Ketamine Injections

A vial of ketamine, which is normally stored in a locked cabinet, in Chicago.

After the medical director for the City of Aurora’s fire department proposed implementing the use of a new sedative in EMS protocols, two councilmembers sought to block the plan by suggesting a moratorium on any new sedatives for the next three years.

The move came amid a contentious debate about the use of chemical restrains in the continuing wake of Elijah McClain’s death.

Councilmembers Curtis Gardner and Danielle Jurinsky, the sponsors of the moratorium resolution discussed at a Monday study session, opposed introducing a new sedative in the near future. The councilmembers said it is inappropriate to be asking first responders to work with a new sedative while three police officers and two EMS personnel are facing charges for their role in McClain’s death.

“I cannot believe that this is a conversation. I cannot believe that this hasn’t been stopped,” Jurinsky said.

Debate about the resolution evolved Monday night to include other potential approaches, such as a ban on chemical restraints specifically – rather than sedatives in general – or requiring paramedics to consult a licensed physician before administering the drug to a patient in the field.

The issue will come back for formal council review at the regular council meeting on Sept. 26. It’s unclear what the specific details to the resolution will be after Monday’s debate.

McClain died in 2019 after a violent arrest, in which he was placed in a carotid hold and injected with ketamine. Following a 2021 grand jury indictment, two Aurora Fire Rescue paramedics and three Aurora police officers faced numerous charges, including manslaughter, homicide and assault.

The case put a stop to Aurora’s use of ketamine. Since then, the city’s fire department has relied on Midazolam.

Last month, Aurora Medical Director Eric Hill discussed adding Droperidol to Aurora Fire Rescue’s sedative protocols during a committee meeting.

City officials have discussed the plan for months but its official recommendation came as a surprise to some fire department and council officials, Jurinsky said.

Jurinsky said the McClain case left firefighters and paramedics “terrified” of the chance they could face criminal charges for using a sedative on a patient who then has a negative reaction to the drug. Jurisnky was also upset that the recommendation came amid opposition from the Local 1290 Aurora Fire Union.

Union representatives spoke at the study session in support of a moratorium on new sedatives.

Gardner said he is generally opposed to the use of sedatives because he believes they raise civil liberty issues. But he is also skeptical of new drug recommendations because of the city’s history with ketamine.

“We were also told that ketamine is a safe drug,” Gardner said.

Both expressed a desire to shield first responders by placing a moratorium on new sedatives, saying they should not live with the fear of lawsuits or prison time.

The councilmembers said that Versed is sufficient for now. EMS personnel are comfortable with Versed, a brand name for Midazolam, because it’s been used in the city for years and they are familiar with using it, Jurinsky said.

Hill said Droperidol is a completely different drug from ketamine and does not affect the respiratory system in the way ketamine does.

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He said sedatives are appropriate in instances where a patient is combative or aggressive but requires medical attention.

Each sedative comes with its own set of risks or side effects and can affect different patient groups differently, he said. Versed, for example, is riskier in patients who are intoxicated from alcohol because it affects their respiratory response. It’s one reason having another option could help paramedics provide patients the best care possible, he said.

“If the patient has a better outcome, that is safer for the paramedic,” Hill said.

Councilmember Dustin Zvonek said a moratorium on new sedatives would not address concerns about liabilities and lawsuits.

“I think just banning it, it’s great theater,” he said.

He suggested a policy that would require paramedics to call a licensed physician before administering a sedative, which could provide them another layer of protection because they are following a doctor’s recommendation.

Councilmember Steve Sundberg asked if councilmembers would consider a total ban on sedatives, something Gardner said he would get behind.

The council also discussed the possibility of prohibiting specifically chemical restraints, as opposed to a total ban on sedatives.

Councilmember Juan Marcano pointed out that McClain’s death occurred “during the scope and course of law enforcement activity.” Hill said he would not comment on a specific case but said chemical sedatives should never be used “for a law enforcement purpose” and only to treat a medical patient.

When pressed by councilmembers, Hill also said he does not believe the Aurora paramedics should be on trial for their role in McClain’s death.

McClain’s mother, Sheneen McClain, told The Denver Gazette that she followed local debates about sedatives for a while but eventually stopped.

“It was just a little depressing because they are still not considering alternatives to chemical restraints,” she said.

Considering any new chemical restraints “shows a lack of humanity,” she said, adding she supports a total ban of their use. McClain said it is inhumane to give a patient a sedative without knowing their medical history or how they will react to the drug.

She is also frustrated that some city leaders do not think the paramedics in her son’s case should face trial.

“The paramedics are accomplices to my son’s murder,” McClain said. “They are accessories to a crime. They should be charged.”

McClain said “it’s appalling” that, three years later, debates continue playing out about his death. The paramedics who injected him with ketamine did not think about their own well-being or her son’s, she said, and followed police instructions instead of their own training.

“Anyone who supports my son’s murderers and their accomplices,” McClain said, “are also a part of the problem.”