Correspondence With Dr. Deborah Mash of the University of Miami Brain Trust

 Dr. Mash,

    I have studied your research regarding Excited Delirium Syndrome (EDS) as a brain disease and possibly linked to one gene. I commend you and your staff for your commitment to the truth and how it helps remove the negative perceptions associated with in-custody death. As we discussed in late November, I am hoping to assist you in validating your research, as I believe the signs and symptoms of EDS and Porcine Stress Syndrome (PSS) are strikingly similar: easily excitable, hyperthermia, abnormal breathing, skin discoloration, muscle tremors, abnormal vocalization and death in the presence of “rough handling” and stressors. In swine they have isolated one gene, known as a stress gene (officially trademarked as Hal-1843 by University of Toronto Innovations Foundation due to Halothane sensitivity), that has historically been a high frequency finding in non ambulatory and/or DOA swine post transport to slaughter. 

    Due to aggressive identification and eradication practices, the occurrence of this gene is on a decline. It still makes up a major percentage of non ambulatory and DOA swine on arrival at the slaughter facility and was found in roughly 11% of swine producing farms that participated in a 2006 study. Not only is there similarities in how EDS and PSS physiologically manifest as a response to stress, there is also a possible link with Halothane sensitivity. A small percentage of human test subjects presented with hyperthermia after being anesthetized with halothane. Though I was not able to determine any other side effects  that were observed during this particular study, it deserves further research. Halothane anesthesia in stress gene identified swine also present with signs and symptoms of PSS (hence, the naming of that gene).

    I have communicated with the owner of a lab that specializes in identifying the Hal-1843 gene in swine (this person also owns a company that does forensics testing for the FBI and other Law Enforcement agencies). The lab does not store samples, it merely tests and returns the results to the respective client. The owner stated that they can test human samples for this gene, their fee is $500.00. For further information on the Hal-1843 gene, he has referred me to the University of Illinois. While I attempt to learn more about what the Hal-1843 gene looks like and the cellular affects it has on the carrier,  I must defer some of my questions to you;

1. Is it possible that the stress gene in humans and swine interferes or is triggered by dopamine and excess epi and causes the massive breakdown at the cellular level?

2. With this line of reasoning, could CNS stimulants be simply facilitating an “animal” response in humans, i.e.; super strength, animal noises, reaction to reflections…?

3. Could this same gene impact the uptake and use of selenium and vitamin D which help protect cell wall integrity? 

4. Has there been any finding of accelerated rigor in subjects dying  from EDS? This has been one of the observations of death in PSS.

 

    I believe there is a high probability of a match of the gene you have isolated in humans and the Hal-1483 gene in swine. If there is not a match, there is still a wealth of information on PSS that can substantiate your findings and help develop policy that will be more successful in the field management of individuals presenting with agitated and/or combative behavior. The irony is that swine have also been used in an attempt to discredit Taser and the agencies and officers that deploy them on out of control suspects. I would be honored to be part of your research team. Please let me know if you would like me to continue this “leg work” and arrange for testing of any samples you have at the University.

Sincerely,

Michael W. Weaver

Team Tactics For The Combative Patient 

Alternative Transport For Federal and State DSHS Dependents

 Proposal for the alternative transport for ambulatory non emergent patients by local EMS and Fire Administrations

   I propose an alternative transport of a specific population of Federal and State DSHS dependents. I have communicated (phone and email) with representatives of Washington State DSHS and Local Para Transit and both were receptive to this concept. Municipal Para Transit fulfills a critical role as they will have to be available and willing to respond to the location of Fire/EMS crews. Once on scene, they will provide transport to non-emergent patients that cannot provide their own transportation or individuals that have mobility issues and require the assistance provided by ADA equipped vehicles (wheelchair access). For transport costs to be reimbursed by DSHS, patients must be delivered to a 24 hour urgent care clinic. To be considered for alternate transport, patients can be screened that meet certain criteria after initial Fire/EMS evaluation.

Two that stand out are;

1. Individuals that are ambulatory and do not have a need to be seen at the Emergency Room (prescription refill, cold symptoms, bandage removal etc.).

2. Abusers of the 911 system that are seen multiple times a week without a diagnosis of illness (typically a mental or behavioral health issue). There will be others in the system that qualify for alternate transport and this will be a huge cost savings to DSHS. The representatives of Washington State DSHS have stated that there is currently a program that is funded for transport of DSHS dependent families to Seattle Children’s hospital. The program pays a transport company $35.00 each way and the representative said that would work for my proposal as well. Also, it was discussed that whichever Fire/EMS agency that participates in this program will receive a “kickback” on a portion of the savings realized by the alternative transport and the 24 hour urgent care clinic vs. the private ambulance and ER visit. I am unsure of what could be agreed upon but the individual I discussed this possibility with seemed unaffected by the suggestion.

                Currently, the hold-up is finding an agency that fits the demographics to participate in the pilot program and meeting the transportation needs of enough individuals to make this cost effective; At least ten individuals under the management of DSHS a day that fit the parameters for alternative transport. My best guess is an agency that uses private ambulance for at least twenty BLS transports a day and has a high client ratio of DSHS dependents. This would possibly provide the needed number of transports via Para Transit and be an income of at least $700.00 a day. The municipality already has the expense of the Para Transit bus and Fire/EMS is already providing evaluation and arranging transport to this target group