Hospital experts debate wisdom of using stun guns to control violent patients
Tuesday, July 20, 2010
Police officers in many jurisdictions use stun guns to incapacitate suspects, but the weapons have started to show up in hospital settings as well, a migration that has raised some concerns.
On July 8, a security guard used a stun gun on the 25-year-old nephew of Supreme Court Justice Clarence Thomas after he allegedly became combative when trying to leave a Marrero, La., hospital against doctors' orders, according to the nephew's relatives. Derek Thomas's family said he was subdued with a stun gun. The hospital has cited patient privacy laws in declining to comment.
There are 151 hospitals in the United States that use or are testing Taser brand electronic control devices, according to a company spokesperson.
Each hospital develops its own stun-gun guidelines, but a company spokesperson said, "Hospital security officers on scene are best able . . . to determine the proper response."
"When used properly," the spokesperson wrote in an e-mail, "Taser technology is among the most effective responses to resistance interventions available to law enforcement officers to halt violent situations that pose a safety risk to an officer, suspect or innocent citizens."
According to Robert Philibert, a professor of psychiatry, genetics and neurosciences at the University of Iowa who has written about the use of Tasers and similar weapons in psychiatric care, stun guns are becoming more common in hospitals as a means of controlling violent patients. "If dialogue fails, then generally a show of force is explored," he said. "Physical restraint is a last choice."
He added that the use of stun guns in patient units is "extraordinarily troubling" and that "in the hospital setting they should only be used with the most utter discretion -- only in the context in which serious threat to life or bodily integrity is in play."
According to Jeffrey Ho, an emergency room doctor and the author of a 2009 paper about the use of Tasers in health-care settings, stun guns do control violent patients and can prevent dangerous situations from escalating and causing injury to the patients and others. He based his findings on a year-long study of the University of Minnesota hospital where he works. "The hospital environment is not 100 percent calm and peaceful all the time," he said. "Acts of violence do occur against staff, physicians, nurses, those types of things, and really the best method of security is to be proactive."
Stun guns use a simple point-and-shoot action, with sharp metal prongs deploying from the gun and embedding in the target. Once embedded, they emit brief electrical pulses that cause muscles to contract and the entire body to go into a paralyzing rigor.
"It's very uncomfortable -- it's painful," says William P. Bozeman, an associate professor of emergency medicine at Wake Forest University, who has studied the physiological effects of the guns since 2002, "but as soon as the Taser stops sending out electricity, the pain is over and you're fully functional again in a matter of moments."
Bozeman published a study in 2009 of 1,201 people who had been stunned and found that 99.7 percent of them have few to no injuries. The mild bumps, bruises and scrapes that did occur were a result of falling down when the muscles locked.
In 2008, Amnesty International published a seven-year study that found that 334 people in the United States died shortly after being struck by Tasers. Drug intoxication was the official cause of most of the deaths, but Amnesty International concluded, "Taser shocks caused or contributed to at least 50 of the deaths." There have been instances of serious head injuries and skeletal fractures from Taser-induced falls. Bozeman says that a few reports raised the possibility that prongs shot into the target's head may have caused seizures.
For this reason, Bozeman, who also works as a trauma-center physician, said stun guns should be used in hospital settings only as a last resort. "From purely a safety standpoint, they can be useful in some situations," he said, "but [using a stun gun is] never okay as a coercive or punitive measure. . . . Sometimes it's not the patient's fault. But they're actively fighting and swinging and assaulting people. . . . I don't have the ability to play an IV line."
Philibert, however, remains cautious. "Yes, they are better than a gun," he said, "but Tasers are still a threat, a symbol that breaches the trust and the understanding of the patient that you have a comprehensive, beneficent attitude toward the patient."
In the Washington area, stun guns appear to be rare in hospital settings. In the District, only law enforcement officers can legally possess them, according to a D.C. police spokesman.
Security officers at Inova Health System facilities do not carry Tasers, according to hospital officials. In Maryland, personnel for Adventist HealthCare-owned hospitals, Washington Adventist and Shady Grove Adventist, do not carry Tasers.