IN THE MATTER OF THE THOMAS R. BRAIDWOOD, Q.C.,
COMMISSIONS OF INQUIRY UNDER THE PUBLIC INQUIRY ACT,
SBC 2007, c. 9

Wosk Centre for Dialogue
Strategy Room 320
580 West Hastings Street
Vancouver, B.C.

May 16, 2008

PROCEEDINGS AT
FORUM (DAY 10)

ORIGINAL

McEachern & Associates
2390 Kensington Avenue
Burnaby, B.C. V5B 4E2
Phone: (604) 299-3595; Fax: (604) 299-3545
Toll-free: 1-866-366-2202

IN THE MATTER OF THE THOMAS R. BRAIDWOOD, Q.C.,
COMMISSIONS OF INQUIRY UNDER THE PUBLIC INQUIRY ACT,
SBC 2007, c. 9

Wosk Centre for Dialogue
Strategy Room 320
580 West Hastings Street
Vancouver, B.C.

May 16, 2008

PROCEEDINGS AT
FORUM (DAY 10)

Commissioner:
Commission Counsel:
Associate Commission Counsel:
Court Recorder:
Transcriber:

T.R. Braidwood, Q.C.
A. Vertlieb, Q.C.
P. McGowan
P. Kealy, C.V.R., C.M.
P. Neumann

1
Dr. Jeffrey Ho (Manufacturer presenter)
Questions by Mr. Vertlieb
Presentation

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Vancouver, B.C.
May 16, 2008
THE COMMISSIONER: Yes. Good morning, everybody. Good
morning, sir. I see we're ready to go ahead.
Yes, counsel.
MR. VERTLIEB: Thank you, sir. We have Dr. Jeffrey Ho
as the first presenter.
DR. JEFFREY HO, a Manufacturer
presenter.
QUESTIONS BY MR. VERTLIEB:
Q
A
Q

Dr. Ho, you are an emergency room physician?
That's correct.
And your first degree was a Bachelor of Science
from Loma Linda University College of Arts,
graduating in June 1988?
A
That's correct.
Q
You received your Doctor of Medicine from Loma
Linda in May of 1992?
A
That's correct.
Q
Then went to Minneapolis and you were a resident
in Emergency Medicine?
A
That's correct.
Q
You have a Fellowship in Emergency Medical
Services from June 1996.
A
Yes.
Q
And your practice as a doctor is as an Emergency
Room physician in the State of Minnesota?
A
That's correct.
Q
When were you first licensed to practise medicine
in the United States?
A
That would be 1993.
MR. VERTLIEB: Thank you, Dr. Ho. You have a
presentation to make and we welcome that.
PRESENTATION BY DR. JEFFREY HO:
A

Yes. Good morning. Thank you. You want me just
to go ahead and present to you?
THE COMMISSIONER: Yes, any way you wish.
A
All right. Thank you for allowing me to present
in front of the Commission today, sir.
What I would like to do today is just talk a
little bit about the human research that's gone on

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Dr. Jeffrey Ho (Manufacturer presenter)
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around Taser devices.
I was asked to come up
here and provide evidence that's come out of my
lab on what we've done as far as human studies,
and so I am going to go ahead and do that.
You have heard some of my professional
qualifications. I'd like to give you just a
couple of others that give me a little bit of
insight to what these devices do and don't do. In
addition to working full time as an emergency
medicine physician, I also work as a Minnesota
peace officer, so I'm a Deputy Sheriff up there,
and so I have the opportunity to use these in real
field situations as well.
I am also an academic medical researcher at
the University Medical School. The hospital that
I work at is a Level 1 trauma centre. It sees
about 103,000 patients per year. I know that
subject to some of previous testimony there has
been issues on whether or not folks have debated
about whether things like "excited delirium" exist
or, you know, whether anybody's cared for patients
like that. I certainly have in my career and so I
have been able to see both sides of this.
By way of disclosure, because I think that's
fair also, just so that you're aware, I am a
consultant to TASER International. I am basically
not an employee of the company. I do not take
stock options. I do personally own shares of
TASER International that I have purchased on my
own.
We receive, as my lab, receive some funding
from TASER as funding streams for the research
that comes out, and I'd like to explain a little
bit about why that is because I know there has
been a perception of bias or conflict.
First of all, my full-time employer is my
medical practice, and so that's where I receive my
pay cheques. What my employer does is protect a
portion of my time for academic endeavours, and at
this point what I am tasked to do under my fulltime employer is to spend time in the lab
researching these devices. There is a contract
that exists between TASER International and my
full-time employer, and so I receive my standard
pay cheque from my employer and TASER basically
pays the contract to allow research work to be
done on their behalf.

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Dr. Jeffrey Ho (Manufacturer presenter)
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As far as any perception of conflict goes,
any of the studies that I am going to talk about
today and that you are going to hear about have
all had to pass through our Medical Research
Conflict of Interest Committee. We go through an
annual review and come up with a plan to make sure
that any conflict or perception of conflict that
is there is managed.
What the current plan that we have in place it has worked very well for the last several years
- has been, if you look at all of my papers, there
is a gentleman on there, Dr. James Miner, who is a
disinterested statistician. He holds all of the
data for our studies. Anything that we gather
goes directly to him and he is the analysis point
of all of our data. So it doesn't come to me. It
doesn't go to TASER International.
In addition, TASER does not design our
studies for us. In fact, they are not part of
that process. We are simply their mechanism to
accomplish work to learn more about these devices.
And then lastly, before any of our work gets
published, it must go through a scientific peer
review process, and I'm not sure if anybody has
talked about that in earlier testimony. But in
order to get published in the medical arena in any
of these scientific journals, our work has to pass
through not only the publisher and the editorial
staff, but also generally two to three of our peer
colleagues, that have to go through not just the
science and the methods, but also things like
funding sources and that sort of thing. It has to
satisfy all of that from an ethical standpoint
before it will be allowed to be published. So any
of the work that I'm presenting to you today has
gone through all of that.
What I'd like to do today is just first of
all some of the objectives that I have are, number
(1) to frame the issue: Why are we actually doing
this type of research? And, you know, the issue
really is, is that there's a perception that
oftentimes after Taser is used it somehow causes
people to die. And so that's the big question
we're asking in the research lab is, is there a
connection here?
What we've found so far is that there appears
to be a misperception on a lot of folks'

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Dr. Jeffrey Ho (Manufacturer presenter)
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understanding of this when they look at those two
events, and that seems to come from, number (1) a
misunderstanding of electricity, and number (2) a
misapplication of logic. And I am just going to
spend a couple of minutes talking about each of
those points.
I would also like to present all the latest
human research that has come out of my lab to you
so that you can be well-informed on that, and
certainly answer any of your questions that come
up.
So the question here is why do people die
after arrest? First of all, I think it's
important to put this in sort of the global
perspective. From a historic precedent, if you
look at arrest related deaths or sudden custodial
deaths, these have been documented back into the
mid-1800s. If you look at that and you go back
and search the medical literature, there have been
waves of interest in police tactics and police
devices on whether or not they are somehow
causative or associated with this sudden event.
Things like pepper spray, the hogtie position,
prone positioning of prisoners, neck restraints,
now it's the Taser device, all of these have been
looked at and people have tried to make a
connection one way or another.
The interesting thing about this is that
again if you go back historically, people have
been dying in custody since before any of these
devices or tactics were utilized. So intuitively,
that doesn't necessarily make sense if we're
focusing on a single device or a single tactic.
So you have to ask yourself, are we really
focusing on the correct problem?
Today the public focus is on Taser, because
that happens to be the latest technology in modern
society, and again that's the reason I am
embarking on much of this research is to answer
that question.
As far as just briefly the misunderstanding
of electricity and the general public, the
interesting thing about this is we're taught when
we're little, you know, that electricity is
dangerous. You shouldn't touch wall sockets. In
the United States we have electricity as a form of
capital punishment. So there is this perception

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Dr. Jeffrey Ho (Manufacturer presenter)
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that electricity is very, very dangerous, and it
can be under certain circumstances. So I think
that that sort of adds to the perception problem.
When you look at electricity, however,
especially in regards to a Taser device and sudden
custodial death, I have had a chance to review
some of the transcripts of previous testimony, and
I know that a lot has been made of certain types
of cardiac rhythms, such as ventricular
fibrillation and ventricular tachycardia. You may
have heard those from cardiologists and
electrophysiology physicians.
Probably the take-home point here, however,
is I think we may be focusing on the wrong rhythm,
so to speak, and that's simply because when you
look at folks that die in custody, and there are
several relatively good studies out there that
examine presenting rhythm, and myself in my own
practice, I've taken care of perhaps a dozen of
these people where they have collapsed right in
front of me in the emergency department, and we
have the advantage of having them on the cardiac
monitor. Ventricular fibrillation and ventricular
tachycardia are not the presenting rhythms, and
that is independent of whether a Taser has been
used or whether pepper spray has been used or
whatnot. When people die suddenly in custody,
that's generally not the rhythm that you see. It
tends to be things like pulseless electrical
activity or asystoly.
Now, you may have heard this also, but I just
wanted to comment that a physician earlier this
week had testified that his recommendation would
be that a defibrillator should be available to
anybody who a Taser is applied to. And again I
think that that is a misunderstanding of what the
data actually shows, because the folks that are
collapsing in custody are not dying from a
ventricular fibrillation problem, and that is the
only problem that a defibrillator will fix. These
other rhythms they do not fix. So again I think
there's a little bit of a misunderstanding on
that.
So then you have to ask yourself, if we're
not looking at ventricular fibrillation, or
ventricular tachycardia, and there's been a
historical documentation of sudden custodial death

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Dr. Jeffrey Ho (Manufacturer presenter)
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long before Taser has been around, what exactly is
the problem here that we're looking at? Is there
a connection somehow?
The other thing I'd like to make the point on
- and this a very easy misapplication of logic to
make, I see this in many of my colleagues that I
work with every day at the hospital - there is
something called a post hoc fallacy which
basically says that after something occurs it
occurred because of the action that directly
preceded that. So, for instance, in a case like
this if a Taser is applied to somebody and they
subsequently go on to die, the Taser must somehow
have participated or contributed to that event.
Now, that is a commonsense way of looking at
it, however, it does not always hold up to
scientific scrutiny, and I will give you a good
example of this. Not too many years ago people
used to believe that the sun rising had something
to do with roosters crowing, and that because the
rooster crowed, the sun would rise, and that would
be sort of a natural, logical fallacy to make,
that if the rooster crows, the sun rises, those
two events are related. The problem with that is,
is you need to have a scientific evaluation of
both events to either validate that or refute the
connection there.
What the post hoc fallacy doesn't take into
account on the rooster analogy that I'm giving you
is that it doesn't discuss things such as the
diurnal nature of roosters, which means they're
going to crow no matter what. It doesn't take
into account the laws of the solar system, which
means the sun is going to rise no matter what.
And when you look at those two independently and
you actually do a scientific study of both of
those, you come to the conclusion that those two
events are not related by any means, even though
they are closely related in time. They have
nothing to do with each other. So again that is
sort of the misapplication of logic that I want to
put forward there.
We are also at risk for that type of
misapplication if we don't do a study of the
entire complex of problems here. So not just the
person that is at highest risk for sudden death,
but also the devices that may or may not

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Dr. Jeffrey Ho (Manufacturer presenter)
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contribute to those. Those are all things that
have to be looked at independently in order to
come to a conclusion.
As far as getting to the meat of the subject,
which is presentation of my data, when we approach
this in my lab with regard to researching these
devices, I've heard a lot of people say, well, you
should research these like medical devices, or the
fact that they are designed to be less than lethal
or non-lethal, you should research them as such.
But I just want to make it very clear that from
seeing both sides of the spectrum on this, that
these devices are designed to help solve high risk
situations, and so any time that you are in a
situation like that, no matter what tactic or tool
is being used there, it needs to be evaluated as
such, so it needs to be evaluated under those
types of circumstances and you need to take all
those factors into consideration.
The other thing I'd like to point out is excuse me - whenever we start something in my lab,
we always start with a very open-ended question,
and that is the question of what would happen if?
So, for instance, if I were to use a Taser on
somebody, what would happen? That's a very broad
question. There's a lot of factors that we do or
don't control for in that, but we just want to
know what is the general outcome there.
The problem with some of the studies that
I've seen out there, and I've seen these thrown
around by a lot of different folks, where they'll
talk about animal studies, they'll talk about
certain other studies that are out there, is they
have not necessarily started with the question of
what happens if? They have started with the
question of can I cause something to happen? And
certainly if you manipulate your testing model or
you use a very specific biased methodology, you
can certainly cause many things to happen that you
could almost predict would happen.
So I give an example. I'm aware of an animal
study where they were able to show - and you may
have heard this term - cardiac capture in a pig.
Well, one of the ways that they were able to show
that was by taking all of the skin and the fat
away from the pig and then drilling a hole through
the chest and filling that hole with conductive

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Dr. Jeffrey Ho (Manufacturer presenter)
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electric gel, and then putting the electrode from
a Taser device into those holes so you basically
have a tunnel of electrode gel in direct
connection with the heart. And then they said,
look, we were able to cause cardiac capture.
I guess I'm a little sceptical of that
because that does not represent real world
situations. That's not how Tasers were designed
to be used. It's -- we don't go around
manipulating people or animals prior to their use.
So again I think it all depends on how you ask the
initial research question before you start your
research.
With that I'd like to just spend one more
slide talking a little bit about animal research
again, because a lot of this has been brought up
in the past and I have had to respond to this
many, many times. My own personal take on this is
that animal research is very, very valuable. We
use it a lot in medicine, but it has a limit.
Animal research can certainly point us in certain
directions, and the problem with that is you have
to interpret the results with great caution,
because you're not dealing with the same model,
such as a human, if that's what your end result is
designed to test.
So, for instance, animals are anatomically
different than humans. So to say that a certain
result occurs with certain positions of electrodes
or something on a pig is a little bit different
than saying that it happens on a human, because
we're built differently.
Secondly, if you look at all the animal
studies to date that have been showing concerning
effects, one of the biggest problems in these
studies is that they're showing concerning effects
with smaller mass animals. We're not using these
on smaller mass human beings. We're using these
on generally full-sized adults, which are in
general much larger than the animals that are
being used in the lab. So you have to be a little
careful about making translational comparisons
there.
The other thing that has been very
interesting to me as, you know, primarily I do
human research, is when these animal studies come
out I read them with great interest and they

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Dr. Jeffrey Ho (Manufacturer presenter)
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again, like I said, they point me in certain
directions, and so we'll go to the lab and study
some of those problems on a human model. And we
now have two very specific studies where we are
not finding the same, or we're not able to
replicate or find the same concerning findings
that they did in the animal study.
I'm going to talk about both of those, but
I'll give you just a brief example of one of them.
About a year ago there was a lot of interest in
the fact that under certain circumstances when a
Taser would be applied to, in this case it was a
swine or a pig, the pig would stop breathing. And
the animal researchers at the time came up with
sort of the aha, we have found what is happening
here. A Taser is probably preventing somebody
from breathing and causing them to suffocate, and
that's why people are dying in custody. That's a
really interesting theory. However, when we do
that same exact experiment on humans in the lab,
what we're finding is that humans breathe, every
single one of them, and so we are not able to show
that humans don't breathe, and so that's where
there's a breakdown sometimes between animal and
human research.
We think that may have to do with probably
not just the animal as the model, but also the
fact that in doing animal research you are subject
to limitations from things like anaesthetics and
other ethical concerns that you have to follow
there. So again that's just a good example of
where human and animal research diverges. And I'm
going to give you another example of this towards
the end of the presentation.
So just indirectly here's some existing human
evidence. This doesn't come from my lab. This
actually comes from TASER International, and this
is something as I read through I'm aware of, and
so we've kind of kept this in the back of our
minds.
TASER International has estimated exposures
to over 675,000 volunteers with no deaths
occurring. Now, many of these exposures have been
in various different positions on the body. They
are not all to the back. I know that somebody
testified earlier this week that all the research
that's been done has been exposures to the back

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Dr. Jeffrey Ho (Manufacturer presenter)
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and that is not true, and I'm going to explain to
you why that is not. At least coming out of my
lab, we have plenty of numbers where that's not
true. And that it's only been done to healthy
people and things like that.
Well, what I want to explain to you today,
here's the demographics of my study population.
When we do our studies, we recruit - recruit is
probably the wrong word - but we ask for
volunteers in people who are participating in
training courses. These are not necessarily
healthy people. I know that earlier this week it
was also said that only healthy volunteers have
applied for this. Actually, if you read all of
our papers, we list their health concerns. They
are asked to fill out a health summary. Many of
them are on controlling medications for various
different problems, including high blood pressure,
diabetes, prior stroke symptoms, prior heart
attacks, coronary artery disease. So they have
the gamut of problems.
The other thing is most of our volunteers are
older in age from the standpoint that if you were
to believe that we were using only healthy young
recruits, 18, 19, 20 years old, that's not
entirely true. In fact, our average age for
participation in our studies is about 40 years
old. So we're using a middle-age population, if
you will.
We're also using folks that generally, if you
look at our papers, we describe their body mass
index as one of the parameters. We're using folks
that have high body mass index parameters, and
that is probably a sad statement on the general
health of North American population. Everybody's
getting a little larger. But if you look at the
numbers that we're using and the weight and
indices of our volunteers, they border on
overweight to obese. And if you were to look back
at the studies that have been done on arrestrelated deaths and the people that actually die in
custody, they are not 18-year-old folks. They are
not people that are super skinny. These are
people that are higher body mass index with other
health problems, just like what our audience or
subject population is in our studies.
And again, the last thing I want to address

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is I know that it was brought up earlier that in
my studies, everybody was done at rest with probe
positioning to the back, and that's not true. I'm
going to walk you through several of our studies
and explain exactly how we did that.
These are just photos of our lab, so that you
get an understanding of what our lab actually
looks like. Our lab is somewhat mobile. We can
take it from training site to training site to
recruit volunteers. We do not do this out of, you
know, Joe's Garage, and we do not just walk up to
somebody and expose them to a Taser. We do a very
methodical evaluation of each subject. They
undergo informed consent.
If you'll notice in this top picture here,
I'll just point with my arrow, this is an
ultrasound machine. Right next to it, this white
device here is a breathing machine.
The question came up earlier about my
disclosure about funding. And what I will say is
that just to be aware that the reason that we take
outside funding for some of these studies is
because these pieces of machinery alone are valued
at well over $100,000. So we would be unable to
do this type of medical research without being
able to pay for these types of devices to measure
parameters.
Oh, thanks.
The other thing I will show you is what we're
doing here and right here, is we are actually
using an ultrasound machine, and here's a screen
of one, here's a screen of the other. We are
getting real-time information. We're watching the
heart to see exactly what it does during an
exposure.
Again in reference to prior testimony this
week I know that a lot was made about the fact
that we don't do EKGs during the Taser exposure of
these individuals. And that is certainly because
of the electrical artefact, and I think that that
was articulated well during the previous
testimony. However, we're doing one better, and
what we're doing is we are actually looking at
what the heart is doing in real time, so we're
doing that before, during and after our Taser
exposures in all of these studies.
I'd like to take you through just the next

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few slides, and just going through some of the
pertinent research that we have put out there,
just so that there is a very clear understanding
of what it is we have and have not found.
This is a study that I'll take you back to in
2006. This was a very first study. This may be
the study where people are misunderstanding that
our population is resting. Indeed, in this study
itself, just this one alone, our population was
resting adults. The reason they were resting is
this was our very first attempt at gathering that
"what if" question.
So what happens if we just expose somebody to
a Taser? We really weren't sure what the
physiologic changes were. We had to start
somewhere. So our baseline study, number (1)
right here, was done on people at rest. And I
think that makes a lot of sense from a scientific
standpoint. You can't jump in the middle of a
question without knowing what your baseline
parameters are, and that's what we did.
In this study we had 66 volunteers, and
indeed they were all shot in the back with a Taser
device from approximately seven feet. Our
volunteers in this included not just police
officers, but many medical professionals, and
that's true of all of my studies. Most of my lab
staff volunteers to go through this, so it's not
again just not healthy recruit police officers.
We're getting a bigger mix of populations. So I
just want to make sure that that's understood.
We did not find significant findings on this.
And one of the things that was made, point in
question in earlier testimony, was that we
utilized serum bicarbonate as a measure of
acidosis on this. And that was simply because it
was impractical to draw arterial blood to measure
a direct pH. And from an emergency medicine
standpoint, and again I know that the prior person
who testified may be more familiar with pH, but I
am under the impression that that is because in
his setting where he works in an operating room,
that's what's available to him. In my setting in
the emergency department, we don't always have
those types of testing available to us, and so
we're using our own measures in what's considered
standard of care in emergency medicine to evaluate

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acidosis. And that was one of the conditions and
one of the findings that we looked at.
We did not find findings of acidosis. The
other thing that's not listed in this title that
you should be aware of is that this was only a
single five-second exposure. So again if you read
this paper, and you read only this paper, you
would come away from this thinking that only our
research deals with people who are exposed in the
back for five seconds at resting condition. And
again that's our baseline study.
I want to take you to our second study listed
here. This one came out in 2007, and this was
designed to address that breathing question that
we talked about earlier. The interesting thing
here is that we embarked on this because we wanted
to look a little bit more at that breathing
parameter, of what happens if you expose a Taser
to somebody, what happens to their breathing
pattern?
What we did was we took our volunteers. We
increased our exposure time to 15 seconds, and we
did it in both 15 continuous seconds. We also did
it in 15-second total increments of five seconds
each, so it was five seconds of exposure with a
one-second break, and then five seconds of
exposure with a one-second break, and then five
seconds of exposure. And we did that to simulate
essentially the two types of exposures that
someone would get in the field. In other words,
if a Taser is applied to somebody in the field,
it's either going to be continuous or it's going
to be intermittent with a few different exposures,
if there's going to be multiple exposures made.
During this test, and I'll show you a picture
of this, all of our volunteers wore a form-fitting
neoprene mask that measures all inspiratory and
expiratory parameters. And again as a very
expensive piece of machinery, what we were able to
measure before, during and after respirations
during this, and what we found was that one of the
parameters that we measure, which is called minute
ventilation, actually gets better during a Taser
exposure. People hyperventilate during a Taser
exposure.
The implication of that is -- I know that you
spent some time having someone talk with you a

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little bit about acidosis earlier in the week, and
the condition of acidosis, the first thing your
body wants to do to sort of buffer that or take
care of that condition, is to speed up your
breathing to blow off some excess carbon dioxide.
And so what we found is that during this exposure
to Taser for 15 seconds, people are actually to do
that. They're actually able to hyperventilate and
blow off that excess carbon dioxide. So contrary
to what the animal studies showed, we found
exactly the opposite result here in the human lab.
This is just a pictorial example of what this
is. You see our volunteer wearing the formfitting mask here. They're hooked up to this,
it's an infrared gas sensor, and then basically
the machine is out here with the computer.
We have our EKG leads hooked up so we get
immediate before and after EKGs on all of our
subjects. And so one of the things again that was
mentioned was people were critical of whether or
not we got EKGs or blood tests immediately
following our testing, and, yes, we did. They
were within seconds of the exposure being over.
All of our testing is done before at baseline,
then we give the test exposure, and then we draw
our lab parameters immediately following. And we
follow those out for 24 hours. So they get -THE COMMISSIONER: Just a minute. Were you able to do
it during the Taser was on?
A
As far as the EKG?
THE COMMISSIONER: Yes.
A
We were not able to do EKGs during the Taser, and
that's because of the electrical artefact that's
showing.
THE COMMISSIONER: Yes. That's what we were told.
A
Yeah, and what I want you to be very clear on is
my very last study that I'm going to show you goes
one better than that, and I will explain why that
is, okay? I think it will answer your question.
If you look at our -- these are just our
sample values from this volunteer. Our minute
ventilation before the exposure started was 13.2.
Their pH again, which in this study we did measure
pH, which is that measure of acidosis, is 7.4 and
that's completely normal for humans. During the
15 seconds their minute ventilation goes up to
almost 19, so this is an increase in their

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breathability. All right, that's an important
distinction to make. That's not what is found in
animals. And their pH afterwards, if they were
going to be acidotic from this, should be
dropping. And right here we don't see that. And
again this pH value is then followed out for 24
hours and we don't find any changes in that.
I know there's a lot of information on this.
Do you have any questions on this before I move
on?
THE COMMISSIONER: No, that's fine.
A
Okay. One of the other studies that we have done,
and this one is in press right now. This will be
coming out published later this year. And this
may be why the prior presenters may not have been
aware of this. As you know, when we publish
something, once it's in press or once it's been
submitted, we can't really divulge it until it
comes out in print, otherwise we sort of violate
the ethics of medical science publications.
But what we have done here is we actually
took volunteers and we got them into an exhausted
acidotic state. So we had them do a series of
anaerobic exercises and we validated with their
blood work that they were acidotic, and that was
to simulate things like fighting with a police
officer or fleeing from them, or something like
that. We then exposed to 15 seconds of the Taser.
And again our exposures have gone from five
seconds to ten to 15, sometimes longer than that,
on all of our studies because again we're trying
to see if there's any changes with prolonged
applications. And again what we're finding is
that we were able to cause acidosis by having them
go through that series of exercises, but then
application of the Taser on top of that for 15
seconds did not worsen that acidosis that is
already present. So I think that that's a key
point to remember. So again you may have heard
testimony earlier in the week that we only do our
subjects at rest and that's not true. And again
this will be published later this year.
This one I will just spend a very brief
amount of time on. This was a retrospective
study. Basically you can't do an ethical study
utilizing volunteers, human volunteers with mental
illness. And so the best that we can do to

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THE
A

THE
A
THE
A
THE
A

extrapolate data from that is in a retrospective
format.
What we did here was we garnered police
calls, and again this is in the United States.
But we garnered police calls involving emotionally
disturbed persons, and what we filtered out for
was any time their behaviour met the standard in
the United States of the officer on the scene
being able to use deadly force against them to
stop that encounter. We measured how often a
Taser was utilized and how often it was
successful, and that was 45 percent of the time.
So that's almost one in two, which is a very, very
significant finding. And this is out in the
American Journal of Emergency Medicine. It came
out last year. So you can find that.
COMMISSIONER: And maybe you'd just better explain
that further. What does your 45 percent
represent?
Okay. The 45 percent represents that 45 percent
of the time the Taser was used to successfully end
that conflict when justifiable deadly force could
have been used otherwise. So in other words, if a
Taser had not been at the scene, these are cases
where, for instance, somebody is having an
emotional disturbance and the police officers show
up and maybe they have a knife and they threaten
the police officers with the knife. In the United
States, and I'm not sure if it's the same as in
Canada, that would be a justifiable encounter
where the police officers could use deadly force
if they felt they were threatened by that person
with that weapon. Forty-five percent of the time
the Taser solved that problem without them needing
to go that direction.
COMMISSIONER: And is one to infer that 55 percent
of the time a weapon was used?
55 percent of the time -COMMISSIONER: A firearm was used?
-- some type of weapon was used.
COMMISSIONER: Some type.
Not necessarily a firearm. Not all of these
resulted in death. We only filtered for the cases
that could have resulted in death, and which ones
the Taser actively solved. So in some of these
also I'm sure the baton was used. We didn't
examine that. Pepper spray may have been used.

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It may have been, you know, just whatever,
tackling the person or distracting them or
something like that. And some of these, yes, did
result in firearm fatalities.
Do you have any further questions on that?
THE COMMISSIONER: No, that's fine.
A
Okay. I would also like to just spend a brief
amount of time on this one that was presented in
two different medical forums. This was again our
exhausted adult population. We did measure EKGs
before and immediately after, and then followed
their EKGs out for a period of 24 hours on these
exhausted adults, and this was after the 15-second
exposure.
The reason I point this out is again, and
you're aware of this, that you can't do the EKG
because of the electrical artefact during the
exposure. But some of the testimony that I've
seen suggests that application of a Taser would
cause somebody to have a funny rhythm that might
persist for a few minutes afterwards, and we are
not finding that, and we're not finding that in
people who are physically exhausted or acidotic.
That's what this work represents.
The second study on this page that I will
call your attention to is one where we took our
volunteer subjects and the question we asked is
what happens when a Taser is combined with someone
who is under the influence of alcohol? At least
in the United States that's a very common
occurrence. I'm going to say at least two-thirds
to three-quarters of our encounters involving
Taser also involve some type of intoxication and
most likely alcohol is one of the easiest things
for our population to get.
So what we wanted to do was take our study
subjects. And again these were not young healthy
recruits. I think our oldest person in this study
was into their mid-fifties, a variety of different
health problems. We used a certain protocol to
get them intoxicated to a level of at least 0.08
and the average intoxication level of the
volunteers was 0.11. After that, we subjected
them to 15 seconds of Taser application and again
the probe position was in a variety of different
places. This was either across the chest, it may
have been across the back, it may have been across

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the extremities. We simulated real world
applications of these devices.
And the only thing that we were able to find
from this, and again this is being written up
right now and going through the peer review
process, but the only thing that we were able to
find with this is that prior to the Taser even
being applied, is that our findings are consistent
with what is known on the alcohol literature, and
that is alcohol consumption to an extreme causes
people to slow down their respirations. And that
makes complete sense if you think about people
becoming intoxicated and then what they want to do
is go home and sleep and they tend to snore and
those types of things. So it is a respiratory
depressant, alcohol is, in and of itself. We did
not find anything that was significant
physiologically when combined with exposure to a
Taser.
One of our other studies that we looked at
here. This was an interesting one because I know
you've heard of the condition "excited delirium"
earlier today. And just before I get too far
afield on that, I know there's debate among
medical folks on whether excited delirium does or
does not exist. I've been asked this question
many times. I have seen the condition that is
described as excited delirium. I've taken care of
many patients with this before. I've had some of
them die in my care. So in my mind there is no
question that that condition exists.
We can talk about the semantics of it,
whether you want to call it "excited delirium" or
"extreme delirium", or something like that. But
that condition with those factors does exist in
medicine. And anybody who will tell you that it
doesn't exist because it's not in the DSM-IV or
it's not in the ICD-9 codes, is probably they're
making a semantic argument but they're not making
a valid argument, and I'll give you an example of
this.
We utilize at our hospital a billing system
where in order to bill somebody for their hospital
visit, I have to choose a code that is recognized
by the International Classification for Disease.
One of the codes that is not in there is stab
wound to the chest. And the reason I know this is

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because a few months ago I took care of this
gentleman who had a stab wound to the chest, and
as I'm trying to give him a diagnosis, it won't
let me diagnose that as a legitimate diagnosis.
Now, you can't tell me that stab wound to the
chest doesn't exist, because this guy had a knife
sticking out of his chest. So what I had to
diagnose him with was "Penetrating trauma,
thorax", and that's what the ICD-9 code shows for
"stab wound to the chest".
In the same vein that these other entities
may not say the words "excited delirium" but they
do say "delirium with paranoid features", "extreme
agitation with psychosis", "drug-induced
delirium", those are all legitimate diagnoses in
the ICD-9 codes, and again if we're going to
debate about the semantics - I'm going off a
little afield here, but I just wanted to make sure
you understood that - that in my mind that does
exist. We may just argue about the semantics of
it.
This study was designed specifically to look
at one factor of excited delirium, or whatever you
choose to call that, and that is you may have
heard that in many cases folks with this sort of
extreme agitation or excited delirium often
present with very elevated core temperatures.
It's not uncommon for them to come to the
emergency department and have temperatures of 107
or 108 degrees Fahrenheit in these conditions.
What we wanted to find out was if you apply a
Taser to somebody and it causes their muscles to
contract, one of the prime mechanisms for
generation of body heat is contraction of your
muscles. So when you go out and exert yourself or
you shiver, those are all forms of contracting
your muscles. We wanted to know does that
contribute to causing temperature elevation and
perhaps contribute to an excited delirium piece of
the condition here?
What we did is we had them swallow one of
these devices here on the left, these little
purple pills. They're very small and they just
kind of go through your GI tract and they're in
there for about 72 hours. Within this pill is a
micro-transmitter. It measures core body
temperature every five seconds and shoots the

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reading out to this device that they wear on their
belt. And so the volunteer was asked to swallow
this pill, wear this device for the next 24 hours,
and then at some point during that 24-hour period
we exposed them to a 15-second taser discharge.
We're able to time-stamp exactly when we give the
discharge, so we know on the temperature readout
when we collect this data afterwards what that
looks like. And when we run this through, we
found zero core temperature elevation in
association with the Taser device exposure. And
so this is also in press right now. It's coming
out in the Journal of Forensic Science later this
year.
A couple of other areas that we have had to
take a look at, and I think they were sort of
legitimate questions that came up. But we wanted
to see if what we had done to date was all of our
exposures had involved, you know, the assumption
that deployed probes from a Taser are sort of the
worst-case scenario. What we were seeing was a
lot of criticism that while we think that perhaps
the drive-stun, which is that contact method of
application, is perhaps worse than deployed
probes. And that's simply because you're
concentrating the focal area of applied
electricity. And so we were wondering if that is
true, and so we've embarked on some drive-stun
studies to see if any of our parameters change
with that.
These two have been presented and in fact
we're going to be presenting another one later on
this year in Toronto. But basically prolonged
Taser drive-stuns, and these are 10- and 15-second
drive-stuns, we're not able to find worrisome
changes in serum biomarkers for physiologic
damage. All of those things that we check, and
again we're looking before and after, and we
follow them out for 24 hours.
This other one is quite interesting as well.
One of the -THE COMMISSIONER: Just excuse me.
A
Yes, I'm sorry.
THE COMMISSIONER: When you say, "change in
physiology", we all know the effect by reason of
the videos and so on, when you use it in the probe
mode on --

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A
Yes.
THE COMMISSIONER: -- the muscles -A
Yes.
THE COMMISSIONER: -- and the person falls. By the use
of your term "change in physiology", I take it
you're meaning that doesn't happen?
A
No. That's a good question. Let me just explain.
What I am meaning by the term "physiology" here is
concerning not the fact that it may cause pain or
it may cause your muscles to contract. What I'm
meaning here is that we are examining for
physiologic changes at the microscopic level that
would be associated with a bad outcome, death,
injury, those types of things, and we're not
finding that. So when we look at things like
markers for cellular damage, cardiac enzymes,
those types of physiologic biomarkers, we're not
finding changes in those.
Did that answer the question?
THE COMMISSIONER: Yes.
A
Do you understand that? Okay.
The second study here is that what we looked
at here was a drive-stun specifically to the
shoulder area. And the reason this question came
up is you have a nerve that runs very close to
your neck here and runs down sort of behind your
shoulder. It enervates the heart and then there's
also a very close connection to the spinal cord,
which goes straight up into your brain. There
have been some critics that have said that if you
use this area of the trapezius or the shoulder in
a drive-stun fashion, you can actually cause
damage to some of these nerves here. And you can
either cause people to stop breathing, you can
cause their heart to stop, you can cause them to
have seizures. And again we haven't seen this but
we went to the lab to look at this.
This particular study was looking at whether
or not breathing occurs during that type of an
exposure. What I'm going to show you on the next
slide is an actual ultrasound of the person's
diaphragm and the fact that they're breathing
during this ten-second drive-stun to that
particular area.
So what you have here is this bright white
line right here depicted by the arrow is the
person's diaphragm. And the diaphragm is a large

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muscle that sits underneath your lungs. When you
breathe, your diaphragm -- when you take a breath
in, your diaphragm expands downward, and when you
take a breath out, your diaphragm expands upwards.
So when you breathe your diaphragm will move back
and forth in rhythmic fashion.
What you'll see here again, and this is an
interesting way of confirming respiration, you
will see the person at rest with the diaphragm
moving back and forth, and then you will see
depicted in some yellow letters here the Taser
drive-stun will be applied. You will see their
diaphragm start to move faster. So I'm going to
play that right now for you.
No, maybe I'm not. All right, there we go.
(VIDEO PRESENTATION)
So this is them at rest. They're breathing
normally, rhythmic movement up and down of the
diaphragm. You will see the Taser drive-stun come
on now. You will see their diaphragm move much
quicker. So they are hyperventilating at this
time. This is a ten-second exposure to that area
we talked about. You will then see the Taser
drive-stun stop right now, and their breathing
goes back to rhythmic pattern. We were able to
reproduce this in all the subjects that took place
in this study. Now, and again just another
interesting way that we're looking at respirations
and we're not finding any changes with that.
(VIDEO STOPPED)
Now, this is perhaps the newest study that I
want to bring your attention to, because this
information is not known until actually today it's
being presented in San Francisco. So as soon as
I'm done here, I'm going to try and make it down
there to make this presentation. But this speaks
to the big question of whether or not Taser
application across the cardiac axis or vector,
that I know that prior folks have used that term,
can cause any dysrhythmic changes in the heart or
any funny rhythms. And what we're seeing here is
we are replicating the three animal studies where
they were able to generate cardiac capture and

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even ventricular fibrillation. You'll notice
exactly where we're putting the Taser electrodes
there, the right sternum, and again here at the
apex of the heart, which we know is something
called the PMI, and that's called the point of
maximal impulse of the heart, and you can feel
that on yourself when you feel your heart beating.
We have used this vector, and during this
we're going one better than that EKG question that
you asked earlier. Because we can't check an EKG
during exposure, we are actually visualizing the
heart in real time. We're getting a moving image
of the heart and what it's doing on all of these
folks with ultrasound. We're not finding any
evidence of cardiac rhythm problems in humans when
we do this.
So again this is a very good example of a
study where animal data diverges from human data,
and I think, you know, you have to sort of look at
those separately, and at the end of the day we are
using these on humans, not animals, and so I tend
to think that the human data is better than the
animal data, and that's especially when you're
looking at this in a comparative fashion.
This is the picture we get, just so that you
know what we're looking at. We are looking at one
of the valves of the heart in an ultrasound in
real time as the Taser is being applied. These
two peaks are evidence that the heart is beating
in normal fashion. It's called normal sinus
rhythm. We got this on every one of our persons,
and in anybody who we lost this picture, because
they were maybe moving around, we used the second
picture here and were able to calculate the heart
rate in all of our subjects.
So I know that in the animal studies they
were able to record heart rates of 300 beats per
minute. The fastest heart rate we had during an
exposure, and again these are prolonged exposures.
These are not five-second exposures, these are ten
and 15 seconds. The fastest heart rate we had was
156 beats per minute. That person actually came
into the study before any exposure and had a
resting heart rate that was 110 or 120, something
like that. So they were nervous to begin with.
We did not approach any sort of beats per minute
in the 300 range, or anything like that. Again

24
Dr. Jeffrey Ho (Manufacturer presenter)
Presentation

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because of these peaks that we're visualizing
here, this can't be anything other than a normal
sinus rhythm. This is not ventricular
tachycardia. It's not ventricular fibrillation.
You can't confuse those two.
So this is pretty clear evidence to us in our
lab that we're not seeing this that they saw in
the animals, we're not seeing this in humans. And
again this is brand new data as of today. It's
just hitting the release as of today. So I'm
thinking that anybody who testified previous would
not have known any of this.
Some of our current work that we are still
ongoing.
We are looking at other devices that are
coming out. So there are other devices that TASER
is manufacturing with different delivery systems,
such as a shotgun delivery device, and things like
that. So we're looking at that.
We're also looking at methamphetamine study.
We're looking at still continuing our human
studies with various factors such as increasing
their physiologic stress prior to Taser
application to see if we can make a connection
with anything, and again so far we have not.
One of the things, one of the examples that
I'd like to give you on this is we really haven't
seen any connection between Taser and an abnormal
heart rate, or Taser and breathing. And so we
have sort of exhausted that portion of our human
data. We don't think we need to be looking at
that so much any more. We think we need to be
looking at other things.
One of the things that we're looking at is
whether or not using a Taser causes somebody an
extreme amount of stress. And the way that you
look at that is by measuring their stress
hormones. We are doing a study where we look at
an exposure to a Taser versus exposure to pepper
spray, or if you didn't have either of these two
mechanisms to control somebody, just plain handto-hand ground fighting with somebody. Which of
these three causes the most stress? And what
we're finding is that ground fighting and hand-tohand combat and pepper spray have much more
stressful effects on the body when you measure it
looking at stress hormones than does an

25
Dr. Jeffrey Ho (Manufacturer presenter)
Presentation
Questions by Mr. Vertlieb (cont'd)

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application of a Taser. We believe that this is
because the Taser is sort of an instant on/instant
off phenomena. Once it's off there's no residual
lasting effect, whereas pepper spray hangs around
for many, many minutes afterwards. And so do the
effects of grappling or hand-to-hand combat. So
this is still in its preliminary stage. We're
still working on this. I don't have any final
results to present to you on this at this point.
I just want to point out as one of my final
slides that there are validation studies of my
work that are coming out. There has been a lot of
folks, and I understand this because I am also in
the scientific medical profession, where you have
to scrutinize things such as industry funding. I
welcome people validating my studies, and indeed
there are folks coming around behind me and doing
just that with other independent funding sources.
The nice thing about this for me is that they
are finding the exact same results I am. They are
just about two, maybe three years behind me on
this. But I welcome them to validate that and
they are doing so, because it makes me know that
we're credible and we're presenting legitimate
evidence here.
So I will wrap this up, sir, just by saying,
you know, the things I'd like to leave you with
today are that number (1) beware of the faulty
logic that exists out there, and number (2) the
current body of research that is out there that
involves human study on Taser devices has not
shown a connection between Taser and sudden death
events through any mechanism that we are able to
measure known to modern medicine.
And I am going to end at this point, and I
would be happy to answer questions, if you have
any.
THE COMMISSIONER: Yes, all right. Counsel, do you
wish to begin?
MR. VERTLIEB: Yes, thank you, Mr. Commissioner.
QUESTIONS BY MR. VERTLIEB, continuing:
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Dr. Ho, you're here today, though, at the request
of TASER, that's why you're presenting here today?
That's correct.
And Mr. Tom Smith was involved in your process

26
Dr. Jeffrey Ho (Manufacturer presenter)
Questions by Mr. Vertlieb (cont'd)

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about coming here today?
Yeah, he called me. That's correct.
Right. And you are from time to time in the
course of all this work paid by Taser as a
consultant?
That is correct, for things like speaking
engagements when we go and do educational pieces
and that sort of thing, and it's primarily to
present our work.
And so you were here yesterday. You flew in from
Minnesota yesterday, and you're here today.
You're being paid by TASER to do this work today?
Actually, I am not. I am supposed to be in San
Francisco, which is where I'm trying to get to as
soon as this is done.
Okay.
So this is a quick diversion up here on my way
down to San Francisco, which is -- I view San
Francisco as purely a research academic endeavour,
and so I do not get paid for the research that we
do.
Now, are you going to be discussing in San
Francisco this human study that you just mentioned
from 2008?
If I get there on time, correct.
Has that article been published?
No, as I said before, today is the very first day
that you will see that. The way it works in
medicine and science is you develop your project,
you bring your results forward and the very first
venue that you generally put them out to are
things such as medical conferences, which in this
case would be the conference in San Francisco
today. Once it is put forth before all of your
peers, I mean, it's free game to talk about and
disseminate a little bit. But then the real work
begins after that because we have to write up the
final manuscript, so to speak, and then that ends
up going through the peer review process for
publication.
Okay. So what you were just telling us about is
work that's in progress, it hasn't been peerreviewed or published anywhere?
It's been peer-reviewed to the point to get into
the conference and it has to go through some of
that. It's also been peer-reviewed at my own
institution, but it has not been published yet,

27
Dr. Jeffrey Ho (Manufacturer presenter)
Questions by Mr. Vertlieb (cont'd)

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no.
Okay.
I will make the point that all of our work that
we've done so far has not failed to be published
for any peer review concerns. So I have no doubt
that this is not going to get in somewhere. We
just have to write it at this point.
All right. So these are some thoughts of yours
you'll be presenting to your colleagues in San
Francisco?
Well, they're not just thoughts, they're actual
findings. We're presenting our hard data. You
don't present thoughts at scientific conferences.
You present actual conclusive data.
Now, you mentioned that you're a peace officer.
You're a Deputy Sheriff from Meeker County?
That's correct.
Does your police department use Taser?
They do.
Now, I just want to be clear about the expertise
that you're bringing here. You're an emergency
room physician, as I understand it.
That's correct.
So if someone was discussing delirium, which is a
psychiatric illness, you would defer to a
psychiatrist in a discussion of the subject of
delirium?
Oh, not at all. As an emergency physician, I am
the first line that sees all comers with whatever
problem there is, and that includes medical,
psychiatric, whatever the problem is.
Right.
So I take care of these people all the time. In
fact, I would actually make the assertion, and
this may be institution-dependent, but at least at
our institution our psychiatrists do not see these
people in the acute phase of their delirium. They
see them after I've stabilized them and they take
care of them as an in-patient.
Okay. Would you defer to a cardiologist in the
subject of the way a heart works?
Well, in certain areas, yes, in certain areas, no.
I will tell you that from my specialty emergency
medicine is designed to take care of any critical
problem, actually any problem that presents within
about the first hour or so of care. So for
instance if you came to my hospital in cardiac

28
Dr. Jeffrey Ho (Manufacturer presenter)
Questions by Mr. Vertlieb (cont'd)

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arrest, I would not be calling a cardiologist to
see you. That would actually be a bad move and
would probably result definitely in your demise.
So I'm the guy that sees you and resuscitates you
and takes care of all of that. So I'm the one
that does know how the heart works under these
certain acute sudden-death circumstances.
From a cardiologist's standpoint, and
especially like an invasive cardiologist or an
electrophysiologist, they definitely know how the
heart works, and they do things with it every day
in the lab, but the way that they're inducing
ventricular fibrillation in the lab, the way that
they're taking care of people is on a scheduled
outpatient basis. When they induce ventricular
fibrillation, they are running a catheter up
inside the person and actually touching the heart
with this catheter. So I don't necessarily think
that that means they know anything about how
external current works, because that's not what
they do in the lab. They do it from the inside.
That's a completely different concept.
Well, we heard from a cardiologist, he's not doing
it in a lab, he's doing it on real patients.
Yes. He's doing it in his lab on real patients.
Right.
And that's, I guess, when I use the term "lab" in
that setting I'm not talking about research. I'm
talking about his practice lab. That's where he
does his operative procedures on them.
The cardiologist that has been here before you is
a gentleman named Zian Tseng. You know his name
by reputation?
Well, I can't say I know it by reputation. I've
just seen it in the media.
You know he's a cardiologist, electrophysiologist?
I'm seen him say that, yes.
Have you ever thought to pick up the phone and
speak with him about your thoughts on Taser and
his thoughts on Taser?
Not necessarily, no. I mean, I -Have you ever spoken to him about his thoughts on
the subject?
I have not. Was he asking to speak with me? I
mean, I'd be happy to call him if...
You've never stopped a human heart as part of your
medical work?

29
Dr. Jeffrey Ho (Manufacturer presenter)
Questions by Mr. Vertlieb (cont'd)

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Yes, we do.
Have you?
Yes, in certain circumstances when we have certain
rhythms where we have to use electricity,
defibrillation, cardioversion, even medication, we
can cause temporary stops in the heart rhythm.
Are you saying that you implant pacemakers in
patients?
No, not at all. I think if I'm giving that
impression I don't mean to say that. What I'm
saying is that there are other things that you can
come in with, other than a need for a pacemaker or
a cardiac arrest. If you come in with a heart
rate, let's say, of unstable ventricular
tachycardia, one of the ways that we're going to
reset your heart to beat normally is to
temporarily stop it with the use of electricity
and allow it to reset itself. So that's what I'm
trying to explain to you is that's my job, I do
that all the time.
Now, you've talked to the Commissioner at some
length about medical research. What does an
epidemiologist do, to your knowledge?
Well, they are generally folks that are trained to
evaluate trends and statistics, and especially
with regard to public health. They're the ones
that will look at things like if you have a
certain number of cases of, for instance, measles.
They are the ones that are trained to evaluate
whether this represents an outbreak, whether it's
just a spontaneous couple of cases, whether it's
starting to turn into an epidemic. And I know
that there are some that are trained into sort of
tracing it back to a primary event. They can
locate perhaps the initial index patient that
presented with that. That's my understanding of
an epidemiologist, and I'm not one of them.
Okay. Now, you mentioned earlier testimony about
one of your studies. Dr. Tseng had some caveats
about your 2006 study.
Okay.
You've mentioned some of the ones he mentioned,
that the vector was across the back and there was
only a five-second application and it was funded
by TASER, I think.
Well, the machinery was funded by TASER. So the
blood work that we had to draw was funded by

30
Dr. Jeffrey Ho (Manufacturer presenter)
Questions by Mr. Vertlieb (cont'd)

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TASER.
He said you had an ECG in 32 of 66 subjects.
That's correct.
But he didn't know why there wasn't an ECG in all
these 66.
Sure.
What is the answer, sir?
The answer is actually very easy. It's one of
logistics. As we were gathering the data, our
intent was to gather an ECG before and after and
then for 24 hours on every subject that went
through there. The problem with that was we only
had a two-and-a-half-day time period in which to
do this. And our longest, most time-consuming
event in the data gathering process was the
application of all the EKG pads. And so we sort of
had to make a critical decision. Do we try and
get more EKGs on everybody and less in our number
from 66, perhaps, to 25 and get EKGs on everybody,
or should we go ahead and get as much data as we
possibly can on everybody and just do EKGs on the
ones that we have time for? And that's how we
came up with that 32. It's also why we have an
odd number of 66. I've been asked, well, why did
you stop at 66? Why not stop at an even 100?
Simply because we ran out of time, that's what we
could fit in.
I'm just asking because Dr. Tseng had mentioned it
to us and he didn't know why.
Yeah. And that's the simple answer is -That's fine.
-- we couldn't fit in.
No, that's fine.
Believe me, I would love to do a thousand, but we
can't do that. Not enough time.
And Dr. Tseng also mentioned a case where there
had been a gentleman shot with Taser and he
happened to have a pacemaker. Are you familiar
with that incident?
I believe I've read the case report. I'm not
intimately familiar with it.
Dr. Tseng was telling the Commissioner that that
was of particular interest because it was the one
time that the actual recording during the Taser
itself was noted. Do you remember the
Commissioner asked you about that and you talked
about the artefact?

31
Dr. Jeffrey Ho (Manufacturer presenter)
Questions by Mr. Vertlieb (cont'd)

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Yes.
How have you accounted for that pacemaker case in
your research?
I guess I'm not sure of what is your question.
It was apparently a study from Los Angeles.
Right. Well, I wouldn't say it was a study. It
was a case report. You have to be a little
careful about that, the difference between studies
and case reports. Case reports report events of
curiosity to physicians, and studies are actually
controlled methodologic processes where you go
through a scientific method, you come to a
conclusion. So, I mean, I think if we're talking
about the same case, the case was reported as an
intellectual curiosity as a case report. It was
not a study.
Now, in terms of studies that were here in British
Columbia and of particular interest to British
Columbians would be deaths that would be proximal
to Taser use, you understand that?
Sure. I don't think that's just unique to British
Columbia.
Right.
I think that's unique to North America and the
entire world.
We've been told that there were seven deaths in
our province in the last few years proximal to
Taser application. Knowing that you were coming
here, I'm just curious, have you looked at any of
those cases for analysis?
I have not.
We were told that in Canada there's perhaps 19 or
20 deaths where Taser was proximal to the death.
Have you looked at any of those cases in your
research?
I have not.
On a larger scale, we have heard that perhaps 300
deaths or so in North America where Taser was
proximal, have you looked at that as part of your
research?
We do have a project that is involving looking at
that, yes.
That's in progress right now?
That's correct.
Earlier at one of your slides you mentioned that
sudden death has been around or known to doctors
for many years going back to the 1800s.

32
Dr. Jeffrey Ho (Manufacturer presenter)
Questions by Mr. Vertlieb (cont'd)

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That's correct.
And you mentioned hogtie.
Yes.
You're a police officer but you would know, I'm
sure, that hogtie, at least here in this country,
is not being used any more. It's not allowed
because of the risk of death.
Yeah, and I think if you look at the data on that
we went through a time period where the perception
was hogtying was the causative aetiology of sudden
death. There have been some studies in the lab on
that that position does not contribute to anything
known again on how you would cause somebody to
die. So that position is actually being allowed
in certain departments making a comeback, so to
speak.
What ended up happening was everybody thought
that hogtying - and this goes back to that slide
that I was explaining to you earlier. Initially
hogtying was thought to be the prime culprit,
that's what's causing people to die. So it was
outlawed everywhere. Nobody hogties anybody
anymore. And what happens, people still die. So
that's not the answer.
And that's what I'm getting at is that we
also said that about pepper spray, we also said
that about the vascular neck restraint. We've
also said that about prone positioning. Today
we're sitting here discussing whether or not that
applies to Taser. These are bumps in the road of
history where new tactics and new tools come along
and we must look at those, I mean, as a society we
should. But the connections have not been found
there. I think we're not asking the right
questions.
I just ask you because we're trying to get all
points of view on the subject.
Sure.
And that's why we're exploring it this way.
Sure. And I guess to answer your question, in the
United States there are many departments now that
do allow that because the literature does not
support that position. And just in addition to
that, those departments that do use that do not
show a higher custodial death rate than
departments that are not using that tactic.
Dr. Ho, are you aware of any other electrical

33
Dr. Jeffrey Ho (Manufacturer presenter)
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device that's capable of incapacitation that has
gone to market without independent testing and
government research?
I guess I'm not. I don't stay up on all the
devices that may or may not go to market, and I
certainly don't know what is and what is not
researched out there as far as outside of my own
domain of expertise. I'm not sure if I'm
answering your question, but I'm not sure what
you're getting at, either.
I just wanted to be clear on this excited delirium
that you mentioned, and I think many would agree
there can be just semantics around it. But in
terms of delirium, are you really saying that you
would know as much about that as a psychiatrist?
Well, when you're talking about true agitated
delirium, I think I would know more about it than
a psychiatrist when it comes to the initial
presentation and taking care of the person as far
as resuscitation, ensuring their safety,
stabilizing their condition. Would I know as much
about it as a psychiatrist perhaps in long-term
care or what's the appropriate disposition of that
person or how long they need to stay in the
hospital for? Absolutely not. I don't hold
myself out to be somebody that cares for patients
that way.
Now, your studies, you mentioned that people in
some of your studies were subject to exertion of
some sort?
Yes, that's correct.
And how is that done?
We did a proscribed series of anaerobic exercises,
and what they were it was 45 seconds of push-ups,
as many as they could do, and they were not
allowed to rest in a down position. They had to
rest in an up position. And they had to keep
going until they absolutely just couldn't do any
more push-ups. So that's designed to invoke what
we call anaerobic exhaustion.
And let me start over. Before we even
started them on that, we drew their blood so that
we had a measure of what's known as their pH
status. So that before they did anything, we knew
that they were at baseline physiology. We then
had them start their push-up regimen, and
immediately following their push-up regimen, they

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got on the treadmill and ran at eight miles per
hour at an eight-degree incline of elevation, so
it's essentially an uphill sprint on the
treadmill. And they would go for no time limit.
They just had to go until they couldn't keep up
with the treadmill any more. So when they came
off the back end of the treadmill, that portion of
their exercise was done. Immediately following
that we would draw their blood, which would ensure
their pH status to be acidotic, and that's how we
knew that they were exhausted. And we actually
had some very remarkable pH levels, things that we
were not believing that we would see, pHs to get
that low. We actually got them fairly low. And
then we would subject them to their 15-second
Taser exposure, and then immediately draw their
blood work again after that, and that's how the
experiment was done.
So 45 seconds of push-ups.
Yes.
And then treadmill. How long on the treadmill?
It's eight degrees of elevation at eight miles per
hour, and they would go until they could not keep
up with the treadmill any further.
I just don't know how long that would be, would
that be minutes, hours?
Well, I think that depends on -- no, no, not at
all. It depends on your own conditioning. We
probably had some people go as long as two
minutes. Most people didn't go for more than
about 45 or 50 seconds.
Okay. Now, recently we've seen an article and an
editorial in the Canadian Medical Association
Journal, a group of doctors at the University of
Toronto have been working at research in this
field. Are you familiar with that research?
With the article or their research?
With the article.
I'm familiar with the article, yes.
And have you read the editorial as well?
Which editorial?
In the same journal.
Is that from Dr. Stanbridge or Stanbrook -Yes.
-- or something like that? I have read that, yes.
So do you agree or disagree with the article and
editorial?

35
Dr. Jeffrey Ho (Manufacturer presenter)
Questions by Mr. Vertlieb (cont'd)

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Well, I'm not really sure what -- the editorial, I
think, I felt it was fairly inappropriate for a
deputy editor of a scientific journal to make that
sort of commentary. I got the impression that it
was a fairly biased editorial to begin with, which
I don't believe is the job of a true editor. I
don't agree with his comments in there. For
instance, I believe one of them was talking about
utilization of defibrillators for sudden custodial
death, and again if you remember back to the whole
context of my lecture, that's not the rhythm that
people are having when they die suddenly in
custody. So again we're -- we're focusing on the
wrong problem.
With regard to the Toronto article that
you're talking about, that was not a study. That
was more considered what's a meta-analysis. It's
taking a compilation of all the data that's
available and sort of putting it together and
putting it forth in the public sector. I think, I
mean, it is what it is, it's a meta-analysis, it's
not its own freestanding study.
So let me just read the conclusion just to
refresh.
is this the editorial or is this the meta-analysis
portion?
No, this is not the editorial.
Okay.
This is the review article.
Okay.
Conclusions. Despite many studies suggesting
that stun guns do not affect the heart, the
evidence and studies presented in this review
suggest that in some circumstances stun guns
may stimulate the heart while discharges are
being applied.

A

So I think it would be helpful to hear your view
of whether you agree or disagree with that
comment.
Sure. Well, I mean, just on the face of it,
semantically I would agree with that. If you look
at it it's worded, it's crafted very carefully,
it's worded very carefully, "under certain
circumstances" I believe is what the exact quote
is. So again if I went to the lab and I peel away

36
Dr. Jeffrey Ho (Manufacturer presenter)
Questions by Mr. Vertlieb (cont'd)
Dr. Joseph Noone (Medical experts presenter)
Questions by Mr. McGowan
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the skin of a pig and I drill down to the chest,
which is one of the studies that they talk about
in there, yes, it's possible to do just about, you
know, whatever it is you want to do. But when you
look at that compared with the human data that's
out there, that's not what we're finding, and
again that's sort of one of my main points here is
I'm a holder of the human data. The human data
that I presented to you on the last slide, again
which is being presented in San Francisco today, I
guarantee you that the folks in Toronto are not
aware of. So their article is being written
without that knowledge. They may alter that
statement knowing that, I don't know, but those
are my comments on that.
MR. VERTLIEB: Well, Dr. Ho, we want to thank you very
much for coming. We appreciate you being here and
helping us with some of the information you've
provided.
A
Thank you for allowing me to present. Thank you,
sir.
THE COMMISSIONER: Yes, and I reiterate that. Thank
you for sharing your research with us.
A
Thank you very much.
(PRESENTER EXCUSED)
THE COMMISSIONER:

We'll take a ten-minute break.

(PROCEEDINGS ADJOURNED)
(PROCEEDINGS RECONVENED)
THE COMMISSIONER: All right. I believe we can
commence. Yes, counsel.
MR. McGOWAN: Thank you, Mr. Commissioner. The next
presenter is Dr. Joseph Noone. He is a practising
psychiatrist in our province and he has come here
today to share his thoughts on a number of
matters, including the topic of delirium.
DR. JOSEPH NOONE, a Medical
experts presenter.
QUESTIONS BY MR. McGOWAN:
Q

Dr. Noone, before we send you off on your
presentation, I am just going to spend a few

37
Dr. Joseph Noone (Medical experts presenter)
Questions by Mr. McGowan

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moments on your background introducing you to the
Commissioner. You were born and grew up in
Ireland?
That's correct.
And prior to attending medical school you served
as an officer in the Parachute Regiment of the
British Army?
That is correct.
After which you attended medical school at the
Royal College of Surgeons in Dublin, Ireland?
Yes.
And you obtained a first place psychiatry medal at
the conclusion of that on your professional exams?
I believe, that's a long time ago.
Yes. You went on to do your internship in
Toronto?
Yes, I did my rotating internship in Toronto.
And tell the Commissioner just briefly about your
residency and post-graduate program.
After completing my internship in Toronto I was
accepted into the McMaster University Medical
School residency in Psychiatry and I spent
approximately two years there. Because I was
interested in forensic psychiatry, criminal
forensic psychiatry, I then moved to the Clarke
Institute of Psychiatry in Toronto and completed
my residency training there, and graduated as a
specialist in 1980 in Toronto as a psychiatrist.
You have a number of honours and awards, Dr.
Noone, I won't take you through them all. But in
January of 2003 you were elected as a
Distinguished Fellow of the American Psychiatric
Association?
Yes.
In terms of your work and employment, currently
you are a Professor of Psychiatry, Clinical
Professor of Psychiatry at the University of
British Columbia?
Yes, I am. I have been since 1993.
You are the Medical Director of the Adult Program
at Riverview Hospital currently?
That is correct.
You are also the Medical Manager of the
Psychiatric Intensive Care Unit at Riverview?
Yes.
And in addition you are the Director of the Code
White training in British Columbia?

38
Dr. Joseph Noone (Medical experts presenter)
Questions by Mr. McGowan

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A

Well, certainly in Riverview and for the B.C.
Mental Health and Addictions.
Okay. And just very briefly, what is Code White
training?
Code White is a level of training for staff who
have to deal with higher levels of aggression, and
basically it focuses on the whole range of
training but specifically on team interventions at
the higher level.
You also have currently and have for a number of
years obtained a clinical and consulting practice?
That is correct, yes.
And just tell the Commissioner very briefly about
your clinical and consulting practice.
My clinical practice is mostly in the area of
clinical aspects of violence, so it brings me to
work and consult in such places as Provincial
Corrections, Correctional Services of Canada,
emergency hospital work, and in providing at times
on request consultations to the Coroner's Service
of B.C. In that regard I've testified there on
ten occasions, in that regard, a number of those
were related to in-custody deaths.
You also provide emergency on-call psychiatric
services at the emergency wards of a couple of
different hospitals; is that right?
Well, I am on staff at Vancouver General Hospital,
Riverview Hospital and Surrey Memorial Hospital.
The Surrey Memorial Hospital is just so that I can
keep up my own skills in emergency psychiatry in
that setting.
You've throughout your career had a special
interest and some expertise in the forensic and
emergency psychiatry fields, and specifically in
the prevention and management of aggressive
behaviour in healthcare; is that correct?
The prevention and management of aggressive
behaviour in healthcare has been my main focus for
the last 27 years of clinical practice.
And do you in your practice come into contact with
people in extreme agitated states presenting both
at emergency wards and in other areas of your
practice?
Yes. I see obviously a lot of agitated people in
emergency. I also see highly agitated people in
the Psychiatric Intensive Care Unit at Riverview
Hospital, which is a 15-bed doubly locked unit,

39
Dr. Joseph Noone (Medical experts presenter)
Questions by Mr. McGowan
Presentation

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which takes referrals from anywhere in the
province on patients that the general hospital or
secondary system can't manage.
In addition I consult to Fraser Regional
Correctional Centre as a consultant psychiatrist
and I am usually asked to assess for certification
or transfer to emergency inmates in that setting.
Q
So it's not the case in your practice that you're
isolated in any way from patients presenting in an
extreme state of agitation and -A
No.
Q
-- (indiscernible - background noise) long term?
A
I see it on almost a daily basis, at least Monday
to Friday anyway.
MR. McGOWAN: Thank you, Dr. Noone. I'm going to
invite you to give your presentation.
PRESENTATION BY DR. JOSEPH NOONE:
A

Thank you. Sir, I appreciate the opportunity to
make a presentation to this public inquiry.
About four weeks ago I was asked to address a
few questions from my clinical experience and
background. The questions were: (1) What is
excited delirium? (2) How do you handle people
who are agitated? And I guess that means how do I
handle people who are agitated. And, what force
do you use in that capacity?
I will attempt to answer these questions to
the best of my ability. Basically the context,
bringing it into my own area, the context as I see
for my presentation looks at the understanding,
de-escalating and responding to highly agitated
individuals.
So I think the first question would be what
is excited delirium versus what is delirium, and I
think that has come up a number of times. I will
start with reality, so I will start with delirium.
You may notice I put "excited delirium" in quotes.
That was deliberate.
It is clear that delirium is a bona fide
medical condition. In fact, advanced delirium is
a medical emergency and it is not a psychiatric
emergency.
What delirium is is an acute confusional
state with fluctuating levels of consciousness.
There is usually hyperactivity, although there may

40
Dr. Joseph Noone (Medical experts presenter)
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be lethargy. There is a rapid succession of
confused, unconnected ideas, and there is often
illusions and hallucinations. Illusions are
misperceptions, visual misperceptions.
There are many causes of delirium and in
there's a mnemonic "I WATCH DEATH", it gives a
list of those and I have included that in an
appendix to my report. But the major causes of
delirium that one sees, the most obvious is
related to drugs, closed-head injury,
hypoglycaemia, electrolyte disturbance, acute
psychosis, meaning either schizophrenic-type
condition or a manic or bipolar mood disorder
condition. So there are many causes. And
actually the skill is dealing with the causes to
deal with the diagnosis.
As I mentioned, it's a medical emergency
requiring intensive medical assessment and
management, and the goal of treatment is to
reverse the cause or causes. Usually, it's
multifactorial, a number of things come together
in a certain kind of escalating way, and then the
person enters a confusional state.
Excited delirium is not a valid medical or
psychiatric diagnosis, and that's not just a
semantic difference. And what I mean by that is I
noted the last speaker indicated that the only
difference was a semantic one. Yes, there is a
semantic distinction to be made, but there is also
the great concern that I have is that this excited
delirium is basically an excuse for anything that
happens, blaming it on the person who may suddenly
die, and not on the people who are delivering care
at that time.
A few weeks ago I was in a conversation with
a colleague from law enforcement, and the subject
came up of the airport incident. And immediately
this person said, "Oh, the minute I saw that, I
thought excited delirium." So law enforcement
people are being taught that any agitated
behaviour is excited delirium, whereas delirium is
a very rare condition, even though in some areas
where there is drug abuse it might be higher. But
relatively speaking, it's rare. There's a lot
more acute psychotic presentations in the
emergency than there are delirium. In fact, some
of the delirious patients that I receive at

41
Dr. Joseph Noone (Medical experts presenter)
Presentation

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Riverview Hospital are delirious because of the
medications they got in the secondary hospital.
So I think it's much more than a semantic
difference, and it's basically putting police
officers and others into the false belief that
they can actually diagnose any agitation as being
excited delirium, and that then from that they can
do essentially what they want, and that's a
concern to me.
It provides a convenient post-mortem
explanation for in-custody deaths, where physical
and mechanical restraints and conducted energy
weapons were employed. There seems to be a lot of
focus on Tasers at the moment, but a Taser
incapacitates somebody long enough for them to be
physically restrained and then mechanically
restrained.
The suggestion that forceful prone restraint,
hogtying, are proved to not have any effect on a
person, I think is absolutely unfortunate.
So I guess my main concern around the
concept, the, quotes, "excited delirium", is that
it's being used more and more frequently in an
attempt to automatically absolve law enforcement
from any and all responsibility for their
involvement in sudden in-custody deaths, and
that's my concern.
Now, the second part of the question was,
what is the best way to treat an emotionally
disturbed highly agitated individual, and that's
what I'll like to speak to now.
There is an old police term called EDP,
meaning "emotionally disturbed person". I like
that term. It's descriptive, it's not judgmental
and it describes what you see. It doesn't
describe the aetiology or the causes for it. It
just describes exactly what you see, an
emotionally disturbed person. And I must say,
even though it's an old term, I'm somewhat sort of
very favourable towards it. And older-time police
officers, that's the term they use, and they were
absolutely right all the time. They weren't
making diagnoses, they were just describing a
person. And also it says emotionally disturbed
person, and I think that's important, because
we're dealing with people here, and that can get
lost at times.

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Dr. Joseph Noone (Medical experts presenter)
Presentation

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So how do we, what is the best way to treat
an emotionally acting-out person? First of all
you need to ACT, and the little acronym I've put
here is you need to assess quickly. So when you
meet an agitated person, you've got to assess them
fairly quickly as to what's going on. You may
have to then before you have a lot of information,
you may have to contain their behaviour, because
they're confused, they're frightened, they're
psychotic in some cases. They've got an acute
confusional state going on. And then once you
kind of contain them and assess them, you've got
to treat them specifically for the underlying
condition for which they are disturbed and
agitated about.
So what do you look at for the assessment?
You've got to be open-minded. You've got to
consider all possibilities. You've got to be
objective. You've got to genuinely support the
person. You need to remain calm, and you need to
take your time. On a scale of one to ten, you
need to come in at around three or four. You
could always escalate your response, escalate the
amount of control you have, you may need, but if
you go in low, you can usually get compliance. In
my experience, particularly if the staff are
experienced, you can in most cases get compliance.
If you go in at eight or nine, which can happen
and it certainly can happen in a law enforcement
environment, it is very difficult or impossible
then to diffuse the situation. Diffusing has to
occur as early as possible, just like prevention.
And in fact your attitude of power and control, if
you go in at eight or nine or ten, may well
escalate the situation. So that's why where
possible I prefer to work with a clinical team in
the emergency or in a psychiatric intensive care
unit for that reason, you have people who are, or
you are approaching it as a team.
In terms of containing behaviour, I think a
trained team is essential. And by that the most
important word is "team". Okay? One on one, you
know, certainly in the mental health area, we do
not approach one on one, or even two on one, or
even three on one in a highly agitated situation
unless we have assessed that we can deal with the
situation with that amount of resources. You

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Dr. Joseph Noone (Medical experts presenter)
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can't go in there and then get overwhelmed, so you
have to assess what's going on.
If necessary you have to put on hands-on
technique. But how you put hands-on technique is
as important as putting hands on. If you grab
people roughly, they will react. I would react;
you would probably react. So gentle touching, not
touching, showing support, is what will bring this
confused person down to a level where you can deal
with them. They may have to be transported to a
hospital. Usually, if they are highly agitated,
they will be triaged to four-point mechanical
restraints in the emergency department. That's
what usually happens.
The specific treatment occurs in the
emergency department. The medical assessment is
done there because by definition this is a
superimposed -- with delirium, a superimposed
condition for which there are medical reasons.
And then at the same time as that's happening,
they usually, you know, the psychiatric
consultation is obtained. So it's usually the
casualty officer and the psychiatrist, emergency
psychiatrist, working together with more focus on
the medical assessment initially because really in
psychiatry we want to make sure that all -there's an assumption sometimes that all behaviour
is psychosis and it's not psychosis. There's lots
of other reasons for it. And the big mistake we
don't want to make is to treat something as
behavioural when in fact it has a medical cause.
And then, based on the assessment by the
medical person or the medical team and the
psychiatric team, treatment is done on the basis
of those assessments.
A word of resources, because emergency
hospital departments vary in their ability to
respond to behavioural emergencies. You know,
optimally there should be a range of resources
available, and some of the resources that are very
helpful in this area include what's on the slide:
mobile crisis intervention teams, and Car 87 teams
a Vancouver constable with a registered nurse or
psychiatric nurse to provide onsite assessment and
intervention for mentally ill individuals. More
recently Car 67 at Surrey does essentially the
same thing. They are not 24/7, though, but they

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Dr. Joseph Noone (Medical experts presenter)
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are from 2:00 p.m. to 2:00 a.m., with a uniformed
RCMP officer in an unmarked car, teamed with an
experienced mental health worker. Again, you
know, if teams like this can be deployed
effectively, the success rate goes up
tremendously.
Another resource that's maybe not used enough
but is used in places are psychiatric liaison
workers. These are experienced mental health
nurses who work in emergencies and are available
to -- they are part of the psychiatric team, but
they work in the emergency and they are extremely
helpful.
For example, Surrey Memorial Hospital have
psychiatric liaison workers who are there 24/7,
and even with two staff from 10:00 a.m. to 10:00
p.m., so these are people who do nothing else but
deal with psychiatric emergencies, and obviously
they are extremely valuable, and they usually work
with an emergency response psychiatrist.
Hospital-based psychiatric emergency
services. There's a need for brief-stay units.
And the kind of units I am talking about are often
called psychiatric assessment units. Now, there
is one at St. Paul's, there's one at Vancouver
General and there's one at Surrey Memorial. And
they again are a response that's very important.
And not wishing to proselytize, but Riverview
Psychiatric Intensive Care Unit, which I am the
director of, is a provincial resource for
psychiatric patients with a high level of
aggression, and it has 15 beds and is a secure
unit.
One of the questions I was asked to put my
mind to was the use of a Taser on individuals who
are in delirium. In delirium there is a very high
risk of further medical compromise. The person is
in a highly agitated dangerous state. To Taser
such individuals, and I am speaking now as a
clinician, is contraindicated due to the high risk
of death, in my opinion. I'm not a researcher, by
the way, I'm a clinician, and this is based on the
assessments I've done and the patients I've seen.
A comment on RCMP policy 3.2.2 and 3.2.3, I
kind of looked at this and didn't quite understand
it for a moment. But it mentions excited delirium
and the importance for the police to know about

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excited delirium, which is not a medical or
psychiatric condition, does not exist, and is used
now as an expression to cover any agitated person.
Medically untrained personnel may apply this to
any agitated person and a team intervention using
soft empty hand control in most cases would be the
most appropriate means of restraint, although
individual assessments might dictate otherwise.
Talk a little bit about the mental health
approach. In terms of management of aggression,
there's a number of areas, and I've listed them
here: understanding, prevention, de-escalation,
self-protection and Code White intervention,
meaning a team intervention. You always try to
kind of resolve the situation at the lowest level,
but sometimes and you -- but you need resources
for the whole continuum.
Code White is a trained team response for a
higher-risk behavioural emergencies involving
patients in health-care settings.
Okay. A couple of things about aggression.
Aggressive behaviour does not come from out of the
blue. But when you go to an area first, people
will tell you, oh, never saw it coming, it came
from out of the blue. Usually people that happens
is ones they don't have a lot of confidence in
handling aggression, and I guess they hope that if
they don't see it, it won't happen. But it does
not come out of the blue. It occurs in a
situational interactional way, and usually there's
lots of precursors which allows you to intervene
as early as possible.
Violence is interactional. In other words,
there's a relationship between the person who is
violent and the person they're being violent with.
That is not to say, and I'm just saying that's the
nature of aggression and violence, that it's
interactional.
And again another way of putting this is it
takes two to tango, or as these individuals say,
"I'm afraid you misunderstood, I said I'd like a
mango." Okay. So it also points to the
importance of communication.
The philosophy, this is the healthcare
approach to prevention and management of
aggressive behaviour, is respect and
professionalism. That is the underlying attitude

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that has to be there. If you don't have that
attitude, then you're not going to handle
disturbed people very well.
Not power and control. Power and control
will cause conflict. It will incite the
situation. Now, you may have to use control of
the situation, but how you do it is important.
Again even with hand contact, whether it's done in
a rough way or done in a supportive way, and you
can't fake it. You can't fake respect. Some
people say you can just appear respectful, but
people, even disturbed people, will pick up how
you're treating them.
Again communication is terribly important.
Your body language, facial expression, the
distance, how you manage distance, the speed of
movement, and in terms of the verbal, the volume,
the tone, the rate, the rhythm of speech. And the
only way to get skilful at this is to practice it,
you know. And in our training in the hospital we
do a lot of scenarios where we play the scenario
out to get people to develop these de-escalation
skills.
You need to assess the level of resistance in
order to determine and justify the level of force
of your intervention. And that's often very hard
to get across to staff that they have to be able
to describe what was the level of resistance.
They're very good at saying what they did.
They're not so good at saying what was happening
when they did it.
Don't use a fire extinguisher to put out a
cigarette, I guess is a way of looking at it.
The levels of resistance that we teach the
mental health staff in British Columbia, and again
a lot of this is taken exactly from police
information and police training as well, is levels
of resistance: compliant and co-operative,
passively resistant, actively resistant,
assaultive behaviour, or deadly force or potential
deadly force behaviour. Because you really have
to know what that level is before you decide how
to apply any form of force continuum.
In mental health we do what's in the green
there, levels 1, 2 and 3A. We do not do what's in
the red, or it looks kind of orange to me this
morning, but we don't, you know. In other words,

47
Dr. Joseph Noone (Medical experts presenter)
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presence, dialogue, exactly the same as law
enforcement. However, when it comes to hands on,
in empty hand control, we only use superior
technique and strength. You might ask, well,
where do you get the superior technique and
strength? We get it from a team intervention. If
you have a trained team, the amount of risk is
greatly reduced. If you have one or two people
trying to manage the situation, they have to use
much higher levels of force to have superior
technique or strength.
We do not use, and it's against our policies
to use pain compliance, that is, pressure points
or painful joint locks. We find it just pisses
people off and they get worse, not better.
We do not use impact, whether it's impact
with our fists or our knees or anything else, or
impact with the floor, or impact with a wall. And
we do not use any form of restricted techniques
such as lateral vascular neck restraint and
certain stuns like brachial stuns.
We obviously don't use compliance tools, and
in the area of compliance tools I put pepper
spray, batons and Tasers, and Level 5 firearms.
So we believe that within the top part of
that we can handle the vast majority of disturbed,
mentally ill or intoxicated or drug-related people
and behaviours.
The team, there is always a leader who
directs the intervention. The team perform handson using techniques that we try to not go muscle
on muscle. We try to use what we call gentle
trapping techniques, so you're not in a conflict
with the person. You're just using body position,
balance and attitude to achieve that. So you're
not going in gangbusters.
We also have staff members who do not reach
either a team member or a leader level of training
because of age, because of many factors. And we
use them as support people. They're still part of
the team, but they do not get themselves involved
in any physical intervention. They prepare
medication, they clear the area, they settle down
other patients, other staff. They have lots of
roles. But one of them is not actually directly
handling the situation.
Just to give you a kind of an idea whether,

48
Dr. Joseph Noone (Medical experts presenter)
Presentation

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you know, you might say sort of, so what, you do
it, you know, very gently, but, you know, maybe
it's not going to work.
So what I'd like you to look at now is a
comparison of the use of seclusion, which is in a
locked room, in the referring hospitals, these are
general hospitals mostly around the Lower
Mainland, and in the Psychiatric Intensive Care
Unit. Remember they are sent to the Psychiatric
Intensive Care Unit because they believe that they
can't manage them further.
Some 55 patients were discharged in late
2005. The total length of stay, this is of the 55
patients in the referring hospitals. These are
general hospitals, including teaching hospitals.
For the 55 patients it was 618 days. You know, in
our Psychiatric Intensive Care Unit, that same 55
patients between them were there for 1,223 days.
So obviously we keep people longer than just a few
days. Our average length of stay is four weeks.
Now, looking at the total time in seclusion,
because seclusion is a sort of a control course of
measure to control people, and these will all be
psychiatric patients, they would all be certified
under the Mental Health Act of B.C. In the
referring hospital, those 55 patients were in
seclusion for a total of 2,998 hours. The same
patients in the ICU with other patients who were
considered equally aggressive, the 55 patients
totalled only 269 hours even though they were with
us a lot longer. So again it shows the kind of
reductions you can get depending on your approach.
The reasons for less seclusion is (1) I think
the most important is attitude, you know, and that
is the hardest to kind of train, to get people to
do. But the attitude is key. The attitude people
bring to their work, they bring to the clients
they see, that drives the expectations, the
expectations of the staff and the expectations of
the patients. We get people who have been three
weeks in seclusion. They come to us, we take them
out of restraints, and some of them never go back
into seclusion during their stay with us. So
we're working with them. We're not working
against them to control them.
Our training, we have core training in basic
sort of prevention of aggressive behaviour, and

49
Dr. Joseph Noone (Medical experts presenter)
Presentation

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then depending on the risk assessment, we have
risk-specific training, usually two days training,
and then repeated as often as necessary. We also
have practice sessions where we do scenario
training to keep people keep their skills up. And
we have a lot of experience with it, although now
many of us are getting close to retirement age, so
the experience will have to be passed on.
I'd like to sort of finish off with two
quotes from law enforcement authorities, who are
very well regarded in their field, or were:
Policing is a person to person business. It
is very rare that a technological solution
has really solved anything for police...the
best way is to develop interpersonal skills
and self-defence skills.
James Fyfe, 1993, who was a very big name in law
enforcement. Unfortunately, he is now deceased.
Another one from Mr. Arenberg, who is the
organizer or director of the National Association
of Chiefs of Police in the United States:
Training is needed to give officers skills in
how to verbally approach citizens and
suspects alike. ...it depends on how I stop
you, whether you are going to be co-operative
or resistant.
And I think that's an excellent quote because it's
not what you do, it's how you do it that where the
skill is.
I would just like to finish up with a
statement, one about using a Taser with highly
agitated individuals.
I believe that highly agitated individuals,
even more so if they are in delirium, are at very
high risk of further medical compromise, due to
metabolic, cardiac, respiratory and other
complications. To Taser such vulnerable
individuals would be contraindicated medically due
to the risk of death, in my opinion. That's a
clinical opinion.
A further comment on the RCMP policy, 3.2.2
and 3.2.3. I understand the policy dictates that
an individual experiencing excited delirium - it

50
Dr. Joseph Noone (Medical experts presenter)
Presentation

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is now in a policy of a police force - requires
medical attention and must first be restrained.
In some cases there have been delirium, that is
correct. The policy goes on to authorize the use
of a Taser as possibly the most effective means of
restraining the individual. In my opinion, this
policy is seriously flawed for the following
reasons:
First, it references excited delirium, which
is not really a medical or psychiatric condition.
The way it's being used, it could be just about
anything.
Secondly, medically untrained personnel,
including police officers, may apply this to any
agitated individual, whether delirious or not.
This would be a worrisome development, in my view.
Third, a trained team intervention using soft
empty hand control, while working to maintain a
relationship with the individual, in my opinion,
provides the safest and most effective way of
restraint and transportation.
The use of a Taser on a small number of
highly agitated individuals who are really in
delirium, is strongly medically contraindicated,
in my view.
The majority of highly agitated individuals
who come to the attention of the police are
suffering from alcohol or drug intoxication or
withdrawal, and/or exacerbation of a major mental
illness, especially schizophrenia or bipolar mood
disorder. The Tasering of these compromised
disorganized individuals could well be interpreted
at least as discrimination. Such an approach
basically dehumanizes the serious and persistently
mentally ill in the community and could be
perceived as a perpetration of abuse on this
group.
In terms of the policy, it could be said the
RCMP did everything by the book. The problem is,
the book is wrong.
So I think that's a terrible policy. I don't
know who wrote it. It must have been a committee.
I think that's all I have to say. Thanks.
THE COMMISSIONER: Counsel, have you any questions.
MR. McGOWAN: I do have just a few, Mr. Commissioner.

51
Dr. Joseph Noone (Medical experts presenter)
Questions by Mr. McGowan (cont'd)

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QUESTIONS BY MR. McGOWAN, continuing:
Q

A
Q
A
Q
A

Q

A

Q

You spoke about the increased risk of an adverse
consequence from the application of a Taser or an
additional insult to somebody who is in delirium.
Does that apply to other emotionally disturbed
individuals, as well?
Sorry, I don't quite...
You don't like the term "excited delirium".
Well, no, I don't particularly like the term
because I see the way it's being used.
Okay, fair enough.
I just don't like the use of it. I mean, it's
like a Taser. A Taser is a tool. What's
important is what are the rules around its use. A
shovel is a tool, as well. You can dig a hole or
you could hit your neighbour on the head with it,
you know. So, you know, I think we have to look
at the use of techniques and the use of
strategies. And, you know, as excited delirium
seems to have gone off the board, in my view, and
I think in a very serious way because it's only
bought into by TASER International and by law
enforcement, and that's a worrisome alliance, in
my view.
Do you see that the concept of excited delirium or
the term "excited delirium" as being at all useful
to policing in British Columbia, the way it's
being used currently?
The way it's being used, not at all. In fact, I
see the opposite. Now police and law enforcement
are getting the idea that they can diagnose
anybody as having it. So it becomes a kind of a
ready-made excuse. So if the person dies, they
die because of their, quotes, "delirium". They
didn't die because, you know, you were doing
forceful prone restraint, or you were hogtying
them. I mean, the last speaker spoke about that
all these things have been now proven to not be a
problem. That's absolute nonsense clinically, you
know, hogtying, you know, positional asphyxia,
these are all factors. Again, there's many
factors, but they're all factors and, you know, to
say that they were used but, you know, and now
they make no difference, I don't accept that. I
wouldn't accept that.
Does a person die from delirium, Dr. Noone?

52
Dr. Joseph Noone (Medical experts presenter)
Questions by Mr. McGowan (cont'd)

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A

Q

A

Well, again there's some semantics in the
question. They die from the causes of the
delirium. They don't so much die from the
delirium, they die from the factors that cause the
delirium. What can happen, though is all these
factors can come together and can crescendo. And
then the person is highly vulnerable, and they can
die in that state.
What the difficulty is is saying what were
the factors and what weight can one put on various
factors. I think the only way to do that is look
at all the factors and if it results in an incustody death, then the Coroner Service can sort
out what were the factors and what various weight
might or might not be done. Because ultimately in
the use of force you're looking at an assessment
of that particular case in terms of reasonable
force or not reasonable force.
What would you say to a police officer, Dr. Noone,
who is weighing the possibility of using a Taser,
considering that decision in the face of an
emotionally disturbed person or an extremely
agitated person?
Well, it depends on each situation. It depends on
the level of resistance, okay? If the resistance
was deadly force that the person was using, then
of course they would have to respond up to a
similar level. If the person was just at the
state of presence or dialogue and you say, as the
RCMP policy seems to say, that may be the best way
of bringing them to the emergency, I wouldn't
agree with that. Because what that does, it takes
a compliance tool up to the level of just beneath
dialogue. That's way too far, you know, that
doesn't make any sense to me.
I mean, to use Tasers for deadly force, I
don't have a problem with it. To use them for,
you know, severe assaultive behaviour, I don't
mean just shaping up like they're going to fight
with you or something, but serious assaultive
behaviour where they're actually assaulting, I
could see on individual situations where that
might occur.
When I started looking at this area first, I
would have probably said there could be some
instance of active resistance where that might
also happen. Having read this information, I am

53
Dr. Joseph Noone
Questions by Mr.
Deputy Chief Ken
Questions by Mr.
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(Medical experts presenter)
McGowan (cont'd)
Allen (Law enforcement presenter)
Vertlieb

of the opinion that to some extent this Taser
business has got out of hand and therefore I would
restrict it to assaultive behaviour and deadly
force. I would not take it below that, from my
perspective.
Q
Dr. Noone, have you got any personal or financial
interest in this debate on one side or the other?
A
None whatsoever. I'd just like to see proper care
of mentally ill individuals who are in crisis.
MR. McGOWAN: Those are my questions, Mr. Commissioner.
THE COMMISSIONER: Dr. Noone, thank you so much for
this presentation. It takes a lot of trouble to
prepare this and to come here and it's very much
appreciated.
A
Thank you very much, sir.
(PRESENTER EXCUSED)
THE COMMISSIONER: Can we go right ahead or do we need
a break?
MR. VERTLIEB: I think we should just take a break for
a few minutes, please.
THE COMMISSIONER: All right, five minutes.
(PROCEEDINGS ADJOURNED)
(PROCEEDINGS RECONVENED)
THE COMMISSIONER: I understand that we can commence
once again. Yes, Counsel.
MR. VERTLIEB: Next we have Deputy Chief Ken Allen from
the Greater Vancouver Transportation Authority
Police Service.
DEPUTY CHIEF KEN ALLEN, Law
enforcement presenter.
THE COMMISSIONER:

Welcome, sir.

QUESTIONS BY MR. VERTLIEB:
Q

A

Sir, we have with all of our presenters taken them
through briefly background. You are the Deputy
Chief of the Police Service. Tell us about your
career in policing.
I have been associated to law enforcement for
nearly 41 years. I was 29-and-a-half-year member
of the RCMP, and have worked in the transit

54
Deputy Chief Ken Allen (Law enforcement presenter)
Questions by Mr. Vertlieb
Presentation

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enforcement role since late 1996. My career in
the RCMP spanned mostly general duty enforcement.
I did plainclothes investigations as well. I
spent four years as an instructor in Regina
instructing three-and-a-half of those four years
in Firearms and the Use of Force.
In 1978 to 1982 I was involved with the
Emergency Response Teams in the Province of
British Columbia since 1974 and served on the
National Special Emergency Response Team in Ottawa
for six years in my career.
I retired as a Staff Sergeant out of the
RCMP.
I first joined what was then BC Transit
Security as a Special Provincial Constable in a
Patrol Sergeant Supervisor role. Approximately a
year later I was promoted to the Operations
Manager's position and looked after the entirety
of the operations of the department and the
Special Provincial Constables in that role.
In 2004 when we became a designated policing
unit I was appointed to the position of Deputy
Chief Officer of the Greater Vancouver
Transportation Police Service and have function in
that role since that time.
MR. VERTLIEB: Now, we understand you have a
presentation to make that you would like to embark
on so please feel free.
A
I do.
THE COMMISSIONER: Yes, thank you, sir.
PRESENTATION BY DEPUTY CHIEF KEN ALLEN, GREATER
VANCOUVER TRANSPORTATION AUTHORITY POLICE SERVICE:
A

The GVTAPS takes the issue of Taser use very
seriously, and that's why we're here today.
The GVTAPS is quite a new policing agency.
It's proud and professional, responsible and
accountable organization. We operate by the book.
It's an open book.
We are grateful for the opportunity to speak
to the inquiry, to contribute what we can clarify
on our position.
My presentation today will cover three main
areas. The first will be the history and
background of GVTAPS. Second will be our policy
and the use of Tasers, and how it was developed

55
Deputy Chief Ken Allen (Law enforcement presenter)
Presentation

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and what it contains. And third our response
under the Police Act to the events of the past
month relating to concerns raised in the public
about our Tasers, use of Tasers.
The GVTAPS supports the work of the Braidwood
Inquiry and its review of Taser use policies. We
are happy to contribute to this inquiry on Taser
use policies. We have been advised by the office
of the Police Complaint Commissioner that our
participation and review of policies and processes
is appropriate and can be done without
jeopardizing their investigation into specific
incidents.
We have taken the extra step of responding to
the Braidwood Inquiry's request for the files on
individual incidents and documents. Documentation
has been provided to the Commission Counsel this
morning.
We also respect the role of the Police
Complaint Commissioner and his ongoing
investigation into the individual incidents over
the past ten months where Tasers were used by
GVTAPS officers. We will therefore not jeopardize
the progress of the investigations of the Police
Complaint Commissioner by making premature comment
or appearing to make any prejudicial conclusion
about the individual incidents under
investigation. By doing so we are confident that
we can participate fully in this inquiry process
while protecting the integrity of the Police
Complaint Commission process.
I will just give you the history and
background of GVTAPS. GVTAPS is a designated
policing unit in B.C. The service became fully
operational on December 4th of 2005. Our mandate
is to preserve and maintain the public peace, to
prevent crime and offences against the law, aid in
the administration of justice and enforce the laws
of B.C., primarily directed towards any criminal
activity or breach of public peace that could
affect the safety or security of transit
passengers, employees or property, and conducting
investigations and enforcement operations with
respect to any unlawful activity on or around
transit vehicles or other transit property.
GVTAPS provides policing service to the
entirety of the transit system, primarily

56
Deputy Chief Ken Allen (Law enforcement presenter)
Presentation

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concentrating our efforts to the SkyTrain. We
also have a squad of officers who focus on bus
service.
The governance structure of GVTAPS is unique
in that the Police Board is a blend of senior
police executives and three civilians representing
TransLink and the public. This is different from
other municipal police boards, which are made up
strictly of civilian appointees. As one of its
duties, the Police Board approves all policy for
GVTAPS.
The SkyTrain covers a distance of 51
kilometres and has 39 stations.
In 2007 there were over 295 million passenger
boardings in the transit system, 73 million of
those on SkyTrain. This translates into roughly
220,000 boardings per day on SkyTrain.
The SkyTrain stations are a unique work
environment in that they are strictly concrete and
steel with narrow platforms and restricted
entrances and exits. They have automated trains
travelling through on a guide way that contains
600 volts of electricity. Most of the stations
have multiple levels of stairs or escalators
leading to the platform. This creates challenges
in dealing with police incidents and executing
arrests. The officer not only has to take into
account his own safety and that of the person he
is dealing with, but also that of the travelling
public and other transit employees.
The nature of the work environment is such
that officers most frequently work in areas of
high concentration of passenger movement. This
may impact on choices that they employ in the Use
of Force spectrum in effecting arrests.
Our establishment strength is 156 sworn
officers, approximately half of which have a high
level of policing experience along with 41
civilian staff. GVTAPS officers have the same
authority under the Police Act as other municipal
police officers. This authority includes
enforcement of all laws relating to offences under
the Criminal Code, the Controlled Drugs and
Substances Act, Immigration Act and all provincial
statutes, including issuing violation tickets for
transit-related infractions.
Our officers have met all the same training

57
Deputy Chief Ken Allen (Law enforcement presenter)
Presentation

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standards as every municipal police officer in the
province and qualified through the Police Academy,
which includes certification in Firearms and Use
of Force.
To give the Commission an idea of the scope
of the work we do, in 2007 we opened 43,000 files
and made over 23,300 arrests. This included 666
arrests for outstanding warrants, 92 arrests for
weapons associated to robberies, 143 related to
assaults with weapon, and 619 for drug-related
offences.
The second area I wish to address is the
issue of our policy on Tasers. My submissions
will address two separate areas. The first is the
development of the policy, and the second is the
content of the policy and reporting requirements.
The first development, the policy came into
effect in May of 2007 and it was developed based
on common practices within municipal police
agencies in B.C. This policy was approved by the
Police Board, which as you will recall in our case
is unique in that it includes four senior police
executives.
During this time selected personnel commenced
their Taser training, which included training in
the policy.
Starting in July of 2007, trained officers
were authorized to start carrying Tasers.
Currently 93 police officers are trained and
authorized to carry Tasers and the GVTAPS has 20
Tasers in their inventory.
Since we started using them, Tasers have been
deployed on ten occasions. Starting this year we
track incidents where the Taser is drawn but not
deployed, and so far to date there have been six
occasions when this has occurred.
THE COMMISSIONER: What is the "this"? Six times what
happened?
A
On six occasions this year the Taser was drawn but
not deployed.
Second is the content of the policy. Here,
Mr. Commissioner, I will draw your attention that
you should have two versions of two separate
policies before you. And the policy that I want
to draw to your attention is the Use of Force
policy that on the top in the grey shaded area has
the effective date of March 28th, 2005 and on the

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Deputy Chief Ken Allen (Law enforcement presenter)
Presentation

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extreme right of that, just below, is a Board
directive dated May 12th, 2008.
COMMISSIONER: I'm not sure I have that, but...
VERTLIEB: We have a new one for you. This is
brand new, Mr. Commissioner, you wouldn't have
seen it before.
COMMISSIONER: All right. I have it now, thank
you.
The second policy is the Taser policy and that in
the top area is effective date May 7th, 2007.
Below that is revised April 18th, 2008 with the
Board directive May 12th, 2008. And you will
notice under section 2 of policy there is a yellow
highlighted area highlighting the words "actively
resistant". The word difference in both documents
is the inclusion of those two words.
I don't intend taking you through these
policies in detail, as you have them in front of
you. But there are a few points I would like to
make.
COMMISSIONER: Just so I grasp this, Officer, what
is the date and the yellow, the words "active
resistant", how do they relate?
There was a previous policy that was effective on
May the 7th. This new policy was brought into
effect by way of Police Board directive on May the
12th, 2008.
COMMISSIONER: Oh, I see.
Which included the words that are highlighted in
yellow.
COMMISSIONER: Oh, I see. So that on May the 12th
last the policy was modified to include the words
"active resistant"?
That's correct.
COMMISSIONER: All right.
I would be pleased to answer any additional
questions the Commission may have about these
policies.
The first deals with the language of our
original policy, which allowed for Tasering in
situations where someone is non-complaint. As you
are aware, Mr. Commissioner, last month some
concerns arose about this language and we have
addressed this. The Police Board determined that
the words "non-compliant" should be removed from
the policy. It is our understanding that they did
this because the potential for there to be

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confusion created by the use of this terminology.
The concern was that the term, "non-compliant"
could be construed to mean non-payment of fares by
the public.
At the Police Board's monthly meeting earlier
this week at which I was present, in response to
some concerns raised about a potential void left
in the policy creating a potential officer safety
issue, the Board decided to substitute the words
"actively resistant" for "non-compliant".
The versions of the policy you have, Mr.
Commissioner, which they revised May 12th, 2008
have this most recent language in them.
While I can't speak for the Board, I believe
that they accepted that this void in the language
of the policy did create the potential for an
officer safety issue, particularly in light of the
difficult and unique environment in which we
operate, and that's the reason they decided to
include the words "actively resistant" in the
language of the policy.
The other section of the policy I want to
briefly address is the provisions dealing with
what happens when a Taser is deployed. Section 15
in the Taser policy imposes duties on the
individual police officer which include notifying
the Emergency Health Services, notifying a
supervisor and completing the appropriate reports
which include the Use of Force report.
The policy also imposes duties on a
supervisor attending at the scene where a Taser
has been deployed and those are in section 16. I
will go through those points under section 16:
It is the duty of the patrol supervisor upon
attendance at a Taser deployment the
supervisor will
(1) ensure that the subject is examined by
EHS (Emergency Health Services) as soon as
possible;
(2) if reasonable, photograph any injuries to
the subject, photograph the scene, prepare a
sketch of the scene, including any applicable
measurements;

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(3) take possession of the Taser, expended
cartridges and probes, if applicable, and
place in a temporary exhibit locker unless it
can be immediately turned over to the
Inspector Support Services;
(4) request SkyTrain station closed-circuit
TV tapes or other available tapes, if
applicable;
(5) ensure witnesses are interviewed and
written statements are obtained;
(6) notify the Inspector Support Services the
Taser has been seized and provide the number
op the temporary exhibit locker where it is
stored; and
(7) ensure the member has completed the
required reports and that such reports are
reviewed by the supervisor and then forwarded
for further review in accordance with the Use
of Force Policy.
In addition to what is contained in policy,
it is important to emphasize that in each and
every instance where a Taser is deployed we do a
complete and thorough internal review of the
incident to determine whether there are any
policy, training or disciplinary issues which
arise. I can advise the Commission that each of
these ten instances where Tasers were deployed by
GVTAPS members resulted in an internal review to
ensure consistency with policies and training.
This is separate from the external review which we
asked for and which was ordered by the office of
the Police Complaint Commission.
The final area I wanted to address in this
presentation is our response as an organization to
the media attention paid to the GVTAPS use of
Tasers.
As a result of concerns raised in the public
about our use of Tasers, we immediately took a
number of proactive steps. First we arranged a
meeting with the Office of the Police Complaint
Commissioner and asked that an investigation be
ordered into all instances of Taser use by GVTAPS.

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Deputy Chief Ken Allen (Law enforcement presenter)
Presentation
Questions by Mr. Vertlieb (cont'd)

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Second, we asked that this investigation be
conducted by a police agency external to our
organization, and third we also asked that the
findings of that investigation be assessed by the
Chief of Police of a third agency external to both
GVTAPS and the investigative agency.
Finally, we met with the Police Board and
made immediate changes to our policy on Taser use.
We will continue to monitor the effectiveness of
this policy and make further changes as required.
We have taken advice and acted with great
care to ensure our presentation here today could
be conducted in a manner that both serves the
purpose of this inquiry and preserves the
integrity of the Police Complaint Commissioner
investigation. Thank you.
THE COMMISSIONER: Well, thank you very much. We may
have a few questions also.
QUESTIONS BY MR. VERTLIEB, continuing:
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Officer, how many members are there on your Police
Board?
The Police Board, there are seven Police Board
members.
So four are police and three non-police?
That's correct.
I just want to be clear on the policy because it
seems that it's changed very recently. The policy
that we were originally provided was a policy from
May of 2007. And I just want to read out that
policy and then we can discuss the policy that was
changed in the last couple of weeks or so. So the
policy up until very recently said that:
A Taser may be deployed by a qualified
officer to gain physical control of a noncompliant, suicidal, potentially violent or
violent subject...

A
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Et cetera. Now, that was the old policy.
That's correct.
And the new policy has been changed so that the
words "non-compliant" is taken out and it's now
"active resistance"; is that correct?
That's correct.
But before doing that, in April you took out the

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Deputy Chief Ken Allen (Law enforcement presenter)
Questions by Mr. Vertlieb (cont'd)

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words "non-compliant".
The Police Board directed that the words "noncompliant" be taken out of the policy, yes.
So what happened is the policy for quite a long
time allowed Taser to be used for a non-compliant
person, correct?
That's correct.
And then in April of 2008 the policy was changed
so that you could no longer Taser somebody who was
simply non-compliant.
The terminology or the word "non-compliant" was
taken out, that is correct.
And then on Monday you've changed the policy to
now allow for "active resistance" as a
justification for Taser?
That's correct.
So why would it not have been sufficient to have
Taser use when someone was potentially violent?
Why did you need to add "active resistance"?
I can't speak directly for the Board, although I
was present during the discussions in which this
arose. The Board felt that there was an area that
there may be use for the Taser that was not a
necessarily a potentially violent situation, but
one where there was active resistance, and the
nature of the event called for intervention at
that level.
So let's just discuss the scenario. Say
apparently there are these fare blitzes, there's
something called a fare blitz that takes place?
Yes, that's correct.
And what is a fare blitz?
It's normally conducted within the fare-paid zone
of a station, and passengers that enter into the
fare-paid zone, their fares are all checked.
Those that do not have a fare are either contacted
directly by a police officer or directed by a
police officer, by a SkyTrain attendant who has
been checking the fares in conjunction with the
officers at a fare blitz, and a violation ticket
is written up for not having a fare.
So take the scenario, you're running a fare blitz,
and someone is in the fare-paid zone, follow?
Mm-hmm.
And somebody sees the police during this fare
blitz and turns and runs.
Mm-hmm.

63
Deputy Chief Ken Allen (Law enforcement presenter)
Questions by Mr. Vertlieb (cont'd)

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Would your new policy allow you to deploy Taser as
that person was fleeing?
It would depend on extenuating circumstances
surrounding why the individual was fleeing, what
information the officer has available to him at
that time, what would create the escalation in the
use of force to that level.
Well, I'm just really referring to a scenario that
we've been canvassing. Well, let me put it this
way. The scenario put to you in your previous
policy would Taser have been justified simply for
a person running away from the police during a
fare blitz?
No.
I'm having some trouble with that. Part of the
information we were given by your Authority were
some extracts from some of the events. And we
were told of an event where a subject ran from
officers during a fare blitz, no proof of fare
paid while in a fare-paid zone. Taser deploys as
subject fled. An internal review conducted saying
that was within guidelines. Now, I thought
perhaps that was the old guideline and you would
say that the new guideline would not allow that.
Have I misunderstood?
We fully support the inquiry that's before us here
in the use of Tasers and the policy associated to
that. This ventures into an area that deals with
one of the investigations that is currently being
conducted by the external investigation as ordered
by the office of the Police Complaint
Commissioner, and my comments to any one of these
particular investigations could prejudice that
investigation that is currently underway.
So based on this new policy, if -COMMISSIONER: Let me just intervene for a moment,
sir.
VERTLIEB: Sorry.
COMMISSIONER: Let's just give the example of you
do have someone in that zone who is being checked
and upon it being discovered that he didn't have a
ticket he turned and fled, and you have nothing
more than that. Under your new policy would you
call that "actively resistant"?
Not in itself, no, Mr. Commissioner.
COMMISSIONER: All right. And obviously it's not
suicidal or potentially violent?

64
Deputy Chief Ken Allen (Law enforcement presenter)
Questions by Mr. Vertlieb (cont'd)

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A
That's correct.
THE COMMISSIONER: All right, thank you.
MR. VERTLIEB:
Q
Can you tell us, please, about the data tracking
that your force does for Taser?
A
Yes. We use the provincially mandated police
reporting system of PRIME, and all occurrences are
entered into that information management system.
And we can retrieve all of the information with
respect to Taser use from that source.
Q
When was Taser first introduced?
A
In our department in July of 2007.
Q
And what review or investigation was undertaken by
your force before the introduction?
A
I think I need some clarification on the question
you're asking.
Q
Well, what investigation or review did you conduct
before deciding to go with Taser as a tool?
A
With regard to the use of the Tasers or in
carrying the Tasers?
Q
Yes, in regard to deployment of them in the force.
Did you get any -A
We looked at the policies that other agencies had
created, we looked at the particular environment
that we work in and working within the Use of
Force continuum, our policy was created based on
that.
Q
As to the Taser sign out, how do you do that? How
do you control who has one of the weapons?
A
Each Taser is signed out through the Watch
Commander's office, and the serial number of the
Taser is recorded on sign-out and it's checked
back in when it's brought back into the office.
Q
Are cartridges tracked?
A
I can't accurately speak to whether the cartridges
are tracked individually or not when they're
issued. They have a tracking system within them
when they're fired that does provide for that. If
the Taser is deployed, there's a tracking system
built into the Taser itself which records every
time the Taser is turned on.
Q
We've heard about that. Are the cartridges
tracked in any way against reported use?
A
Yes, they are. And that is part of the
supervisor's role is to attend to the scene and
seize the expended cartridges as exhibits.
Q
But you're not sure if the cartridges are checked

65
Deputy Chief Ken Allen (Law enforcement presenter)
Questions by Mr. Vertlieb (cont'd)

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out when they're taken?
I cannot recall offhand whether or not they are in
fact checked out.
Let's move to training. How many hours is the
training for a police officer with your force?
Pardon me?
How many hours is the training?
For the users it's an eight-hour course, and our
policy directs that they will be re-certified a
minimum every two years.
Every two years.
That's correct.
Is that -That re-certification is a four-hour recertification. The individual re-certifies within
that four hours, they would receive that
certification. If they require further training,
they receive that at that time.
And is it every two years based on 24 months,
or...
24 months, that's correct.
Do you have any policy on multiple deployments of
the Taser?
Again I would ask for clarification on your
question.
Well, we've heard that the shot lasts five
seconds. Is there any policy on multiple
triggers?
No, there is not. That's depending -- there is no
policy on that, that would depend on the
circumstances under which it would be deployed.
Do you train for any circumstances where officers
should avoid using the Taser?
No.
Do you train people in this term "excited
delirium" which we've heard about?
The term is used. We don't do any training,
specific training with respect to excited
delirium.
What are your officers told in training regarding
the potential dangers of Tasering a subject?
the biggest thing is the individual involuntarily
collapsing to the floor, and the surroundings
under which they use the Taser to ensure that
there's no explosive material in the vicinity.
You're now keeping track of the times the Taser is
deholstered, taken from the holster?

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Deputy Chief Ken Allen (Law enforcement presenter)
Questions by Mr. Vertlieb (cont'd)

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Yes, that's correct.
And who reviews that?
That would predominantly be the officer in charge
of the operations in tracking to view which
officers are using it, under written circumstances
of why it was taken from the holster.
Is there any procedure in place for detecting a
use which is not in compliance with policy?
Each deployment is investigated internally, or not
investigated internally but is reviewed internally
to ensure that policy procedures and training have
been adhered to. With respect to taking it out of
the holster, it depends on the circumstances that
would be recorded.
Why did you change to now want that data kept?
It was just another source of information that we
wanted to be able to track, particularly with the
controversy with the use of Tasers we wanted to be
able to track to see how many times they would
have been taken from the holster, not used, and
what's recorded with respect to what occurred when
that occurred, when the Taser was taken from the
holster, whether compliance was met or some other
circumstances took place during that encounter.
Moving on to the subject of downloading from the
Taser, do you have the software to download data
from the Taser?
That's correct.
And is the data downloaded?
Yes, it is.
And how often?
Every time that the Taser is deployed it's
downloaded.
And what happens then?
Again it's a review of that information to
determine whether policy has been met with respect
to the information that's there, whether training
is required, and we download both the internal
information from the Taser with respect to the
duration that it was fired, the number of times it
was fired, and the video and audio-recording from
that Taser.
So is that data compared with reported use?
Yes, it is.
And so are you confident that you are catching any
unreported use of the Taser?
We have not had any incidents where that has been

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Deputy Chief Ken Allen (Law enforcement presenter)
Questions by Mr. Vertlieb (cont'd)

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identified.
THE COMMISSIONER: I wonder if you could help me with
this. I am told that a parallel organization to
yours, the Transit Police Authority in Toronto,
don't find it necessary to have either a firearm
or a Taser on their person. Could you tell me
what type of crime it is that you are anticipating
meeting?
A
That we are anticipating?
THE COMMISSIONER: Yes. What actual crime is it that
you are meeting?
A
We encounter the same criminal element in and
around the SkyTrain and the transit environment
that the jurisdictional police encounter. We have
robberies, we have armed robberies, we have
persons that carry firearms on their person,
persons that have been found on the system with
body armour and fully loaded weapons, reports of
shots fired in and around stations. We attend and
assist jurisdictional police agencies in close
proximity to the stations within a couple of block
area, in dealing with all of the criminal
incivilities that they, too, deal with.
THE COMMISSIONER: Now, I'm wondering where your people
are positioned, on the train, in and about the
platforms?
A
They ride the train, they do mostly it's riding
the train, getting off, making patrols around the
stations, like I say, within approximately a twoblock area of the station to make sure that the
environment around the stations is as safe as we
can possibly provide so that our persons that are
using the transit system can come and go to the
systems in relative safety. There has been many
instance where there has been robberies and
assaults occur on patrons who have left the
SkyTrain or buses, or coming to the SkyTrain or
buses in the surrounding communities in which they
are making their way to that transit system.
THE COMMISSIONER: All right, that's most helpful.
Anything further?
MR. VERTLIEB:
Q
Is it the case that your police authority is the
only transit police authority in Canada to carry
weapons, including Taser?
A
We are the only police agency associated to
transportation in Canada. The Toronto Transit

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Deputy Chief Ken Allen (Law enforcement presenter)
Questions by Mr. Vertlieb (cont'd)

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commission, they are Special Provincial Constables
working under the direction of the Toronto Police
Department, but there is no other armed policing,
fully police recognition agency that works with
transportation systems in Canada.
Q
So your force is the only one in Canada that
carries firearms and Tasers?
A
That's correct.
Q
For transit.
A
For transit. And we are unique in respect to the
jurisdictions that we travel through. Most of the
other transit systems do not have the multiple
jurisdictions that we encounter here in the Lower
Mainland.
MR. VERTLIEB: Thank you very much.
THE COMMISSIONER: Officer, I am very happy that you
were able to come and your presentation is very
much welcomed. Thank you for the time.
A
Thank you, Mr. Commissioner.
(PRESENTER EXCUSED)
THE COMMISSIONER: Now, Counsel, first of all, I
understand that we can't have this room next week,
and accordingly on Tuesday we are now where?
MR. VERTLIEB: We are at the Federal Court, which is
701 West Georgia.
THE COMMISSIONER: Federal Court, 701 West Georgia.
And can you give us an indication, I know it's
very much in flux, but can you say anything about
who will be present on Tuesday?
MR. VERTLIEB: yes. We are expecting to have two
physicians, Dr. Charles Kerr, the cardiologist,
and Dr. Mike Janusz, a heart surgeon, and then
Staff Sergeant Joe Spindor from New West Police
Department in the afternoon, and perhaps somebody
else.
THE COMMISSIONER: Thank you very much. Adjourn, then,
until Tuesday at 10:00.
(PROCEEDINGS ADJOURNED TO MAY 20, 2008 AT
10:00 A.M.)