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Showing posts with label dr. charles kerr. Show all posts
Showing posts with label dr. charles kerr. Show all posts

Monday, February 01, 2010

Howard Hyde Inquiry - Proposed Witness List

February 1-2 - Dr. Christine Hall
February 3-4 - Dr. Joseph Noone
February 8 - Dr. J. Kinlay
February 9-10 - Dr. Charles Kerr
February 11 - Dr. Theriault and a psychiatric nurse from QEII
February 15-16 - Dr. Stephen Hucker
February 17-18 - Dr. Michael Howlett
February 19 - Dr. Sarban Singh
February 22 - Cst. Delton MacDonald (Cape Breton Regiobnal Police Liaison Officer)
February 23 - Steve Lurie, CBMHA, Ontario
February 24-25 - Dr. Michael Webster
February 26 - Paul Kennedy, Training Officer, Department of Justice

Thursday, May 14, 2009

Taser did more to kill Dziekanski than restraint: Expert

May 14, 2009
By Neal Hall, Vancouver Sun

Being Tasered five times by RCMP officers contributed more to the death of Robert Dziekanski than being physically restrained by police, an expert doctor told the Braidwood inquiry Thursday.

Dr. Keith Chambers, a Vancouver epidemiologist, found there were two factors that contributed to the Polish man's death at the Vancouver International Airport on Oct. 14, 2007 — the five Taser shots fired at Dziekanski and the subsequent physical restraint by four Mounties.

He said the Tasering of Dziekanski appears on the bystander-shot video to have been a great deal more stressful to him than the act of physical restraint.

"The video shows the greater impact on Mr. Dziekanski of the Taser," Chambers told inquiry commissioner Thomas Braidwood, a retired judge.

The doctor's report on Dziekanski's death, submitted as evidence, concluded "the act of Tasering Mr. Dziekanski for 31 seconds over a period of 49 seconds contributed more to his stress response and subsequent demise than physical restraint."

The doctor was vigorously cross-examined by a lawyer representing the U.S. manufacturer of the conducted energy weapon.

But Chambers disagreed with the lawyer's suggestion that Dziekanski's death was coincidental to being Tasered.

"I couldn't disagree more," Chambers testified.

"To say it's coincident is wrong. Mr. Dziekanski died for a reason."

Getting jolted by the weapon's 50,000 volts of electricity "must be quite frightening, very painful and quite dangerous in terms of falls and other issues," Chambers said.

He also suggested the Taser could have malfunctioned and delivered a higher electrical current that expected.

Chambers pointed out that Dziekanski had been in a state of stress when he left his home in Poland 20 hours earlier and spent another stressful nine hours looking for his mother at Vancouver's airport.

'He was doing well — he did not have a cardiac arrest," the doctor pointed out of the period before police arrived.

"Something happened when the officers did the intervention," he added.

Police were called when Dziekanski began throwing furniture.

Seconds after police arrived, Dziekanski was Tasered and handcuffed. He stopped breathing and died at the scene.

Chambers concluded the "mechanism of death was most likely the creation of a hyperadrenergic state that caused or brought on a fatal arrhythmia."

Hyperadrenergic state is used to describe the physiological response to acute stress that triggers adrenalin and may have caused Dziekanski to hyperventilate and increase his blood pressure and heartbeat.

Chambers said he couldn't rule out the possibility of "direct capture of the heart" by the Taser shocks and the development of ventricular tachycardia, or a rapid irregular heartbeat.

Dr. Charles Kerr, a Vancouver cardiologist, testified by phone from Boston that Dziekanski had normal blood pressure and a relatively normal heartbeat, based on medical evidence from Poland.

Kerr submitted a report last month to the inquiry, saying: "I am in complete support of Dr. Chambers' thoughtful and succinct 'summary opinion.'

"It is hard to escape the conclusion that the Taser applications contributed as a major cause of Mr. Dziekanski's death, certainly through metabolic effects and development of a hyperadrenergic state, but not excluding a direct induction of a ventricular arrhythmia by the Taser application."

Kerr's report said he believes "that there is a very high probability that the multiple Taser applications were instrumental in the development of malignant ventricular arrhythmias and death."

Wednesday, May 06, 2009

Braidwood Inquiry

Scheduled Witnesses (Subject To Change)

Monday, May 4, 2009

Dr. S. Lu (Psychiatrist)

From Mother Jones - Taser's Delirium Defence, March/April 2009:

Shao-Hua Lu, a psychiatrist who treats addicts at Vancouver General Hospital, hadn't heard of ED before 2007, when he began working on a Canadian government probe of Taser safety. "No [practicing] medical doctor would write down 'delirium' on a death certificate as a cause of death," says Lu, who trains Canadian Mounties to identify mental health problems, including various forms of delirium, in their subjects. "I don't understand why MEs would write that."


Tuesday, May 5, 2009

Brian Hilton (CBSA)

Binder Kooner (CBSA)

Wednesday, May 6, 2009

Supt. W. Rideout (RCMP)

Inspector T. Lightfoot (RCMP)

Thursday, May 7, 2009

Don Ehrenholz (YVR Operations)

Dr. C. Kerr (Cardiologist)

See Tasers can cause death, inquiry told - CBC, May 20, 2008

Friday, May 8, 2009

Dr. Z. Tseng (Cardiac Electrophysiologist)

From the May 9, 2008 edition of the Toronto Star (reporting on Dr. Tseng's earlier appearance at the Braidwood Inquiry):

A heart-rhythm expert also told the inquiry there are real risks to Taser use, despite the company's safety claims.

"Just because somebody collapses of sudden death minutes later after a Taser application doesn't mean that the two are not connected," said Dr. Zian Tseng, a San Francisco cardiologist and electrophysiologist.

Tseng said any normal, healthy person could die from a jolt of the conducted energy weapon if the shock was given in the right area of the chest and during the vulnerable point in the beating of the heart.

He stressed the risk of death is far greater if there is adrenaline or illicit drugs coursing through the body or if the person has a history of heart or other medical issues.

Tseng fell into studying conducted energy weapons about three years ago when he created a media storm by telling a San Francisco newspaper the device could induce cardiac arrhythmia.

"Shortly thereafter I was contacted by Taser directly to reconsider my statements to the media. They even offered to support (my) research, to give me grant funding," Tseng said, adding he declined the offer in order to remain independent.

Tseng said there needs to be much more real-world studies on the use of the weapon, instead of using police officers – often large, healthy males – to test the device.

He also said medical examiners should be given more freedom to investigate such deaths, even seizing the weapon for investigation if necessary.

"If there's a person that dropped dead suddenly after Taser application and you can find nothing else on the autopsy, I would venture to say that's due to arrhythmic death."

The risk to suspects being shocked could almost be zero to the heart if police avoided using the weapon in the chest area, and Tsang suggested that be one of Braidwood's recommendations.

Tsang also said police should avoid repeated shocks to lessen the chance they'll set the heart into an abnormal rhythm.

He said the risks are very low of a person dying while being arrested by police.

"What we don't know is has the Taser increased that risk from that very low rate to a slightly higher rate."

Wednesday, May 21, 2008

Police need to know tasers can kill: MDs

May 21, 2008
Suzanne Fournier, The Province

Tasers can cause fatal cardiac arrest and are especially dangerous if the person being Tasered is agitated, stressed, dehydrated, exhausted or has heart disease, two top Vancouver heart specialists warned yesterday.

The Taser may be particularly dangerous if a dart hits close to a person's heart and is hazardous to any of the more than 35,000 British Columbians who have pacemakers or implanted defibrillators, the doctors told the Braidwood Inquiry into Taser use.

Police forces need to know the risks of using the Taser and be fully-trained in resuscitating heart-attack victims, the specialists said.

Dr. Michael Janusz, a heart surgeon at Vancouver General Hospital and a professor at the University of B.C., warned the inquiry that "Tasers must be regarded as being capable of causing cardiac arrest."

The Taser might be safer than a gun or club, said Janusz, but it can cause cardiac arrest and police should be "cognizant of this hazard. This will require a 'mindset' of providing immediate, thorough and meticulous care of critically-injured persons."

Janusz told commissioner Tom Braidwood, a retired B.C. judge, that the risk of dying after being Tasered is similar to the chances of dying during or after major heart surgery.

Janusz cited San Francisco cardiologist Dr. Zian Tseng's findings of about "1.4 per cent mortality for individuals subdued by police using a Taser, [which] is similar to the mortality risk of a coronary-artery bypass operation."

Dr. Charles Kerr, a cardiac electrophysiologist at St. Paul's and a UBC professor, warned that "the perception one gets is that the police officers do not seem to recognize that situations in which a Taser is used could lead to death."

Kerr said there may be a place in policing for the Taser and it is "better than a bullet," but he said it is essential that police understand "there is a potential for harm."

Kerr said although the possibility is low, it appears that even one dart of the dual-dart weapon hitting near the heart could trigger ventricular fibrillation, in which
the heart beats wildly and then stops.

People with "psychiatric disturbance" or who are on drugs are even more at risk, said Kerr.

Even "the pain inflicted by the Taser discharge" and the "extremely agitated state of most people receiving a Taser shock" increases the likelihood of ventricular fibrillation, he said.

As if to underscore the medical specialists' cause for concern, New Westminster police Staff-Sgt. Joe Spindor said later that most Taser training in B.C. is done by the manufacturer or by others like him who have been trained by Taser International.

"They stated the Taser is safe," said Spindor, explaining he was not told it could cause cardiac arrest.

Spindor said police in B.C. do not yet collect or share data on Taser use or its consequences.

Police do not carry defibrillators, said Spindor, who said the New Westminster police have used the Taser without incident since 2000.

Braidwood is inquiring into Taser use by municipal police, sheriffs and corrections officers.

Tuesday, May 20, 2008

Tasers can cause cardiac arrest: heart surgeon

May 20, 2008
By MATT KIELTYKA, 24 HOURS

Taser International’s credibility was called into question by a leading heart surgeon at the Braidwood Inquiry yesterday.

Dr. Michael Janusz, a heart surgeon and clinical professor at UBC, told the inquiry that most physicians would conclude that Tasers are capable of causing heart problems under the right circumstances.

And he questioned Taser’s reluctance to support that view.

“It creates a problem with credibility with the company and can make it difficult to deal with the company regarding safety,” Janusz said. “Tasers must be regarded as being capable of causing cardiac arrest. The consequences are not trivial.”

Both Janusz and expert cardiologist Dr. Charles Kerr, who also made presentations at the inquiry yesterday, said police need to recognize the risks of using a Taser – no matter how small – and be prepared to deal with complications immediately.

Extremely agitated people are especially susceptible to heart problems because of their increased heart rate and other metabolic changes, according to Kerr.

“There should be a realization that the potential for sudden death does exist,” he said. “Policy should recognize that.”

Kerr says officers should be fully trained in resuscitation and have defibrillators within reach when a Taser is deployed.

Tasers could cause cardiac arrest, doctor says

May 20, 2008
Neal Hall, Vancouver Sun

The electrical shock from a Taser stun gun used by police could cause cardiac arrest, a Vancouver heart surgeon told a Taser inquiry today.

"One can conclude the risk of death from a Taser is small but not insignificant," said Dr. Michael Janusz, a heart surgeon at Vancouver General Hospital.

"Tasers must be regarded as being capable of causing cardiac arrest," he said. "The device appears to be safer for all concerned, including bystanders, than guns and clubs, but its consequences are not trivial," he added.

"Hearts don't simply stop," he told inquiry commissioner Thomas Braidwood.

Janusz said there has to be underlying heart disease or other contributing factors such as lack of oxygen due to asphyxia or massive blood loss or severe metabolic abnormalities such as acidosis or abnormal potassium levels.

He said first responders should be thoroughly trained in providing first aid and use of a defibrillator.

Another expert, Vancouver cardiolist Dr. Charles Kerr, made s similar submission.

Janusz also questioned the credibility of Taser International, the manufacturer of the Taser. The company maintains Tasers could not cause cardiac arrest.

"This creates a problem with respect to the credibility of the company and could lead to difficulty in dealing with the company in matters of safety standards and training requirements," he said.

Kerr, who practises in the field of electrophysiology and is current head of the Arrhythmia Management program at St. Paul's Hospital and the University of B.C, told the inquiry that a heart beats as the result of an electrical impulse.

Of most concern about the use of the Taser is the electrical function of the heart ventricles, the main pumping chambers of the heart.

Kerr said there is a potential for harm and cardiac arrest.

"It is my opinion that there is a small possibility that an electrical discharge from a Taser dart could directly induce ventricular fibrillation," he said.


Kerr said the pain inflicted by the Taser causes intense muscle contraction, an increase in heart rate and adrenaline-like chemicals and sympathetic nerve discharge.

"This coupled with subsequent physical restraint of the individual could also result in the inability to breath adequately and possibly a drop in oxygen levels and changes in the acid balance in the blood, which would make the patient more prone to ventricular arrhythmias."

While the Taser appears to be a much safer weapon than guns for both victims and police, police do not seem to recognize that Taser use could lead to death, Kerr said.

In such situations, he added, people should be ready to perform cardio-pulmonary resuscitation and use automatic external defibrillators.

"It would seem reasonable to recommend that an automatic defibrillator be readily available in such circumstances," Kerr said.

Cardiologist, heart surgeon tell Taser inquiry weapon can cause cardiac arrest

May 20, 2008
The Canadian Press

VANCOUVER — Two heart specialists told an inquiry into the use of Tasers on Tuesday that a jolt from the weapons can "almost certainly" cause heart problems and possibly even sudden cardiac arrest.

Dr. Michael Janusz, a heart surgeon and professor of surgery at the University of British Columbia, told the inquiry that based on his study of available literature on Taser use, "almost all physicians would conclude that Tasers can induce ventricular fibrillation."

The hearing was told ventricular fibrillation is an extremely rapid rhythm in the heart's lower chambers, leading to ineffective contractions of the heart.

"In summary, Tasers almost certainly can cause cardiac arrest in humans, particularly in people with underlying heart disease," Janusz said.

A spokesman for Taser International has told the inquiry that Tasers are not risk free and that the term "non-lethal" does not mean safe.

Taser International has maintained there's a big distinction between a Taser jolt being the cause of a death and it being a contributing factor.

Dr. Charles Kerr, another UBC professor and a heart surgeon, told the inquiry Tuesday that based on his reading of animal studies and the agitated state of most people who receive a Taser shock, he has concluded a Taser jolt could induce ventricular fibrillation.

"Whatever the cause of death in patients receiving Taser discharges, there does appear to be the potential of a cardiac arrest situation, as has been demonstrated on a number of occasions," Kerr said.

In a state of ventricular fibrillation, "the heart cannot pump blood and, unless it is interrupted quickly, sudden cardiac death will follow."

Both men also agreed outside the inquiry that the Taser may still be preferable to a firearm or a club.

Kerr was asked whether they should be used when many questions about their safety remain unanswered.

"My personal opinion is that they are probably better than a bullet but I think we need to have the understanding that the entire situation, whether it's the Taser or (Taser contribution) there is no question that there have been situations of sudden death," Kerr told reporters.

Janusz said each situation that a police officer uses a Taser has to be judged independently. "Certainly in many or most situations it's a safer alternative than a gun or a club. "But I believe the risks are there and you have to be cognitive of the risks and be prepared to deal with any consequence arising from it."

The current phase of the inquiry is looking at the use of the weapon in general and the next phase will look specifically at the death of Robert Dziekanski at the Vancouver airport last fall, after he was hit with an RCMP Taser.