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Shocking force:

Police in Maryland didn't follow Taser safety recommendations in hundreds of incidents

Shocking Force: Police in Maryland didn't follow Taser safety guidelines, The Sun has found.

As two Montgomery County police officers slowly closed in with Tasers pointed, Anthony Howard retreated up a small step and backed himself against the front door of a townhome on a quiet cul-de-sac in the Washington suburb of Gaithersburg.

Minutes earlier, the 51-year-old man had asked an officer: "Are you gonna kill me?"

High on cocaine, Howard started the standoff by dancing barefoot on an SUV roof, barking and muttering gibberish on the late afternoon of April 19, 2013. Two dozen neighbors gawking at the bizarre spectacle laughed when Howard jumped off the Ford SUV to avoid an officer's stream of pepper spray, and they taunted police, urging them to use their stun guns.

Police said in a report on the incident that Howard had thrown "boulders" and charged at officers. But a 17-minute video taken by a resident and obtained by The Baltimore Sun shows that when officers approached Howard for the last time, he was standing still, holding a child's scooter. Officers fired two Tasers, shooting electrified darts connected by long wires into Howard's body.

After he dropped the scooter and keeled over onto a flower bed, police continued to pump electricity into Howard; he kicked wildly on his back with four officers standing over him. Police fired their Tasers at Howard nine times for a total of 37 seconds — far above the recommended limit of 15 seconds. He stopped breathing and died shortly afterward.

The repeated stunning that Howard received from the Montgomery County police is part of a troubling pattern across Maryland, a six-month investigation by The Baltimore Sun has found.

The first-ever data analysis of all Taser incidents in Maryland reveals that police agencies across the state have predominantly used the devices against suspects who posed no immediate threat. In hundreds of cases over a three-year period, police didn't follow widely accepted safety recommendations.

Legal and policing experts worry that misuse is rampant across the nation as an increasing number of departments outfit more officers with stun guns; a Taser is used by law enforcement 904 times a day on average. The experts warn that too often officers are turning to Tasers before exhausting other means of dealing with disorderly people, actions that courts are beginning to brand as unconstitutional excessive force.

And while the Taser has been hailed as a less-lethal way to handle difficult situations, police and even the manufacturer say if the weapon isn't used right, it can lead to death.

More than 400 people have died nationwide since 2009 in encounters in which police used electronic-control weapons such as Tasers, a Sun analysis shows. California tops the list with more than 60 deaths. Maryland ranks in the top 15 with 11 deaths, including five who died after being hit by Tasers for longer than what is now recommended.

The Sun's analysis of Taser use in Maryland found:

• Nearly 60 percent of those hit by Tasers in Maryland were described by police as "non-compliant and non-threatening," according to data from 2012 when the state began collecting data through 2014.

• In one out of every 10 incidents, police discharged the weapon for longer than 15 seconds — a duration that exceeds recommendations from Taser International, the U.S. Department of Justice and policing experts. The data downloaded directly from the devices often shows more activations than officers document in police reports.

• Officers fired the weapons at the chest in 119 incidents in 2014 — even though Taser has warned since 2009 that doing so could cause cardiac arrest. Data from earlier years only shows when police struck the "front torso," which includes the chest. That happened hundreds of times.

• According to police reports and other accounts, three people died after being repeatedly hit by a Taser in "drive-stun" mode, when the hand-held device is pushed directly onto the body, and two died after being hit with multiple Tasers at the same time. Both practices are discouraged by Taser and policing experts. In another death, a coroner determined a man was in handcuffs and face-down on the ground when an officer hit him with a Taser.

• Taser policies from 15 Maryland police departments with the most stun gun use vary widely. Some don't incorporate the warnings Taser has issued over the years or safety recommendations from national policing experts. Harford County's Taser policy is 53 words and stresses each use must be reported — except when used during training or on animals.

• In four Taser-related deaths, the state medical examiner's office found that "excited" or "agitated" delirium was a contributing factor. Some police agencies have enlisted consultants to train officers how to spot the condition and to call medics before deploying Tasers when they do. Symptoms are behaviors police often encounter, including incoherent speech and shouting, agitation and distress.

The Baltimore Sun created a database of every Taser use by police from 2012 to 2014 with information obtained through the Maryland Public Information Act. The Sun also interviewed law enforcement officials, people who were stunned with the weapons, and family members of people who died after being hit by a Taser since 2009; and reviewed use-of-force policies across the state, autopsies, court records and police reports.

Although the Maryland Governor's Office of Crime Control & Prevention collects data on every Taser incident, the agency's online annual reports only summarize the aggregate information. Data from 2015 is not yet available.

Anthony Howard's sister, Robbin, said that she and her family have been asking questions about his death but have gotten few answers. The family abandoned legal action against Montgomery County after police declined to turn over any videos they had obtained from neighbors who recorded the incident on their mobile devices. Two bystanders told The Sun that when police returned their devices, their videos had been erased.

"These officers have to be held accountable. They're very Taser-happy," Robbin said while watching the 17-minute video of her brother's death for the first time in her Clarksburg home last month with her father, two brothers and Anthony Howard's son.

Police and Taser officials point out that the weapon has been used successfully thousands of times to aid during arrests and protected officers, suspects and bystanders.

Police say they need a safer alternative to lethal use of force against unarmed suspects — 80 percent of those shot by Tasers were not carrying weapons — as officers frequently face dangerous situations amid intense scrutiny of their actions.

Takoma Park Police Chief Alan Goldberg, a master Taser instructor who spoke on behalf of the Maryland Sheriffs' Association and the Chiefs of Police Association, declined to comment on any specific incident but said exceptions exist if officers need to exceed the number of recommended activations.

"That's your only means other than shooting someone," he said.

Goldberg said officers come under stress during confrontations and do not realize how long they activate the trigger. He also said the weapons can be overused when officers first add them to an arsenal. He called it the "new-toy syndrome" that eventually lessens when officers learn what the Taser can and cannot do.

"Everybody wants to see the effect of the tool when they're on the street," Goldberg said. "They rely on it. You don't have to get your hands dirty."

The number of Maryland police departments using Tasers has grown to more than 75, and they are buying more. Baltimore City recently added 1,000 Tasers to its arsenal.

In 2011 the Maryland General Assembly authorized the collection of Taser data. A task force convened by former Attorney General Douglas Gansler had recommended two years earlier that the information be collected to better understand how Tasers are being used.

The task force also recommended the establishment of a statewide Taser policy, an action that failed to pass when police leaders across the state balked at a mandate. Such legislation hasn't been considered since then, even though policing experts warn that Maryland's hodgepodge of policies, each written by an individual department, imperils the public and exposes police officers to greater liability.

Only two states — Connecticut and Vermont — have statewide policies governing stun guns.

Chuck Wexler, executive director of the Police Executive Research Forum, which issued best practices for stun guns in 2011 under a contract with the U.S. Department of Justice, said police agencies need to adopt those national standards. He said the challenge is daunting, given that thousands of police agencies across the country use the weapons, but that doing so could reduce the number of deaths.

"This is a problem in the country," Wexler said. "Getting them all to know about these standards is a challenge. It's important because our guidelines are based on research and studying how people were dying."

Police use of force, especially in confrontations with black men, has become the focus of national debate. The General Assembly is considering a number of bills aimed at reform in the wake of last year's riots after Freddie Gray's death from injuries suffered in Baltimore police custody.

That debate has not touched on the use of Tasers, which were predominantly deployed against African-Americans in Maryland. Out of nearly 3,000 Taser uses over three years, 64 percent of those hit by the stun guns were black men.

Gansler said it's time for the legislature to revisit Tasers, now that the state has several years of data, and as residents are at risk of injury, police face legal liability and taxpayer money is spent to defend against lawsuits. He said Maryland needs a statewide policy.

"The state should absolutely revisit it," Gansler said in an interview in his Washington office. "Tasers have been used by a lot more law enforcement officers and law enforcement departments. We should have uniformity and consistency throughout the state."

Taser safety bulletins

In 1993, brothers Tom and Rick Smith formed AIR TASER Inc. in Arizona. The firm became Taser International in 1998 and started marketing the weapons to law enforcement. The company dominates the market, and Tasers are the only stun guns used by police in Maryland.

With technological advances and evolving medical research, Taser frequently issues safety bulletins to police departments around the country. For more than a decade, Taser has warned that officers should minimize the number and duration of "exposures" to what's necessary to achieve their objectives.

Taser spokesman Steve Tuttle said in an email response to questions that while the weapon is "not risk free," more than 500 medical and safety studies have established the "general safety" of the device.

A March 2013 bulletin says use of the weapon "involves risks that a person may get hurt or die due to the effects." The bulletin tells users that following the instructions and warnings "will reduce the likelihood" of death or serious injury.

A Taser fires two electrified darts up to 25 feet to cause neuromuscular incapacitation. The Taser can be activated multiple times, typically in five-second intervals. The weapon can also be used in drive-stun mode, which causes pain.

The Police Executive Research Forum found in 2011 that drive-stunning may only exacerbate a situation by enraging the suspect. Unless officers have no other choice because the dart mode doesn't work or they need to create a safe distance to protect themselves, the forum concluded the drive-stun mode "is of questionable value."

A few years later, Taser said in a bulletin that "drive-stun use may not be effective on emotionally disturbed persons or others who may not respond to pain due to a mind-body disconnect."

Tuttle emphasized that no published medical or scientific literature shows that using a Taser in drive-stun mode "can kill a human or contribute to sudden death."

Maryland police officers used the drive-stun method in 14 percent of all incidents over the three years, and both darts and drive-stun mode were used in another 10 percent.

In one of the drive-stun cases, Montgomery County police Officer Susanna Stanley was dispatched on Oct. 10, 2012, to check on a suspicious black man standing in front of an apartment door in a Silver Spring complex. Stanley said in an incident report that she had trouble getting the 65-year-old to cooperate.

The police officers involved in cases examined by The Sun either couldn't be reached to comment or declined to be interviewed.

Silver Spring resident Karreem Ali, known formerly as Cicero Satterfield Jr., "appeared to be drunk or high on something," according to the report. Stanley said that when Ali would not respond to her commands, she attempted to guide him out of the building to a nearby sidewalk.

Officer James Walsh then arrived and tried to move Ali, but the 5-foot-4-inch, 225-pound man increased his resistance and began swinging his arms, the report said. Walsh sprayed Ali with pepper spray, but the report said it had no impact.

Stanley then used her Taser in the drive-stun mode, "with little effect." Still, she continued to drive-stun Ali, and the officers managed to get Ali's hands cuffed behind his back "after a 10-minute struggle."

The computer-chip log on Stanley's Taser showed 16 activations, for a total of 108 seconds. The longest drive-stun lasted 25 seconds.

Toxicology reports would later show that Ali had no drugs in his system. The man known as "Bubba" battled mental issues. A day earlier, he had called police to his apartment to report that his brother had stolen his prayer rug. The brother told officers that Ali had mental problems, and the matter was dropped.

Walsh asked paramedics to wash pepper spray from Ali's face, but then they left. It is standard protocol for paramedics to check any person struck by a Taser, and Walsh later explained in a deposition why he did not tell the paramedics an officer had used one on Ali.

"I was worried about his eyes, and I honestly thought something might be wrong with his shoulder. It didn't come into my mind to think about the Taser," Walsh said.

Stanley, Walsh and two other officers then loaded Ali into a transport van. Moments later, Ali stopped breathing. Paramedics returned to rush Ali to the hospital. Ali never regained consciousness and died four days later.

The autopsy noted that Ali had sustained multiple cuts and bruises on his head and neck and broken ribs during the struggle; the officers said they also used a baton on Ali. He had another 21 "diamond/square shaped abrasions" from the Taser on his upper left and right sides, both arms and left leg and left buttocks.

The medical examiner ruled that Ali died from "schizophrenia induced agitated delirium complicated by police restraint, cardiomegaly and obesity." The manner of death — homicide, accident or natural causes — could not be determined.

'How many times do you think you Tased him?'

Ali's family filed a lawsuit in federal court.

In August 2013, the family's attorney, Gregory Lattimer, questioned Stanley. According to a 38-page deposition, Stanley said she confronted Ali because the 911 caller had said he was trespassing. Stanley, then a six-year veteran, said she and Walsh were trying to make him comply.

"You Tase people to get them in handcuffs?" Lattimer asked.

"If they're not complying and resisting," Stanley replied. She said Ali had not thrown any punches but was kicking his legs while being held on the ground and refused to follow orders.

"How many times do you think you Tased him?" Lattimer asked.

"I would say probably 10," Stanley replied.

Lattimer showed Stanley the computer report from her Taser, which recorded 16 trigger pulls.

She continued to say she only stunned Ali five to 10 times, noting something was "going on" with her Taser.

During Walsh's deposition that same day, he said Ali did not use "force" against either officer.

"But he was noncompliant to her, which is — it's still resistance," said Walsh, then a 12-year veteran. And with Ali's hands tucked beneath his stomach, both officers feared he could pull a weapon.

Lattimer asked Walsh why Stanley repeatedly stunned Ali on his left side after they handcuffed his right wrist.

"We used the Taser on the left side to get the same success we had on the right," Walsh replied.

In March 2014, a new Montgomery County Police Department policy warned officers that any activation longer than 15 seconds "may increase the risk of death or serious injury." The warning came three years after the Police Executive Research Forum guidelines and a year after Taser issued its warning about such prolonged exposures.

The following month, the county paid Ali's family $450,000 to settle the lawsuit but admitted no wrongdoing. Based on orders from the county government's attorney, police officials declined to comment on Ali's death or the incident.

Still, Ali's family continued to believe Ali died after choking on pepper spray, and they were not aware that he was stunned so many times.

Terry Satterfield, a retired psychologist, said his brother would often stay away from the family when his mental illness flared up. He also had asthma. The second of 13 children, Ali had embraced the Muslim faith and worked as a teacher and barber.

"Bubba was my role model," Satterfield said at his home in Clinton.

When The Sun told him about the multiple Taser activations, Satterfield sobbed, got up from the couch and walked around the room, trying to regain his composure.

"No, man," Satterfield wailed.

Satterfield called for police to improve training when confronting people with mental issues. He said his brother had received services from the county's mental-health system.

"Bubba respected the police," Satterfield said. "He called the police for protection … but the same department he respected let him down and killed him."

Relying on Tasers

Plaintiffs' attorneys and policing experts said the Maryland data show that officers may be turning to Tasers before their safety is at risk.

In reporting Taser incidents to the state, police departments must record the reason for discharging the weapon. Officers have only three options: "non-compliant and non-threatening," "use of threat" or "use of force."

Of all incidents from 2012 through 2014, police reported firing Tasers in 59 percent of cases because individuals were noncompliant. Officers said they fired because individuals used force against them in 23 percent of cases and because officers were threatened in 18 percent.

Lattimer, the attorney who sued Montgomery County, said police officers believe they can use Tasers whenever suspects do not comply with their instructions — regardless of the reason.

"They use Tasers as a compliance mechanism," Lattimer said. "'If you don't do what I say, I'm going to Tase you.'"

Police also must report whether the suspect was armed; only 20 percent were. Guns accounted for 2 percent, "edged" objects 8 percent and "blunt" objects 1 percent. Officers listed "other" in the remaining 9 percent of cases, according to the data.

Goldberg, who spoke on behalf of Maryland police associations, said the data do not provide a complete picture of every Taser incident. An officer can still be in danger when dealing with a noncompliant suspect, he said, but the state doesn't collect the data in a way that shows that. Nor do the data show the suspect's level of resistance.

Moreover, the terms from which police must choose have different meanings in each agency, he said, and the state does not require further clarification.

"I don't like that terminology," Goldberg said.

Goldberg also said the data does not capture numbers for "success stories" when officers threaten to use a Taser by pointing its laser-aiming mechanism at suspects to resolve incidents without force. Taser cites studies that show pointing the laser or activating the drive-stun to demonstrate the electrical current leads to fewer discharges.

"I'd like to know those things," Goldberg said.

The Maryland data also don't reflect when individuals are hit with a stun gun after being handcuffed, which is widely discouraged unless doing so is necessary to prevent bodily harm to officers or others.

Police used a Taser on a handcuffed individual in one death in Maryland, according to an autopsy.

In that incident, paramedics and police responded to an accident scene on the night of June 28, 2011. Delric East, 40, had crashed his 1993 Cadillac Eldorado into a guardrail as he drove down Columbia Pike in Silver Spring. The air bags deployed, trapping East in the car.

When paramedics arrived, East began to "violently resist" their help. Montgomery County police officers freed East, but he continued to be combative.

In an autopsy that found East died of PCP and alcohol intoxication, a medical examiner wrote that police placed him "face down on the ground, applied handcuffs and subsequently deployed a Taser." A mask also had been placed on East's face to prevent spitting before he was hit with a Taser, according to the autopsy.

East stopped breathing during transport, "one minute" from the hospital. The medical examiner ruled the death an accident.

Coroners conduct their own investigations, interviewing officers and reading police reports, before making their determinations. The conclusion in this case contradicts what officers had written in previous reports — that East was shocked before being restrained. An officer wrote in a report at the time of the incident that the Taser was deployed and the subject "was eventually subdued and handcuffed."

Another police report written four months after the incident showed that Officer David Courtemanche fired his Taser at East for four cycles for a total of 37 seconds. The first cycle lasted 21 seconds.

East's family members attempted to obtain videos of the incident recorded by the police cruisers' dashboard cameras. But in August 2012, Montgomery County attorneys denied their request.

The county said that the recordings were part of a personnel investigation — exempting them under the state Public Information Act. County lawyers also feared the videos could end up on YouTube, documents show.

A family attorney requested that the Montgomery County Circuit Court review the denial. In an April 2013 order, Judge Eric M. Johnson wrote that the family could use the videos in a civil lawsuit and only show them to a "close family relative," or face contempt charges, and must destroy all copies at the end of the litigation.

The family never filed a lawsuit, saying a lawyer had advised them they didn't have a case. And they never got the videos.

Montgomery County police spokesman Capt. Paul Starks stressed that officers followed proper procedures in the four deaths since 2009 — the most in any jurisdiction in Maryland — and noted that grand juries declined to file charges against the officers involved.

"We can't change history. We're sorry," Starks said. "The fact that these people have died is sad and tragic. Family members love and miss them. … But sometimes the results of proper law enforcement aren't pretty."

Starks said Maryland law prohibits the agency from discussing personnel matters and whether any officer received internal discipline for their actions.

Officer Scott Davis, coordinator of the department's Crisis Intervention Team, said it's difficult at times to get someone handcuffed when suspects use drugs or have a mental illness. Depending on the situation, sometimes activating the Taser for more than 15 seconds is needed, he said.

"We have to make split-second decisions," Davis said.

Repeated Taser shots

Taser has "continuously warned of risks from repeated exposures since June 2005," according to Tuttle, the company spokesman. And since March 2013, he said the warnings have advised that "repeated, prolonged or continuous" use of the device on a person "may contribute to cumulative exhaustion, stress, cardiac, physiologic, metabolic, respiratory, and associated medical risks which could increase the risk of death or serious injury."

Data obtained by The Sun shows the incidents with the longest activations stretch across Maryland.

Hagerstown police recorded one use in 2013 with 31 activations for 159 seconds. A Cheverly officer's 23 activations in one 2012 incident lasted for 91 seconds; a Baltimore officer's 22 activations in a 2012 incident lasted for 68 seconds. Others included 16 activations for 80 seconds in Baltimore County, and 16 activations for 102 seconds in Rockville.

None of those people died.

Emergency medical personnel have been put on alert about such cases. Since 2010 they have been advised to consider additional evaluation and treatment for patients hit by a Taser for longer than 15 seconds, according to the American Academy of Emergency Medicine.

Taser and police officials said that the computer chip in the weapon holds officers accountable, as they may not remember how long they shocked individuals and record shorter uses in police reports.

"It's recording and tracking how it is being used," said Starks, the Montgomery County spokesman. "The officer can't adjust that."

Travis Lamont Smith of Baltimore experienced one of the longest Taser hits recorded in Maryland.

In December 2012, two Baltimore officers responded to Dudley Avenue in the Northeast District to confront a suspected burglar. The officers found Smith trying to enter a rowhouse. They wrote that Smith was removing his shirt and pants and that he charged at one officer. Another fired a Taser.

Smith pulled out one of the barbs, the report said. The officer reloaded a Taser cartridge and "used it again."

Paramedics transported Smith to MedStar Union Memorial Hospital. After doctors examined him, he was released without being charged.

The police report does not indicate how many times Smith was shocked. But state data shows that the officer activated the Taser for 22 cycles, totaling 68 seconds, one of the highest in the state in a single incident.

In a recent interview, Smith said he was trying to enter his grandmother's house and never charged at the officer. He also said his hands were raised when the officer fired the weapon. After he pulled a barb from his chest, another pierced his side, he added.

"I was trying to survive," Smith, 28, said on his grandmother's porch. "It was taking over my body. It's the worst feeling in the world."

Baltimore City police officials said they have since updated their Taser policy to make clear that officers should avoid repeated exposures.

John Hoey was hit by a Taser by officers from three different police departments — Anne Arundel, Baltimore and Prince George's counties — over four months in 2014, according to police records. In each case, he was unarmed.

In early April 2014, Anne Arundel County police shot the 49-year-old Pasadena man once with a Taser after a traffic stop. He later pleaded guilty to resisting arrest.

A week later, Baltimore County police arrived after a neighbor said Hoey had tried to break into the upstairs apartment in the same house where his girlfriend rented a unit. Police stunned him twice while he was in his underwear with his hands cuffed behind his back on a bed in his girlfriend's Lansdowne apartment, the report said.

The report does not list how many times the officer activated the device. But state data show twice for a total of 10 seconds. Numerous charges against him were dropped after he pleaded guilty to malicious destruction of property for breaking a padlock on the door between the two units.

Using a Taser on handcuffed suspects is "strongly discouraged," Baltimore County spokeswoman Elise Armacost said. "However, it is not prohibited because every case is different."

The third Taser incident occurred in July 2014 after a College Park gas station owner called Prince George's County police to complain that Hoey's car was stuck at a pump. His vehicle's alcohol monitoring system had malfunctioned.

Officers helped him move the car to a corner of the lot earlier in the day, but different officers returned hours later after the owner complained that he was still there.

Officers believed Hoey was intoxicated, smelled PCP and found the drug after ordering him out of the car, the police report states. As four officers used their knees, hands and batons to handcuff him, Hoey resisted until he was hit by a Taser, the report states.

The "use of force" report filed by police says there were two Taser strikes for a total of five seconds. But state data list eight activations for a total of 32 seconds — above the recommended 15 seconds. The police report states Hoey was stunned before he was handcuffed, but Hoey says he was hit by a Taser while handcuffed.

"It was like they were taking target practice on me," Hoey said.

He pleaded guilty to drug possession, but charges of trespassing, resisting arrest and disorderly conduct were dropped.

Police officials did not explain why the state data and the incident report do not match. An attorney for the Prince George's County Police Department said gas station surveillance video of the incident backed up the officers' accounts.

Statewide over three years, three-fourths of the incidents that led to a Taser being deployed were criminal in nature, data show. About 20 percent were coded "non-criminal," and 5 percent were traffic-related.

Chest shots

Since 2009 Taser has advised police that whenever possible, they should avoid targeting "sensitive areas of the body, such as the head, throat, chest/breast, or known pre-existing injury areas." The preferred target areas, according to Taser, are "below the neck area for back shots and the lower center mass (below chest) for front shots."

John G. Peters Jr., president of the Nevada-based Institute for the Prevention of In-Custody Deaths, said that Taser's safety bulletins about chest shots have evolved. "They've gone 180 degrees on their warnings," he said.

In 2009, Taser suggested avoiding the chest because of the "controversy" over whether the weapons "do or do not affect the human heart." Then in 2013 Taser warned: "When possible, avoid targeting the frontal chest area near the heart to reduce the risk of potential serious injury or death."

The company makes clear in safety bulletins that following its guidelines could help police avoid legal liability.

"Should sudden cardiac arrest occur in an arrest situation involving a Taser electronic control device discharge to the chest area — plaintiff attorneys will likely file an excessive use of force claim against the law enforcement agency and officer," the company said in a bulletin.

Peters, whose institute was once funded by Taser, believes that officers need to be better trained on "when not to use it."

"Police have over-relied on it," Peters said. "Even the manufacturer has agreed that officers have become codependent on the Taser and they would rather not physically engage people and use the Taser. That's pretty much true nationally."

He added: "Police officers have one-half the power of God: the power to take a life. They don't have the power to restore life. You want them to be as well-trained as possible."

In one high-profile case in Baltimore, a teenager died in a hospital after being hit by a Taser in the chest.

In May 2014, a toothache and a series of seizures landed 19-year-old George Vonn King, who was in the foster care system, in the emergency room at Good Samaritan Hospital. After suffering another seizure at the hospital, he was to be moved to intensive care.

King objected and tried to leave the hospital. He became combative and struck a nurse. Five security guards couldn't restrain King and called police. An officer struck King in the chest with the Taser's drive-stun mode and with the darts. State data shows six discharges totaling 27 seconds.

King fell into a coma, dying five days later. A lawyer told The Sun at the time that he represented the family, but no lawsuit has been filed.

Prosecutors later cleared the officers of wrongdoing.

In one of the biggest judgments against Taser International, California attorney John Burton won a $10 million wrongful-death lawsuit against the company in 2011. The company appealed, and it was later settled for a confidential amount. No other details about the settlement were made available.

The case involved a 17-year-old boy who died of cardiac arrest after being hit by a Taser in the chest for 37 seconds in the Charlotte, N.C., supermarket where he worked. The teen was arguing with a supervisor when someone called police, who arrived and hit the employee with a Taser.

Burton said officers resort to Tasers when traditional methods for calming tense situations would suffice.

"They're just so subject to abuse," Burton said. "It's torture."

Differing policies

Taser recommends at least six hours of training on how to use the weapon. But policies at several of the state's largest departments disregard key safety recommendations from experts and Taser's manufacturer, according to a Baltimore Sun analysis of the 15 agencies with the most incidents from 2012 to 2014.

Those recommendations advise officers to avoid shocking suspects more than 15 seconds. Any further discharges should be "independently justifiable, and the risks should be weighed against other force options," according to the Police Executive Research Forum. The guidelines also discourage targeting the chest or shocking someone who is handcuffed, and make clear that Taser's electrified-darts method is preferable to the device's drive-stun mode.

Baltimore City and Harford County did not include any of those recommendations during the three-year period. Baltimore updated its policy in October to include them.

Harford County's Taser policy remains one of the shortest.

"While the Harford County Sheriff's Office policy does not give specific recommendations on Taser usage, it should not be construed as a disregard of specific safety recommendations," Maj. John Simpson, chief of the Services and Support Bureau, said in a statement.

Simpson said deputies receive "comprehensive training" and yearly recertifications on proper use of force. He also said the department's policy is "under review" and will be modified to include separate sections to address the various methods of force, including Taser and pepper spray.

Anne Arundel County includes the four recommendations in its policy. Along with Baltimore County — and Montgomery County starting in 2014 — the county tells officers to avoid activating the Taser for longer than 15 seconds. Eleven other agencies give officers latitude to determine what's needed to gain control.

Five agencies, including Anne Arundel and Howard counties, instruct officers to avoid targeting the chest area. Four other agencies say officers can shoot in the chest area if they have no other choice. The others provide no guidance to officers on the matter.

On shocking handcuffed suspects, seven agencies don't offer guidelines. Five others say officers shouldn't stun them, while Baltimore, Montgomery and Prince George's counties provide exceptions to that rule.

While policing experts have said officers should limit the use of Tasers in drive-stun mode, only six agencies discourage the practice in their policies.

Police departments in Maryland, Virginia and three other states have begun revising their policies after the U.S. Court of Appeals for the 4th Circuit deemed some routine Taser uses as excessive force.

The task force convened by former Maryland Attorney General Gansler issued dozens of recommendations in 2009, including many of the guidelines eventually adopted by the Justice Department. Gansler sent the report to every police department in the state and to every state attorney general across the country.

In Gansler's home state, the recommendations were "sadly ignored," said Cary Hansel, a defense attorney who served on the panel, to the peril of residents who face serious injuries and to police and local governments that face legal liability.

"You see repeatedly what I consider lazy law enforcement, where officers don't want to take the time to use verbal techniques and calming techniques," Hansel said. "They are just flippantly going to the Taser."

Excited delirium

It is rare for coroners to directly blame a Taser for a death. The state medical examiner's office in Maryland hasn't done so in any of the deaths here.

One of the more common causes of death is the condition called excited or agitated delirium. In Maryland, the condition has been blamed, in part, in the deaths of four people hit by Tasers in confrontations with police since 2009.

But for years experts have debated the legitimacy of the condition. While coroners have adopted the controversial diagnosis, it is not recognized by the American Medical Association.

Symptoms of excited delirium include acting irrationally, removing clothes, shouting and grunting, refusing to follow orders, and displaying extraordinary strength and high tolerance to pain. Such individuals, who also may be mentally ill, and on cocaine or PCP, are considered to be at a high risk for sudden cardiac arrest when resisting police restraint.

A 2009 Taser bulletin warned officers that people who exhibit signs of excited delirium, exhaustion or distress after being stunned need immediate medical attention. "These subjects are at significant risk of arrest-related deaths," the bulletin said.

Maryland's medical examiner, Dr. David Fowler, said the only accurate way to determine whether a Taser caused a death is if a person were shocked in a controlled setting where the heart was monitored.

Excited delirium "is a very, very complex and interesting topic, and it's not going away anytime soon," Fowler said.

Gansler's task force said that because excited delirium is open to interpretation, medical examiners should "specifically indicate" whether the use of a Taser "may have or did contribute to the death."

"Excited delirium should not be cited as the cause of death where there is a known direct cause," the task force wrote. "The medical examiner should explain in the autopsy and death certification the cluster of symptoms that led to the finding of 'excited delirium.'"

Fowler, who has been in his role since 2002, said isolating one direct cause of death in Taser cases is extremely difficult. Instead he has identified a number of factors that contributed to those deaths, including drug use, mental health problems, excited delirium, heart conditions and police restraint.

"I'd love to be able to give you a clean answer. The human being is complex," he said.

Taser use could play a role, he added, but it cannot be cited as a cause without scientific evidence. When and if his office finds such proof, he said, it will say so in an autopsy.

Fowler noted that other uses of force, such as hogtying and chokeholds, have been deemed improper and are no longer used by police. "Then along came Taser," he said. "There is a suspicion that Taser is another one of these events in a long history."

"Most people have gone from the idea of saying the Taser is perfectly safe — the jury is still out — to one where it's less than lethal."

But blaming the Taser without proof could result in police losing a useful tool that's a better option than other potentially lethal uses of force, he added.

As federal agencies such as the FBI devise new ways to track deaths from police encounters, Fowler, the president of the National Association of Medical Examiners, said there should be a central database for deaths involving stun guns and excited delirium.

Medical examiners working separately across the country cannot detect trends, he said. He compared it to groups who track deaths from consumer products or the data collected on sudden infant death syndrome.

"It's very important because that's the only way over time we're going to get enough statistical data to be able to analyze this and say whether or not it is or is not a risk," he added.

For the past decade, the Institute for the Prevention of In-Custody Deaths has taught police officers across the nation and in Maryland how best to avoid fatalities by immediately requesting medics once they have identified someone exhibiting signs of excited delirium. Suspects who have been stunned also should be immediately transported to a hospital once in custody, said Peters, the institute's president.

"The gold standard, which has been adopted across the country, is when you get a call like this or you arrive on a scene, you request EMS to come and stage," Peters said. "When you have the person down, EMS moves in."

In one case in Baltimore County, emergency personnel were the first on the scene.

On May 27, 2010, Carl D. Johnson, 48, crashed his truck near the intersection of interstates 795 and 695.

Johnson refused to get out of his car, which was stuck in mud, according to police reports. The wheels spun until the tires blew. A Maryland State Police trooper said he instructed Johnson to roll down his window. When he did, the trooper attempted to unlock the door, and Johnson punched his hand.

The trooper sprayed pepper spray and Johnson got out, wiping his eyes before swinging punches, according to the reports. Two Baltimore County police officers fired Tasers. Johnson fell. Officers handcuffed him while he was on his stomach. Minutes later, he was unresponsive. CPR was administered, but Johnson died.

Johnson's family sued and blamed his death on excessive force. The lawsuit also said Johnson was a diabetic and behaved erratically when experiencing low blood sugar levels. To settle the lawsuit, Baltimore County paid $90,000 and the state police paid $80,000, while not admitting to any wrongdoing.

His autopsy cited excited delirium as a cause of death.

'There's got to be a different way'

The family of Anthony Howard, the man who died in 2013 after Montgomery County police hit him with Tasers, didn't immediately know what had happened to him. They worried when he didn't show up to work. For decades, Howard worked alongside his brother repairing cars at a body shop.

He didn't respond to calls and texts. The anxiety spilled into the next day. Then the family heard about a television report in which police shot a man with Tasers in front of a crowd in Gaithersburg.

Howard's sister, Robbin, called the reporter, who contacted a police captain. More than 27 hours after Howard died, six officers arrived at her home to tell her of her brother's death.

Family members were enraged. Why had it taken so long to notify them? Why did police fail to inform them that an autopsy was ordered and performed?

In the following weeks, Howard's relatives knocked on dozens of doors in the townhome community in search of video that captured the incident. Residents told the family that police had collected cellphones to download the videos but deleted the recordings.

The family called lawmakers for help. They circulated petitions to change the laws on Tasers. The efforts failed, and they abandoned any thought of a lawsuit.

Starks, the Montgomery County police spokesman, said he didn't know why the videos weren't turned over to the family, as he was not part of that decision. He said the videos that police obtained in 2013 included the 17-minute video taken by a bystander and later obtained by The Sun.

Starks also said officers responding to the Howard incident feared he would enter a townhome or charge at one of the bystanders.

Last month, the family watched the 17-minute video. As it played, they stared at the screen. For long stretches none of them blinked. They sat silently and shook their heads. They noted afterward that Howard complied with an officer's order to drop two small rocks, and they watched him back up against a door. Officer Shaun Santos fired pepper spray, but the wind blew it back in his face, stirring laughter from the crowd.

On the video, as two other officers approach with Tasers, bystanders playfully yell for them to "Tase that man!"

Officer Alexander Patapis fires his Taser.

"Tase him again!" someone shouts.

Officer Dana Russell fires her Taser.

Both officers were named in police reports.

"You can hear them Tasing him again," Howard's 24-year-old son said as he watched the video. "He's down on the ground; they're still Tasing him."

An onlooker in the video yells, "He's dead!" and "This man got Tased seven times!" The mood shifts when Howard doesn't move. "These are all white cops!" a young man shouts.

"It's sad," Howard's 82-year-old father said softly after watching the video, his eyes filling with tears. "I don't understand."

As the three-year anniversary of the death approaches, the family still struggles to understand why officers hit him with a Taser rather than waiting for medical professionals.

Montgomery County police classified the incident as "criminal" and Howard as "noncompliant" in its report to the state. In a police report, the department says "none of the video seized reveals anything contradictory to officer or civilian statements." In a supplemental synopsis, investigators said one of the two barbs from Russell's Taser didn't connect with Howard's body.

A grand jury later determined the officers' actions were justified. An autopsy found he died from a combination of agitated or excited delirium, cocaine intoxication, heart trouble and police restraint.

"He comes to me in my dreams," said Anthony Howard Jr., wiping tears. "I don't have that father figure in my life. There's got to be a different way to deal with these people."

Copyright © 2016, The Baltimore Sun

How we did it

During a six-month investigation, The Baltimore Sun produced the first-ever analysis of Taser discharges in Maryland. With raw data obtained from Maryland Governor's Office of Crime Control & Prevention, The Sun created a database of every Taser discharge on a individual from 2012 to 2014. That office has details on every Taser incident, but its online reports only summarize the aggregate data. To find people behind the data, The Sun requested more than 150 police reports that corresponded with the times, dates and locations of Taser incidents listed in the state's information. In addition to police, lawyers, government officials and law enforcement experts, reporters interviewed the people who had been stunned or, for fatal encounters since 2009, their family members. The Sun also obtained and reviewed several thousand pages of police records, 47 police department policies for Tasers, 10 autopsies and scientific research on the weapon.

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