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Brady, Richard (MPD)

From: Anzallo, Michael (MPD)


Sent: Wednesday, February 17, 2010 5:10 PM
To: Lojacono, Christopher (MPD); Dixon, George (MPD); Golway, Samuel (MPD); Brady, Richard
(MPD)
Subject: FW: Theory about the Misprogramming of the Instrument
Attachments: INTOX MIS PROG EXPLANATION.doc

Assistant Chief Michael Anzallo


Metropolitan Police Department
Internal Affairs Bureau

From: Burke, Patrick (MPO)


Sent: Wednesday, February 17, 2010 12:29 PM
To: Anzallo, Michael (MPO)
Subject: FW:Theory about the Misprogramming of the Instrument

Mike, this is Paegle's theory on how King might have erred in misprogramming.

rI~ eki4 PaPrid /I. &w


Washington, DC Metropolitan Police Department
Homeland Security Bureau
300 IN Ave. NW #5050
Washington DC. 20001
E-mail: Patrick.Burke@dc.gov
Cell: 202437-7984
Office: 202 727-2049
Fax: 202 727-3896
Commitment to Excellence!

From: Paegle, I1mar (MPD)


Sent: Wednesday, February 17, 2010 8:37 AM
To: Burke, Patrick (MPO)
Subject: Theory about the Mlsprogramming of the Instrument

Pat:

Thanks for meeting with Alex and me yesterday. I appreciated the encouragement.

I've prepared what I feel is a plausible explanation for why the Intoxilyzers were not programmed correctly. The
error was not intentional, in my opinion, but the absence of safeguards in the calibration procedure allowed the
mistake to go undetected for some time.

3119/2010
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I don't have a scanner available, so I'll send down a copy of the relevant page in the service manual by inter-office
mail and will include a copy of a solution's certificate of analysis as well.

If you need something in the General Orders about testing instruments for accuracy in order to comply with the
DC Code, the directive ought to be general in nature. You might try something like this:

"Officers and civilian technicians responsible for maintaining and reparing evidential breath testing equipment
must verify that an instrument is functioning properly after any work on the device, to include calibration, has been
completed. Such checks shall include a number of accuracy tests appropriate to the work performed. A record of
these tests must be maintained for the period required by law and departmental guidelines."

IImar

3119/2010
) )

There might be a plausible explanation lor Ofc. King's misprogramming of the


Intoxilyzer instruments. The service manual for the SOOOENprovides step-by-step
instructions for the calibration routine. Step S of the Calibration section instructs the
technician to enter the values of simulator solutions to be used in the process in
milligrams (g/21OL x 1000) via the keyboard, A .02 solution would be entered as 20, a
.08 solution as ~O, a .20 solution as 200, and so on. This is the procedure Ofc. King had
been following until October 2008.

In parentheses following the instruction about solution value entry, however, there is a
note in bold face type that informs the technician that "[all! solution values entered at this
time will be actual gas chromatography values recorded on the alcohol standards analysis
data sheets ... " This note is a reminder to factory technicians not to use the expected
BrAC values tor each of the solutions the company prepares but to use the BrAe values
tor the actual proportions of the individual mixtures. Should a solution have a slightly
lower or slightly higher concentration of alcohol than the formula requires for a particular
reference value, the company's gas chromatograph would make the correction
automatically. For example, to produce a value of. 100 in any breath testing instrument,
500 ml of solution has to contain 605 mg of ethanol. A few milligrams more or less will
not make a difference in the result, but a change in the concentration of alcohol in the
mixture outside the permissible range would alter the expected result by a predictable
factor. Let us now say for illustration that a particular batch of solution contained less
alcohol than expected tor a .10 solution, which would require an entry of 100 in the
calibration routine. The company's gas chromatograph might tell the technician to enter
98 instead because the expected BrAC for that mixture in a breath testing instrument
would actually be .098 g/Z! OL.

Since CMI's gas chromatograph is used only to prepare alcohol reference solutions tor
instrument calibration, it is programmed to report not the actual weight of alcohol in the
fluid but to report the expected BrAe values tor the mixtures. The gas chromatographs
in virtually all other laboratories, including those preparing alcohol reference solutions
for commercial purposes, report the actual weight of alcohol in a particular volume of the
liquid when checking the accuracy of a solution mixture. This value is then divided by a
factor of 1.21 to arrive at the expected BrAe value in evidential breath testers. The
certificates accompanying each solution sold commercially provide both the gas
chromatograph value and the expected BrAe value for that concentration. A certificate
from Guth Laboratories, for example, reports a gas chromatograph value of .0605%
(w/vol) tor the solution and states that it "will give a breath alcohol analysis instrument
reading of .050 g/210L +1- 3%."

It may have struck Ofc. King in late 2008 that because of the note, he might have been
entering the incorrect values for the solutions, values which were probably under-
reporting actual BrACs. Had he contacted CMI, a technician would have certainly
informed Ofc. King that company did in fact use the gas chromatograph measurements
for its instrument calibrations. Ofc. King, however, would not have known that CMI's
gas chromatograph results, unlike those of commercial solution manufacturers like Guth
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and ACS, were reported in the BrAes expected for the actual alcohol levels of their
solutions.

Seeking to correct his past mistakes, Ofc. King then began to enter the gas
chromatograph values from the certificates of analysis provided with each simulator
solution MPD purchased and by doing so, he instructed the instruments to over-report
actual breath alcohol concentrations. I Ie also directed the civilian instrument technicians
assigned to the lDSU to follow the new procedure. As a reminder to himself and others,
Ofc. King even labeled the simulators containing the solutions used for calibration
purposes with both the BrAC values and their corresponding gas chromatograph figures.

Had Ofc King been checking the results of his calibrations as a matter of procedure either
before the change in calibration data entry or afterwards. he would have known right
away that something was wrong in the process. The absence of these post-calibration
accuracy tests eliminated an important safeguard against under-reporting or over-
reporting test results. The problem could have also been caught by a sound simulator test
protocol in the field. but this, too, was not in place. In any case, it should have occurred
to Ofc. King that increasing solution values in the calibration routine by 20% or so for
whatever reason would certainly have affected the outcome of subsequent BrAC
measurements.

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