Retired forensic pathologist Joyce Carter has studied the concept of excited delirium for years, starting with her fellowship at the Dade County medical examiner’s office in Miami in 1988.

Axon has historically said that its Tasers are most effective when used on the largest body part, which most assume to be the chest. And for years, the company  denied any link between the use of the device and risk of cardiac arrest. Recently, however, Axon changed its guidelines to warn of a slight risk of cardiac arrest and to suggest avoiding the chest. Nonetheless, the company continues to deny liability in most Taser deaths. (Axon did not respond to multiple requests for comment on this story.)

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On September 30, 2023, police responded to a call for help in Bolingbrook regarding a 41-year-old man in diabetic crisis, who also was diagnosed with bipolar disorder and schizophrenia. The man, John Taylor, was shot by a Taser while scuffling with police and later died at a hospital. Bolingbrook police, Illinois State Police, and the Will County State’s Attorney and Will County Coroner all denied public records requested for this story, citing an ongoing investigation.

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Jan 4, 2024 — Ontario's police watchdog says a 46-year-old man who died during his arrest in Sudbury had been shot by police with a stun gun.

Across the country, officers deploy Tasers frequently against people suffering from mental health crises, according to a collaborative investigation by MindSite News and the Medill School of Journalism at Northwestern University based on public records requests filed with more than 100 cities nationwide seeking such data. Even in non-lethal situations, being tased may have long-term mental health consequences.

The AP investigation also found that many of those who died were experiencing a mental health crisis. (The investigation also led to a documentary aired on PBS Frontline on April 30.)

Conducted Energy Device (Taser) in Subjects With Mental Illness. Journal of the American Academy of Psychiatry Law 44-213-17.2016

•In Augusta, Georgia, Medill and MindSite News identified at least 78 incidents where force appeared to be used in response to a mental health call from 2016 to 2022, based on matching addresses, times and dates from use-of-force logs and 911 call logs. In 25 of those incidents, a Taser was used.

Bear Heels’s mother called the Omaha Police Department to report that her son, who had bipolar disorder and schizophrenia, had gone missing.

“Mental health systems in place aren’t funded appropriately,” Markman said, “and law enforcement should not be the number one agency dealing with mental health.”

Augusta resident Christina Graham tried to avoid involving police when she sought mental health help for her 33-year-old husband, Nelson Lee Graham, in August 2022. She filled out a state form – form 1013 –  authorizing his involuntary commitment to a hospital but said she never received a response.

About three hours after officers were called to the hotel, an ambulance still had not arrived. Garrett told MindSite News he felt uncomfortable with the police surrounding him and talking about him, so he tried to run from them. An officer grabbed Garrett’s belt to prevent him from leaving, as Garrett “got too irate to contain,” kicking and “pulling away,” according to a police report.

“To say that no one can die from an electrical shock to their body or multiple ones is just ridiculous. A person can die from putting their finger in a socket.”

Indeed, Taser use often follows a family member’s call for help, as MindSite News and other media outlets have found. A Reuters investigation found that more than 100 of 1,005 Taser fatalities in the U.S. from 1983 to 2018 “began with a 911 call for help during a medical emergency.”

Sep 5, 2016 — On the other hand, if that orange light is flashing, it means that drivers may proceed, with extreme caution and, if necessary, giving way to ...

A study conducted by Michael D. White and Justin Ready at Arizona State University in 2016 found that people who were emotionally disturbed or mentally ill were nearly twice as likely to die after being shot by a Taser as those who were not.  The study was based on media reports of Taser incidents between 2002 and 2006.

A comparative interrupted time-series assessing the impact of the Armstrong decision on officer-involved shootings. Police Practice and Research. May 20, 2022.

The Reuters investigation found that, of Taser fatalities resulting in wrongful death lawsuits, 34% of the people suffered from mental illness.

Type of work: Investigative / Enterprise In-depth examination of a single subject requiring extensive research and resources.

Just before 11 pm on August 2, 2022, the Atlanta police department received a call from a crisis hotline asking police officers and emergency medical workers to respond to a Hyatt hotel, where 20-year-old Jarontez Garrett was reportedly acting erratically.

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Bittrex has agreed to remit $29,280,829.20 for its willful violations of the BSA’s AML program and SAR requirements. FinCEN will credit the payment of $24,280,829.20 as part of Bittrex’s agreement to settle its potential liability with OFAC. FinCEN’s investigation found that, from February 2014 through December 2018, Bittrex failed to maintain an effective AML program. This included deploying inadequate and ineffective transaction monitoring on its platform resulting in significant exposure to illicit finance. Further, Bittrex’s AML program failed to appropriately address the risks associated with the products and services it offered, including anonymity-enhanced cryptocurrencies. Bittrex failed to file any SARs between February 2014 and May 2017, a period of over three years. Bittrex also failed to file SARs on a significant number of transactions involving sanctioned jurisdictions, including transactions that were suspicious above and beyond the fact that they involved a sanctioned jurisdiction. A detailed description of FinCEN’s consent order can be found here.

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A typical case was that of Adam Trammell, who died after being tased by West Milwaukee police officers who responded to a call about a naked man in an apartment hallway. Trammell was in the shower when police arrived, and ultimately was tased 18 times and suffered a black eye and broken rib in his encounter with police, as described in the Milwaukee Journal Sentinel.

Beyond AtlantaA Taser stun gun can transmit up to 1,200 volts. A recent investigation led by the Associated Press found 538 people were killed by Tasers or stun guns in the 10-year period between 2012 and 2021. Taser manufacturer Axon Enterprise used to describe the device as “non-lethal” but now calls it “less lethal.” Another national dataset, compiled by the advocacy group Campaign Zero, found that nearly a quarter of people who died as a result of being tased by police were experiencing a mental health crisis.

WASHINGTON – The U.S. Department of the Treasury’s Office of Foreign Assets Control (OFAC) and Financial Crimes Enforcement Network (FinCEN) announced settlements for over $24 million and $29 million, respectively, with Bittrex, Inc. (Bittrex), a virtual currency exchange based in Bellevue, Washington. This is OFAC’s largest virtual currency enforcement action to date.  It also represents the first parallel enforcement actions by FinCEN and OFAC in this space. Investigations by OFAC and FinCEN found apparent violations of multiple sanctions programs and willful violations of the Bank Secrecy Act’s (BSA’s) anti-money laundering (AML) and suspicious activity report (SAR) reporting requirements. These enforcement actions emphasize to the virtual currency industry the importance of implementing appropriate risk-based sanctions compliance controls and meeting obligations under the BSA. The failure to take action can result in violations of OFAC and FinCEN regulations and expose exchanges and others in the virtual currency industry to potential abuse by illicit actors.

The National Incident-Based Reporting System, or NIBRS, implemented to improve the overall quality of crime data collected by law enforcement.

Being shocked by a Taser can be painful and terrifying for anyone, but it is especially traumatic and cause lasting physical and psychological damage for people in the midst of a mental health crisis, experts say. Ironically, the very people who may be the most  vulnerable to being harmed by Tasers – those in mental distress – are also more likely to have one used against them.

Official websites use .gov A .gov website belongs to an official government organization in the United States.

“For years, Bittrex’s AML program and SAR reporting failures unnecessarily exposed the U.S. financial system to threat actors,” said FinCEN Acting Director Himamauli Das. “Bittrex’s failures created exposure to high-risk counterparties including sanctioned jurisdictions, darknet markets, and ransomware attackers. Virtual asset service providers are on notice that they must implement robust risk-based compliance programs and meet their BSA reporting requirements. FinCEN will not hesitate to act when it identifies willful violations of the BSA.”

•In Sacramento, Tasers were used in response to mental health calls 46 times between 2013 and 2023, representing two thirds of the incidents in which police used force in response to a mental health-related 911 call.

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If a Taser strikes a person on or near the chest, the shock can reach the heart and alter its rhythm, causing ventricular fibrillation, a type of arrhythmia, Zipes explained. In people with underlying medical conditions, drugs in the system or elevated heart rate due to emotional distress, the electrical current delivered by a Taser is more likely to be deadly, Zipes said.

“To say that no one can die from an electrical shock to their body or multiple ones is just ridiculous,” said Carter, who served as chief medical examiner for Houston and consulted for the U.S. Armed Forces. “A person can die from putting their finger in a socket.”

In a federal civil rights lawsuit, Trammell’s family received $2.5 million from the Village of West Milwaukee. Mark Thomsen, a veteran civil rights litigator who represented  the Trammell family, rejects the excited delirium diagnosis.

Sela Breen is a reporter with the Medill Investigative Lab-Chicago at Northwestern University and is studying journalism, international studies and theater. She is also a contributing writer at VeryWell... More by Sela Breen

A few days before Garrett’s encounter, on July 27, a homeless man named Ernso Prinvil was walking naked through Atlanta traffic and acting erratically, as described in public records obtained by MindSite News. An officer chased Prinvil on foot, ordering him to stop and “get on the ground,” commands Prinvil ignored.

Bittrex has agreed to remit $24,280,829.20 to OFAC to settle its potential civil liability for 116,421 apparent violations of multiple sanctions programs. As a result of deficiencies related to Bittrex’s sanctions compliance procedures, Bittrex failed to prevent persons apparently located in the Crimea region of Ukraine, Cuba, Iran, Sudan, and Syria from using its platform to engage in approximately $263,451,600.13 worth of virtual currency-related transactions between March 2014 and December 2017. The applicable sanctions programs generally prohibited U.S. persons from engaging in transactions with these jurisdictions. Based on internet protocol (“IP”) address information and physical address information collected about each customer at onboarding, Bittrex had reason to know that these users were located in jurisdictions subject to sanctions. At the time of the transactions, however, Bittrex was not screening this customer information for terms associated with sanctioned jurisdictions. This information was not voluntarily self-disclosed.

The three-judge panel ruled that the officers used excessive and unconstitutional levels of force but granted them immunity because of ambiguities in the law. However, the panel put police departments “on notice” that, moving forward, unless someone poses “an immediate safety risk,” Taser use may not be permissible.

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Two days later, police officers identified Bear Heels, 29, dancing and behaving erratically at a gas station in Omaha. When they tried to restrain him and bring him to the police car, Bear Heels resisted. He  was shocked by a Taser 12 times and punched several times as police tried to handcuff him. He was eventually cuffed to a gurney, but medics said he had no pulse. He was pronounced dead at the hospital, with the cause of death ruled as excited delirium.

Garrett told MindSite News he doesn’t believe he was a threat to himself or others, and feels the use of a Taser was unnecessary. Since that night, he said, he’s had a hard time adjusting to regular life.

He was talking to himself and expressing “suicidal ideations,” according to a police report, so the officers filled out paperwork to have Garrett involuntarily committed to a hospital for a mental health evaluation. Garrett’s mother was there, and asked officers to “stand off,” since her son had recently had negative interactions with police.

When Prinvil approached the officer with a “clenched fist and fighting stance,” the officer fired his taser, hitting Prinvil in his abdomen and exposed genitals. Ultimately an EMT removed the taser darts from Prinvil’s body, and he was transported to the hospital and charged with disorderly conduct, public indecency and obstruction.

For information on complying with virtual currency sanctions, see OFAC’s Sanctions Compliance Guidance for the Virtual Currency Industry here and OFAC’s FAQs on virtual currency here.

Citations & References:"Why Did 1,000 People Die After Police Subdued Them With Force that Isn't Meant to Kill?" Associated Press, March 28, 2024. https://apnews.com/article/associated-press-investigation-deaths-police-encounters-02881a2bd3fbeb1fc31af9208bb0e310 "Mapping Police Violence" database. Campaign Zero. Undated. https://airtable.com/appzVzSeINK1S3EVR/shroOenW19l1m3w0H/tblxearKzw8W7ViN8 Conducted Energy Device (Taser) in Subjects With Mental Illness. Journal of the American Academy of Psychiatry Law 44-213-17.2016 In Puerto Rico, Calling 911 in a Mental Health Emergency Can Get You Tased. MindSite News. December 21, 2023. Man Dies Days After Being Tased by Richmond County Deputy. WBAC. December 22, 2022. Man Dies After Scuffle With Cops, Being Tasered: Bolingbrook Police. Illinois Patch. October 1, 2023. Special Report: ‘Breathe, Ronald, Breathe:’ The court case curbing Taser use. Reuters. August 23, 2017. A comparative interrupted time-series assessing the impact of the Armstrong decision on officer-involved shootings. Police Practice and Research. May 20, 2022. Emergency Medicine Association Finally Withdraws its Approval of Policy Paper Endorsing “Excited Delirium” as Cause of Death. Physicians for Human Rights. October 13, 2023.

“He really needed people to de-escalate the situation,” said Mahmud Fitil, an Indigenous activist with the Great Plains Action Society who has been involved with the Bear Heels case for years.  “Talk to him in a calm manner. He needed trained mental health professionals. He didn’t need police officers.”

•In Minneapolis, Tasers were used 82 times on people in mental health crisis following a 911 call between January 2020 and March 2023, the MindSite News/Medill analysis of public data shows. Twenty-seven of the subjects were Black and six were Native American.

On Dec. 16, 2022 when her husband was acting erratically and she feared he might cause harm, Graham called the same state crisis hotline that handled the call about Jarontez Garrett. She hoped clinicians would come to help – instead, three police officers arrived at her home. Nelson Graham refused to leave with them, sitting on his bed with crossed arms. After he ignored their verbal commands to comply, an officer fired a Taser at him multiple times until he became unresponsive, according to a police report. Nearly a week later, Graham was dead.

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A number of cities in North Carolina, South Carolina, West Virginia, Maryland and Virginia have passed stricter regulations on Taser use since the Fourth Circuit Court of Appeals ruled in January 2016 that Tasers should only be used on someone who poses “an immediate safety risk.” The ruling came in a case filed by the family of Ronald Armstrong, who died in 2011 after being shocked by a Taser while in the midst of a mental health crisis in South Carolina.

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Support our mission to report on the workings and failings of the mental health system in America and create a sense of national urgency to transform it.

This story is the latest installment of Fateful Encounters, an ongoing investigative collaboration between MindSite News, the Medill Investigative Lab-Chicago at Northwestern University and other media outlets exploring police response to mental health crises. This work is generously supported by the Sozosei Foundation.

Northwestern University assistant professor Kari Lydersen and MindSite News staff reporter Josh McGhee contributed reporting. McGhee is a Rosalynn Carter Fellow exploring the ways that the mental health and legal systems intersect to the detriment of Black and brown people in America.

Ten months after the appeals court ruling, the Supreme Court declined to hear an appeal in the case. That left the ruling in effect – but only in the five states of the 4th Circuit. Reuters reported the next year that Taser usage fell dramatically in several cities in the five eastern states.

Emergency Medicine Association Finally Withdraws its Approval of Policy Paper Endorsing “Excited Delirium” as Cause of Death. Physicians for Human Rights. October 13, 2023.

The National Alliance on Mental Illness’s recommendations on police use of force urge officers to only use conducted energy devices (CEDs) – which include Tasers, stun guns and similar non-firearm weapons – on those experiencing mental health crises when there is a great risk of injury to an officer, the individual, or a third party. The group also recommends such devices only be used if no other de-escalation strategies are  possible.

•In Spokane, Tasers were used in response to 20 mental health-related 911 calls between 2018 and 2022, according to a review of police reports available online. Seven of those cases started with 911 calls mentioning suicide.

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A 2022 study by researchers at the University of South Carolina found that most respondents to a survey indicated they placed Tasers higher on their “force continuums,” and some law enforcement agencies stopped using Tasers altogether, in response to the ruling. But the study found that officers fired guns and pointed firearms at people at higher rates than before, presumably relying on guns instead of Tasers.

Celestin’s family told local media that it should be mandatory for mental health clinicians to ride along with police on such calls. A response of that nature might have prevented Celestin’s death as well as the 2017 death of Zachary Bear Heels, an Indigenous Omaha man.

Markman’s clients have included the family of Jean Samuel Celestin, who died in April 2019 after being tasered and left in restraints during a mental health crisis in his home in Ocoee, Florida. Body camera footage shows Celestin begging for mercy from officers, apologizing and clearly confused by the situation. “You are about to get shot, get on your fucking stomach right now,” one of the officers shouted at him, as seen in the bodycam footage.

Garrett, a promising basketball player and student at Norwich University, had been experiencing family problems and feeling overwhelmed for weeks, he told MindSite News. On July 31, he’d been arrested for misdemeanor trespassing and loitering, and earlier on August 2 he had an encounter with police that “required several officers to subdue and arrest” him, the police report said.

Armstrong was shot five times by a Taser while sitting on the street outside a hospital with his arms and legs wrapped around the post of a stop sign. The necessary papers to involuntarily commit him on a psychiatric hold had just been served.

Douglas Zipes, a cardiologist and expert in electrophysiology who has testified in Taser cases in court, told Mindsite News he believes excited delirium is “a fictitious term” and that he has not seen any evidence to prove its validity.

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“When virtual currency firms fail to implement effective sanctions compliance controls, including screening customers located in sanctioned jurisdictions, they can become a vehicle for illicit actors that threaten U.S national security,” said OFAC Director Andrea Gacki. “Virtual currency exchanges operating worldwide should understand both who—and where—their customers are. OFAC will continue to hold accountable firms, in the virtual currency industry and elsewhere, whose failure to implement appropriate controls leads to sanctions violations.”

Jan 2, 2021 — Sharing on how to charge Oculus Quest 2 headset and controllers together with the LED light color changes and the duration required.

•In Puerto Rico, the Center for Investigative Journalism (CPI, in Spanish)  analyzed hundreds of use-of-force reports from 2018 through  2021 and found 23% to 30% occurred in cases where people were suffering an apparent mental health crisis. In more than half of these cases, officers used a Taser, according to the findings of the investigation, a collaboration between CPI, Medill and MindSite News.

"Why Did 1,000 People Die After Police Subdued Them With Force that Isn't Meant to Kill?" Associated Press, March 28, 2024. https://apnews.com/article/associated-press-investigation-deaths-police-encounters-02881a2bd3fbeb1fc31af9208bb0e310

In Atlanta, Tasers were used at least 29 times from 2019 through 2022 in response to a 911 call about a person experiencing a mental health crisis, according to data obtained through the investigation. The Tasers were disproportionately used against Black men.

In January, California became the first state to prohibit the term from many official proceedings. Lawmakers in Colorado, Hawaii, Minnesota, and New York may follow suit. The American Medical Association repudiated the diagnosis in 2021 and last October, the American College of Emergency Physicians (ACEP) withdrew its approval of a 2009 policy paper that had frequently been cited as medical support for the theory.

An officer fired his Taser at Garrett, and the electricity-conducting darts struck him in his arm and lower back, according to the police report. Then the officers handcuffed him. He was taken to jail, charged with disorderly conduct and transferred to Grady Memorial Hospital, where staff said he was experiencing a mental health crisis, according to the police report.

In an article responding to that study, attorney and former Glenville, N.Y. police chief Mike Ranalli argued that instead of making sweeping changes to policy and replacing Taser use with firearm use, police departments should institute better training as to what constitutes a safety risk. He also noted that once an involuntary commitment order was issued for Armstrong, officers focused only on carrying it out rather than de-escalating the situation.

“The key factor to me was the impact the commitment order had on the officers,” Ranalli wrote. “As soon as they learned it had been signed, they immediately discontinued any attempt at verbal persuasion, which had worked so far, and instead resorted to orders and then the CED [conducted energy device] on a person in obvious crisis.”

“It is a term that was developed by law enforcement experts to defend law enforcement experts when they use excessive force,” Thomsen told Mindsite News. “There are serious issues as to whether or not it is a legitimate medical diagnosis.”

Jeremy Markman, an attorney who has represented families of people harmed or killed by Tasers, told MindSite News that the core issue remains a lack of meaningful mental health care that leaves police facing crises they aren’t equipped to handle.

Carter, the nation’s first African American chief medical examiner, told MindSite News that Axon, formerly TASER International, has continuously pushed the idea that deaths happen because of excited delirium, not shock from Tasers.

While no comprehensive data set exists on the number of times Tasers are deployed against people in mental health crises, the collaborative investigation by MindSite News and the Medill School of Journalism at Northwestern University involving more than 100 cities nationwide was revealing. Sixteen cities provided use-of-force logs documenting 450 incidents in which Tasers were used on people following a mental health-related 911 call since January 2020. Many cities provided use-of-force logs that don’t indicate the type of force used, and some cities lumped in Tasers with other types of force (like pepper balls).

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In the Reuters investigation, 290 incidents – nearly 27% of Taser fatalities – listed excited delirium as the cause of death.

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Nationally, Tasers have been used on people with mental illness 28% more often than those without mental illness, according to a 2016 study in the Journal of the American Academy of Psychiatry and the Law.

The 40-year-old theory, increasingly rejected by medical experts, posits that people in a state of severe agitation are prone to sudden death. It has long been used to defend officers involved in the deaths of people in custody, including, in recent years, George Floyd in Minneapolis; Daniel Prude in Rochester, New York; and Angelo Quinto in Antioch, California.

"Mapping Police Violence" database. Campaign Zero. Undated. https://airtable.com/appzVzSeINK1S3EVR/shroOenW19l1m3w0H/tblxearKzw8W7ViN8

•In Atlanta, Black men made up more than 80% of those shot by Tasers, although Blacks constitute only 46.7% of Atlanta’s population.