Key findings in forensic pathology assessment of deaths following conducted energy weapon exposure - an overview.

Conducted Energy Devices (CEDs) or Conducted Energy Weapons (CEWs) are devices supplied to police and military forces worldwide, developed as a less-lethal option to disarm and immobilize individuals in dangerous situations. Their use in countries where they have been extensively adopted has reduced mortality during arrests by two-thirds and emergency medical interventions related to police actions by 80 %. Although adverse effects and complications from CEW application are very rare considering their widespread use, ocular, cranioencephalic, cutaneous, and pulmonary injuries have been reported. Fatal cases mainly involved traumatic brain injury and severe burns caused by the ignition of explosive substances. While negative effects on cardiac electrical activity appear theoretically possible, they can only be substantiated by following specific investigative steps. A literature review conducted between 2010 and 2025 highlights the key aspects for a forensic assessment. It discusses the critical findings on which forensic experts should focus to ensure comprehensive collection of all evidence necessary for reconstructing the mechanism of death. Circumstantial data and injury dynamics would benefit from the use of police body cameras as well as electrocardiographic tracings from Automated External Defibrillators (AEDs) available to law enforcement. Medical personnel should carefully document the location and penetration depth of the probes, especially in very thin individuals, and when penetration occurs between intercostal spaces or near the pericardium. Furthermore, autopsy, histological, toxicological, and genetic investigations should be undertaken to exclude other pathologies that may account for sudden death. In the forensic field, it may be useful to shed more light on CEW-related fatalities and cases of sudden death in young individuals. Although the latter may involve anatomically slender subjects, they may also present undiagnosed genetic or psychiatric conditions or have used novel psychoactive substances not yet identified.