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In Wake Of Elijah McClain's Death, A Bill Would Ban Sedations In Police Confrontations

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Rep. Leslie Herod is one of two Democratic state lawmakers who introduced a bill this week to prevent paramedics from using ketamine and similar drugs to “subdue, sedate, or chemically incapacitate” people during encounters with law enforcement.

Even though Elijah McClain was in handcuffs the night Aurora police confronted him in 2019, a paramedic sedated him with ketamine, saying he showed signs of a syndrome called excited delirium. Some emergency doctors consider it a rare syndrome where a person is so out of control that they’re a threat to themselves and others.

But critics and McClain’s family say the 23-year-old Black man didn’t have excited delirium. They point to police body cameras and say McClain was trying to be heard by officers and medics. They say he wasn’t out of control. He was struggling for his life. Not long after being sedated, McClain went into cardiac arrest. He later died.

The incident has led two Democratic state lawmakers -- Reps. Leslie Herod and Yadira Caraveo, a pediatrician -- to introduce a bill this week to ban sedations in situations like the one that McClain was in.

“What happened to Elijah McClain never should have happened,” Herod told KUNC. “There were multiple things that happened in his case that should never happen again.”

The bill would prevent paramedics from using ketamine, a powerful anesthetic, and similar drugs to “subdue, sedate, or chemically incapacitate” people, including those simply deemed suspicious, like McClain was when police stopped him, as well as those suspected of crimes.

“Excited delirium will no longer be a reasonable rationale to use what we're calling as chemical restraints,” Herod said. “If these types of drugs are used in the field in a non-hospital setting, (medics) must have the ability to accurately get someone's weight and check their ongoing vitals, which we saw multiple times, did not happen in instances in Colorado where ketamine was used at the direction of law enforcement.”

An independent report for city officials found that Aurora Fire Rescue appeared to sedate McClain without properly diagnosing him.

“Aurora Fire appears to have accepted the officers’ impression that Mr. McClain had excited delirium without corroborating that impression through meaningful observation or diagnostic examination of Mr. McClain.” the Feb. 22 report stated. “Mr. McClain’s behavior in the presence of (Emergency Medical Services) should have raised questions for EMS personnel as to whether excited delirium was the appropriate diagnosis.”

The report also noted that McClain received a much higher dose of ketamine than guidelines recommend, an amount based on a “grossly inaccurate” estimation of his size.

“Higher doses can carry a higher risk of sedation complications, for which this team was not clearly prepared,” the report stated.

Investigations by KUNC and in collaboration with Reveal from the Center for Investigative Reporting highlighted two other cases of men in Arapahoe County and Lakewood who were sedated by paramedics for excited delirium although they were already in handcuffs. Both men, pointing to videos in their cases, said they were not experiencing excited delirium when they were sedated. Both have filed lawsuits as has McClain’s family.

Around the state, our investigations found that medics sedated people 902 times in two and a half years for the syndrome. That’s a rate about 15 times higher than one expert -- a retired Ohio emergency doctor who helped define excited delirium -- told us he would expect to see. In about 17% of those 902 sedations, people developed complications before they arrived at the hospital, according to data provided by the Colorado Department of Public Health and Environment.

Under the bill, paramedics would only be able to use ketamine and other drugs that can sedate people in “a justifiable emergency,” for instance life-or-death situations, and only if they can assure a person’s vital signs can be monitored.

The bill also seeks to ban police from influencing the actions of paramedics, including ordering them or convincing them to sedate people. It also requires that officers and paramedics intervene and prevent sedations that are not emergencies with proper support and to report bad actors to higher-ups.

Doctors disagree on whether excited delirium is a valid medical condition. Anesthesiologists and psychiatrists have raised concerns about the safety and rights of people sedated by paramedics and are especially wary because of the likelihood of police involvement in response to 911 calls.

Yet emergency doctors across the country, including about two dozen in Colorado, have defended ketamine's use in such cases, calling it an intervention that can save lives.

The bill also calls for changes to the little-known group in Colorado that approves waivers that allow paramedics to sedate people -- the Emergency Medical Practice Advisory Council, which is made up of emergency doctors and emergency technicians. Last year, members of the council faced a backlash as they renewed waivers amid criticisms of the actions of paramedics and police and calls for a ban.

The bill would add experts to the council, including an anesthesiologist, a registered nurse, a clinical pharmacist and a clinical psychiatrist, among others.

It additionally would require the advisory council to submit a report to lawmakers “any time” it recommends changes to the system that allows paramedics to administer drugs to people outside of a hospital, including those in confrontations with police.

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