The Taser is thought to be a “less than lethal” alternative to a firearm during aggressive police encounters. But in a new tally, Reuters has counted 1,005 incidents in the U.S. in which people died after police stunned them with the electrical weapons, most since the early 2000s. The Taser was ruled to be a cause or contributing factor in 153 of those deaths—far more than the 24 cases the company has counted.

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According to court records, police reports, and news stories from 1983, as well as reports by other organizations, Reuters found that Nine in 10 of those who died were unarmed and one in four suffered from mental illness or neurological disorders, according to Reuters.

In nine of every 10 incidents reviewed, the deceased was unarmed.

More than 100 of the fatal encounters began with a 911 call for help during a medical emergency.

More than 400 incidents included court documents that had detailed accounts of the incidents, and a fourth of those showed that Tasers were the only form of police force.

In 193 out of a total of 442 wrongful death cases filed after the deaths, cities and their insurers paid a total of $172 million, but due to confidentiality, the actual value of awards in legal settlements is certainly higher than $172 million. Tasers save lives, say police officials and Axon Enterprise, the company that makes them, citing independent studies showing that when deployed correctly—according to “guidelines” Axon offers to police—Tasers reduce injuries among both officers and the people they subdue. Steve Tuttle, the company’s vice president for communications, said they are “the safest force option available to law enforcement.” But amid widespread concern about police use of force, there is no authoritative data about fatalities involving Tasers or any weapon used by police. The Taser is one of the most widely used: More than 90% of U.S. police agencies use them, and they have been deployed more than 3 million times in the field, says Axon. The company says that only 24 people have ever died from Tasers—18 from fatal injuries in falls caused by a Taser strike, and six from fires sparked by the weapon’s electricity. Not a single person, the manufacturer says, has died from the direct effects of the Taser’s powerful shock to the heart or body. Axon called the Reuters report misleading because most of the deaths also involved other use-of-force and because the autopsies had not been peer-reviewed, even though courts don’t require that standard. Read more: See a map by Reuters of fatal police encounters that involved Tasers. The probability of dying from a Taser in a police encounter may be impossible to calculate, researchers say, given a lack of official data on their use, the fact that deaths often have more than one cause, and other complexities. Partly due to ethical constraints, little scientific research exists on how Tasers affect people in mental health crises, people under the influence of drugs, those with heart defects, and those who may be pregnant.

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Axon also keeps a record of deadly incidents involving Tasers, but the company doesn’t share that data. After learning of the Reuters investigation, Axon sent a memo to law enforcement groups summarizing some of the key points of the Reuters report, describing them as “not new” and promising to provide “key resources” to repudiate its findings. A History Of Lawsuits As its stun guns took off in the early 2000s, the company also began to face dozens of lawsuits over injuries and deaths. It prevailed in most of its legal cases, but in 2009 it revised its safety warnings to say that exposure of the electrical weapon to a person’s chest risked causing cardiac arrest. In April the company changed its name from Taser International to reflect, it said, a new focus on body cameras and digital evidence. Board member Hadi Partovi, who was also an early advisor and investor in companies like Facebook and Dropbox, told Fast Company that he’s been pushing for the shift in focus since he joined in 2010. “As soon as the company embarked on this new business, I remember having the conversation that this is a much larger opportunity, and if we succeed at it, the name of the company is going to need to be reinvented—the entire business is going to reinvent the company.” Stemming what it has called false accusations about its products and defending the company and its police customers was one of the reasons Taser began to focus on video evidence to begin with. When the company launched Evidence.com in 2009, co-founder and then-chairman Tom Smith said that police video could slice Taser’s own legal costs in half. While its body cameras are thought to be the most widely used among U.S. police—and as it builds up its expertise in software—most of its business still comes from Taser weapons. It’s Up To Police To Decide How They’re Used, Says Axon In a quarter of the 1,005 fatalities examined by Reuters, a quarter involved people suffering from mental illness. Amid cuts in government-funded mental health services, police encounters with those people have become more common: 1 in every 100 police calls involves a person with a mental health disorder, according to research by the American Psychiatric Association. Police experts worry that Tasers are used too often by officers when handling those encounters.

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“Cops have been turned into mental health workers on the street,” Ken Wallentine, former chief of law enforcement for the Utah Attorney General, who advises police departments on use of force, told Reuters. “I fear that some police training and some police practices have allowed the crowding out of persuasion,” he said, “and the Taser has become the default tool.” Officially, Axon warns police against using the weapons on people who exhibit “extreme agitation” and “bizarre behavior.” More recently, the company has warned police against using Tasers on someone “who is actually or perceived to be mentally ill,” but that specific recommendation is not included in a list of warnings it gives to police departments, which have full discretion in designing polices for the weapon’s use. Related: How Will We Police The Police? The company’s warnings do not prohibit Taser use on people suffering from mental illness. “It doesn’t say, ‘You shall not use this on someone that may be emotionally disturbed,'” Tuttle told Reuters. The news agency called its report the most thorough accounting to date on Taser use, relying on court records, police reports, and news stories from 1983, as well as reports by other organizations, including Amnesty International. The Reuters report used stricter criteria to determine which cases to count, but it nevertheless is still 44% larger than the 700 reported by Amnesty at the end of 2016. Updated to include Partovi quote and background on lawsuits and incidents involving those suffering from mental illness.