suddenly have a heart attack and drop dead, you died in custody, technically. You suddenly died, and it wasn't expected. Whether it was from X, Y or Z, you died from a cardiac event. We do include those. That's actually a real known cause of sudden death, in dealing with that. It is a problem.

E. Foster: Do you have a bit of a best-case guestimate where the majority of the deaths are?

J. Ho: I would say that over the years now that I've been looking at this, over the decade or so that I've been sort of tracking all of these, the number of times a CEW is used in relation to somebody temporally dying in police custody has gone up.

Initially when we looked at that, if you weren't really thinking about it critically, your analysis of that would be: "See, I told you. If you use a CEW, your chances of dying are higher." But actually, what that probably correlates more with is that over the decade there are more and more agencies that are using these devices, so they tend to have much more volume on the street.

When we first started looking at this back in 2003 and you only have 400 police agencies out of 17,000 or whatever it is in America using them, you're just not going to have very many represented, because the majority of people aren't using them yet. As that starts to grow, because they're now buying these or using them in the field, you're going to have a higher association.

You have to be really careful about making the association of "just because it was there and somebody died, it caused the death," because that association has not clearly been established.

E. Foster: On the same line, has the number of in-custody deaths increased across the board?

J. Ho: In the decade that we've been looking at this, that part is not clear to me either. The reason I would tell you about that is because again, as we go back…. I told you that we don't really have a good way of tracking this. So ten years ago I'm not sure how many we were actually having. We don't have a good handle on a denominator ten years ago. But as the advent of the Internet and instant news comes out and your ability to do searches has gotten much better, I'm getting more of these. You can refine your search, and things like that.

So yes, there is a sense in my book that arrest-related deaths, regardless of whether a CEW is used or not, are going up. But I honestly couldn't tell you if they are truly going up or if the reporting is better or my surveillance is somehow enhanced. I just don't know the answer to that.

I will tell you — and I didn't include this paper in there — that if you go back in history and look, arrest-related deaths and psychosis-type deaths or excited delirium deaths or whatever you want to call them have been reported well, well before CEWs were ever introduced, well before cocaine was a problem in this country. The earliest paper that I've seen cited on this is back from the mid-1800s.

We know that those types of deaths have occurred in custodial situations, but again, nobody was keeping track of a denominator.

J. Trasolini: Dr. Ho, you've said that you have identified a risk window in some of the newer weapons that in fact were not manufactured. But your study did somehow identify some critical areas to stay away from. Could you give us a little bit more information on that?

What also I'm wondering is that if in fact by changing the weapon slightly, going to a more dangerous area…. The weapons that are now being used in North America — could there be that same window that we're not measuring in these experiments?

J. Ho: Well, I think we are measuring it in these experiments. I don't mean for you to…. Hopefully, you didn't understand that I said there was no window of risk, because there is a window of risk in every device that's out there. I think the important thing that you have to understand is that in these types of weapons we are balancing the need for effectiveness with the need for as much safety as possible.

Obviously, you want to have these devices be absolutely as safe as possible in all situations, but you also want to have them work — okay? You can't have 100 percent of both. That's about as easy as I could put it. If you made this device or weapon 100 percent safe in all situations, it basically wouldn't turn on. I mean, you would just take it out of the mix. It takes it right off the table as being a usable weapon in these situations, so it would have zero effect.

If you make it too powerful so that it works 100 percent in every situation, then obviously the output is too much.
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You're going to be causing damage to people, and that's not acceptable either. So we're trying to find sort of the balance where we get acceptable levels of both.

Like in every other tool that's out there…. For instance, I'm not sure what else your law enforcement officers carry, but ours carry batons and pepper spray and things. Those are not without risk either. I can kill somebody with a baton if I hit them in the wrong place. I can take out somebody's eye with pepper spray if I shoot it too close.

There are a lot of different things there that you have to consider, so nothing is zero risk. We try to make these as balanced as possible. What I'll tell you is that the window that is there today, and the window with the new technology devices, at least the ones that I'm familiar with from Taser International…. That window is extremely small, and it would have to be an absolute perfect shot under perfect circumstances — such as an extremely skinny person, that kind of thing — in order for it to create that type of a risk.

Can it be eliminated 100 percent and still be effective? I don't think it can, at least not with what is known about it today.

J. Trasolini: Yeah, I do understand that. The mere fact that there have been deaths — that, in fact, there is that window there…. That's what I was getting at. Are there measurable parameters? That's what I was trying to get at. In the past there's been this feeling of safety. You say: "This is a safe weapon." And of course, it led to the perhaps more frequent use than it ought to have been used.

At the same time, we are now getting in the situation where we're all looking for some measurable parameters, and that's what I was getting at.

J. Ho: Well, there are measurable parameters — I touched on it in my presentation — where the two factors that we believe…. We have sort of distilled this down to our total charge output of the device and dart-to-heart distance — okay? So you can manipulate either of those. If you're the manufacturer, you can make it greater charge output or lesser charge output. If it becomes lesser charge output, you also have lesser effect, so these…. You're not going to necessarily be able to control people if it gets too low.

Then as far as dart-to-heart distance, really that comes down to training, where you attempt to train officers not to shoot at areas that you believe are going to put it closer to the heart and things like that. Having said that, having walked in those shoes, it's really easy to just say, "Don't ever shoot at the chest," or something like that. The reality of that is….

For instance, if I'm the bad person sitting in this chair and there's an officer in front of me that has the device aimed at me somewhere — let's say it's not necessarily on my chest; it's aimed lower — but I decide to get up out of the chair and charge the officer and he pulls the trigger, the first thing I do when I go to get up out of the chair is I put my head down and go to charge him. That aiming point has now become level with my eye, and I take an eye shot. So to say that you should never shoot somebody in the eye or you should never shoot them in the chest is easy to put on paper, but in a dynamic situation it's very difficult for officers to be able to react with that kind of certainty.

G. Hogg: Well, with our responsibility as a…. We've been charged with looking at the issue, and obviously an issue of public confidence is paramount both here and around the world with respect to these — and also ensuring that police officers who are utilizing them have some comfort and confidence in what they're doing.

Is there any other research that you see that would be the next iteration of research that might encourage or help us in terms of addressing those two issues? And does it need to be stated up front that there is a risk associated with this — as you've eloquently stated — as exists with all weapons, all resources which are utilized by the police, and whether or not the risk is greater or lesser than any other?

I'm looking at the bigger picture in terms of the public confidence and confidence…. We’re seeing our police officers using it less and less because of the media coverage that has happened in this area. We recognize, I think, that Justice Braidwood in his work said that there is a need for it, so we've got to find some way to balance that and provide the confidence to both sides of that.

So my question is: do you have some ideas about that? Or is there other research that needs to be done, in your opinion, with respect to this?

J. Ho: That's a really good question. That makes me believe that you heard my message. I appreciate that.

I don't know that there is necessarily research that needs to be done to support that idea. I mean, what you're talking about — at least in my mind, and maybe this is a very simplistic interpretation of that — is a public education campaign.

I think everyone in this room, having heard all of this, sort of understands that it's not a good idea to fight the police or resist. Those are all things that sort of come with inherent risk.

If we're having this conversation around people that have been resisting…. I understand that there's mental illness, and I understand there's a whole host of factors that lead to resistance, but the bottom line is: that is sort of a dangerous proposition. If you're going to go down that pathway, the police have a duty to respond to that. If the response is that you take CEWs out of their toolbox, my guess is — in fact, it's an absolute prediction — you're going to see injuries go way up, and you'd be having the
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same commission talk about why the police are clubbing people more or why they are causing more head injuries or something like that.

Again, there is that balance. I think we know pretty well what these devices do and don't do and what they're capable of and not capable of. I think it's more a matter of messaging that, good training with the officers, as tight as you can make it, but also so that the public understands exactly what you said — that we need to be able to have our officers have confidence in using this. There's no reason to give your officers these devices if they won't use them. They're so afraid to use it because they're going to come under public scrutiny or a lawsuit or something like that. I get that totally.

I don't know how that all works up in Canada, but that is something we also struggle with every day in America. It's proper messaging, and it's public education.

G. Hogg: Some of the people that have appeared before us and have been critical of you and Taser and the work have equated that criticism to a conflict of interest, I think largely more so than I've seen in terms of any methodology.

Do you have any comment with respect to appropriately peer-reviewed research and any criticisms that your colleagues have of you? What do you think are the most profound criticisms of the Taser and of your work?

J. Ho: Well, what I can say is that I think probably the biggest criticism I get is because of that perceived conflict of interest. Most physicians, if you're going to be the medical director of a large corporation that is making a for-profit product… I'll just use a drug company as an example. If you're the medical director for Pfizer, yeah, those guys are making money hand over fist, and their job is to promote that product.

I have, to the best of my ability, attempted to provide medical direction with as little conflict as possible, and I think I've explained pretty well to you how I've done that. Whether it's perceived that way or not I can't say, but the reality of it is that I'm not making money hand over fist at these. I don't get paid for positive studies or anything like that. In fact, if you look at our work, we've put out our negatives as well as our positives, and it's out there for people to digest.

I'm willing to take the criticism. I understand that. The real reason I do this is I walk in those shoes as both as a physician that wants to prevent injury and as a cop that wants to be able to appropriately use devices that control people in these situations so that I don't get hurt and that person doesn't get hurt. I know that if I don't do this work, it's not going to get done. That's the biggest reason it's out there. And as far as the conflict goes, if we did not have funding from the industry to do this, it wouldn't get paid for. It just wouldn't happen. We would not be talking about any of these 11 papers today without that.

G. Hogg: Is there any other research in existence which is in conflict with your findings — any peer-reviewed work that has been done? If we get away from the issue of conflict of interest and just go to the academic body of work, is there anything in conflict, or what is the one which is in greatest conflict with your work?

J. Ho: If you look at similar work that has been done with methodology of looking at bench research on human physiology, to my knowledge there is nothing out there that is in contradiction to our findings.

The pieces that I've seen that have been thrown at us the most that are contradictory to our work have been early animal studies about five years ago, where right around 2007 we had our respiratory study, which I think you talked about, come out. Right around then there was an animal study where they reported the animal had stopped breathing during CEW exposure on the lab table. That was initially told to us a number of times: "See, we found that CEWs cause the animal to stop breathing, and therefore your study is flawed because you're reporting that humans breathe."

When we examine those papers side by side, first of all, it's two different things. When you're examining an animal, the animal is under general anaesthesia, so you have it on a life-support machine. The machine is breathing for the animal. What they had done in that study was…. In order for the life-support machine to breathe for the animal, they had to give the animal medication that paralyzes it so that the lungs can be inflated normally. They had actually turned the machine off during the CEW exposure so that they could measure skin activation.

To us it was pretty clear: "Well, the reason your animal is not breathing is because it has been paralyzed chemically and you turned off the life-support machine. That's the reason your animal is not breathing." When we pointed that out to them, that argument went away. We do have those come up from time to time, where people will say: "See, we have found something that is absolutely 180 degrees different than what you've had."

The only other study that I'm aware of that has been used somewhat against other findings is a study by Byron Lee, out of UC San Francisco. His is more a survey than a study, but it is in a peer-reviewed journal. He ended up reporting that the year after deployment of Taser weapons by a few California law enforcement agencies the number of officer-involved shootings went up for that year, or something like that. His conclusion from that was that deploying Tasers in a department causes officer-involved shootings to go up.

There are a number of different problems with that study that I probably don't have enough time to get into now, but No. 1, it's a survey. He sent out dozens of surveys to agencies and only got a few back, so it's not really an accurate representation of what's going on there. And
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No. 2, it just doesn't make any sense either. It's kind of like you're comparing apples and oranges and trying to make them connect. It doesn't work.

The best analogy I heard, which somebody who read that paper told me, was that it's kind of like saying that in the summertime more ice cream is sold at the beach, and in the summertime more shark attacks occur because there are more swimmers in the water. If you remove the fact that it's summertime and you just say that shark attacks correlate with higher sales of ice cream, you're sort of missing the point. You're trying to connect two things that can't really be connected.

G. Hogg: In our law enforcement we use radar and radar guns, and we regularly test those. If you're going to go to court with that because you've pulled someone over for speeding, you have to have the calibration and certification of that. Are there certification or calibration issues that should be done regularly with Tasers to ensure we have the same level of comfort that they're functioning accurately as we do with our radar?

J. Ho: I'm probably not the expert to answer that. I don't hold myself out to be an information download expert on Taser devices.

I will tell you that we did just publish a textbook of which I'm an editor. It talks about the forensic analysis of Taser wounds and internal downloads. There's an entire chapter in there about the information that can be gleaned from a downloaded device. It talks about all the problems you can have — for instance, data corruption and decimal point miscarriage and time drift, and things like that. I would recommend that the committee here get at least that chapter out of that book and read that over, because I think it will address some of that.

My view of that — and I didn't write that chapter; I'm not the expert in that area — would be that based on all of those things that could potentially drift over time, it's probably wise to have some policy where you're regularly checking or analyzing these devices.

I think you have to be careful on who you get to analyze those devices. There have been a number of people in the United States that have come up over the years who have kind of hung a shingle out on their garage and said: "I know how to test these devices. Send them to me, and I'll do it." We have found that some of their work has not been completely accurate, so I think you have to be very careful about how you do that.

G. Hogg: I assume that in your research — before you used the Tasers, and they were calibrated to, say, a certain amount of output — you would have checked that already, first, with each one.

J. Ho: We didn't check them before we started the tests, but the way that we sort of…. Our methodology involved taking a brand-new one out of the box, straight from the factory. Before they're sent anywhere in the box, from day one they're supposed to have been calibrated at the factory. We're sort of assuming that the factory did its job, that we open the box and use it and that it's good to go. The chapter that I'm talking about talks about weapons that have been owned by the agency for five years or something that have never been checked.

K. Corrigan (Deputy Chair): You talked earlier about there being a window of risk and that if you made Tasers safe in all situations, they wouldn't turn on. I'm trying to hone in on that a little bit. Having looked at some of the studies…. I must admit I haven't read every single word, probably, of every study, but I have looked at them. I'm wondering what makes you conclude…. Overall, your conclusions seem to be that they are relatively safe. That has been the overall conclusion of the various studies that you've been involved with or that you have presented to us.

I'm wondering if you could summarize what it is in your work or other people's work that causes you to make that statement. I'm wondering, for example, if it's the 2006 "Cardiac Monitoring of Human Subjects Exposed to the Taser," where heart rates did go up during the study. What is it? Is it things, results, like that that make you realize, or is it anecdotal? Is it reading that people die in association with Tasers? Why do you conclude that there are risks and that they're not entirely safe?

J. Ho: Sure. First of all, the piece that you just said about heart rates going up. The reason they go up is because it's painful, and we have pretty good evidence that as soon as you inflict a painful stimulus on somebody, their heart rate jumps up. That's basic human physiology. That's not really a significant finding in the overall effect of safety, so to speak. That's sort of an expected finding that we really sort of anticipated. We also see heart rates go up even before they start the test, and that's because of anxiety. So there are a number of different reasons there for that.

The reason I conclude the way that I've concluded here — and as you've pointed out, most of these have been fairly positive conclusions — has been that if you look, again, at the context of CEWs and what they're used for and what they are designed to do, in the probably tens of thousands if not hundreds of thousands of North American police-subject contacts every year where a Taser-type device or a CEW is used, where it goes totally the way it's supposed to — unreported problems because there aren't any; good outcomes — that is an overall good record.

The vast majority of these things come out very, very well — exactly the way they're supposed to. We're talking about a fairly small handful of cases where we are looking at bad outcomes, whether that's a person who has a
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heart attack afterwards or a cardiac arrest or whether the person loses an eye because of a dart that's fired into the face instead of somewhere else on the body.

If you take that in the context of how many times these devices are used every single day and how many times injuries are prevented in both the officers and the suspects because the suspect gives up or doesn't even want to have a part of that or something like that…. The context of that is, again, that it's not zero risk, and I've said that a number of times this morning. But it is so low as to be acceptable. It really should be acceptable by both parties.

K. Corrigan (Deputy Chair): Okay. So you're saying that there is a risk, but you have these various studies where nobody died, essentially, or it didn't have severe outcomes. I'm not making light of it, but I'm trying to square the two. After the work that you've done, apart from eyes…. But deaths — why are people dying, then?

J. Ho: If you go to that award-winning paper in 2010 that I referred to a few times this morning, we actually are proposing several alternative causes of why people die in custody. To get to the heart of that, we have sort of agreed here, and I will agree to it…. Can you cause cardiac stimulation with a CEW if its proper charge is high-enough output and the dart-to-heart distance is extremely close? I've said yes, because we've actually seen that in the lab. I'm not trying to defend that or say it doesn't happen.

What I am saying is that we see people die in circumstances where that is not part of the factor — okay? You may have in your mind a case where you think that's part of the factor, but I can tell you that as the medical director I've reviewed all these cases. In the vast majority of these I've seen things where people have been shot in the leg, and they subsequently die. I mean, that has nothing to do with electricity being delivered to the person's leg.

I see a number of autopsy reports in these cases where they have massive quantities of illicit substances in their bloodstream, and that is somehow dismissed as: "Well, that probably wasn't the cause." It is.

I've also seen cases where…. We talked about heart attacks earlier — cardiac arrest. Maybe in 15 or 20 percent of these arrest-related deaths these people actually have structural cardiac damage, and they're walking around without even knowing it. They could just as easily have died in a physical exertion event such as running — taking a two-mile jog, or something. In this case it happened to be that their stress test was fighting with the police. They drop dead from that.

What I'm sort of saying here is that you have to put it into perspective, that there are alternative causes for this as well. You have to think about it like that. From all the work that we've done, our lab is now focusing on what some of those alternative causes are, because simply exciting the heart does not explain the number of arrest-related deaths that we're seeing in custody.

Those mechanisms are specifically — and you can read about it in this paper — elevated catecholamine states and major acidosis, as well as prone positioning from preload dysfunction. Those are all very sort of scientific medical terms that I'm telling you. I've included those papers in there with that information in it.

M. Coell (Chair): Well, thank you. I know we were scheduled from ten till 11, and we've kept you a little bit longer than that.

Dr. Ho, thank you very much for coming the great distance you did. It's appreciated, and safe travels home.

M. Coell (Chair): I guess a motion to go in camera so that we can continue with the deliberations of the report.

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Chair:	* Murray Coell (Saanich North and the Islands BC Liberal)
Deputy Chair:	* Kathy Corrigan (Burnaby–Deer Lake NDP)
Members:	* Ron Cantelon (Parksville-Qualicum BC Liberal)
	* Eric Foster (Vernon-Monashee BC Liberal)
	* Gordon Hogg (Surrey–White Rock BC Liberal)
	* Leonard Krog (Nanaimo NDP)
	* Joe Trasolini (Port Moody–Coquitlam NDP)
	* denotes member present
Clerk:	Susan Sourial
Committee Staff:	Josie Schofield (Manager, Committee Research Services)

Witnesses:	Dr. Jeffrey Ho (Taser International, Inc.)

REPORT OF PROCEEDINGS (Hansard)

SPECIAL COMMITTEE TO INQUIRE INTO THE USE OF CONDUCTED ENERGY WEAPONS AND TO AUDIT SELECTED POLICE COMPLAINTS

REPORT OF PROCEEDINGS
(Hansard)

SPECIAL COMMITTEE TO
INQUIRE INTO THE USE OF CONDUCTED ENERGY WEAPONS AND TO AUDIT SELECTED POLICE COMPLAINTS