Forced injection of ketamine may have stopped heart
AURORA, Colorado––Mourners and protesters, including world-class violinists Ashanti Floyd and Lee England Jr., who flew in from New York City and Atlanta for the occasion, on June 27, 2020 played a variety of bowed instruments at City Center Park in Aurora, Colorado, in memory of Elijah McClain, 23.
McClain, a black vegetarian, animal lover, and massage therapist, was pronounced brain-dead on August 30, 2019, six days after being detained by three white police officers, handcuffed, put in a chokehold, and forcibly injected with ketamine.
A drug long used for many purposes, ketamine is probably best known within the animal care community as a veterinary sedative commonly used in doing spay/neuter surgery.
Reported the Aurora Sentinel, “A large and long Aurora protest against the death of Elijah McClain went from peaceful to disruptive to disorderly Saturday when police deployed tear gas against rowdy protesters they said were throwing rocks and bottles at cops. The scene was surreal and chaotic as musicians wandered among the tense scene of protesters and riot-gear-clad police, string music wafting with the sounds of havoc.
“As the protest devolved into mayhem,” the Sentinel account continued, “a dozen or so violinists and string musicians [continued to play] in honor of McClain, who had played his violin to shelter cats.
“Police demanded people disperse,” the Sentinel added, “but then allowed them to reconvene in an adjacent area for the violin vigil. More than 1,000 people remained and police apparently backed off their demands to end the protest.
Keeping the spotlight on shelter volunteer
The mourners and protesters participating in the violin vigil, hundreds of whom marched to the event from neighboring Denver, sought––successfully––to keep the spotlight on McClain.
Aurora pit bull advocates, almost all of them white, hoped to use the occasion to rally support for an ongoing campaign against a 1989 ban on keeping pit bulls within the city. The ban was affirmed in 2014 by 64% of the voters in a municipal election, but a public hearing on a repeal proposal was held on June 18, 2020. Despite the ban, pit bulls remain the breed most often involved in local biting incidents, according to Aurora animal control data, and the breed second most often impounded or owner-surrendered to the city shelter.
A self-taught violinist and guitar player, McClain, according to the Aurora Sentinel, often spent his lunch breaks performing for the cats and dogs at local animal shelters in hopes the music would help to calm them.
“Wouldn’t set a mouse trap”
“I don’t even think he would have set a mouse trap if there was a rodent problem,” friend Eric Behrens told the Sentinel.
McClain’s last words, like those of Minneapolis police violence victim George Floyd, who was choked to death on May 25, 2020, were captured on videotape of the incident.
Never accused or even suspected of having committed any crime, McClain was stopped simply for “suspicious behavior,” specifically wearing a ski mask on a warm evening because he suffered from anemia, which interfered with his ability to regulate his body temperature.
“I can’t breathe. I have my I.D. right here. My name is Elijah McClain,” he tried to explain to the police. “That’s my house. I was just going home. I’m an introvert. I’m just different, that’s all. I’m so sorry,” McClain pleaded. “I have no gun. I don’t do that stuff. I don’t do any fighting. Why are you attacking me?
“I’m a vegetarian. But I don’t judge people.”
“I don’t even kill flies,” McClain continued, to no avail. “I don’t eat meat. I’m a vegetarian. But I don’t judge people. And I respect all life. Forgive me. All I was trying to do was become better. I will do it. I will do anything. Sacrifice my identity. I’ll do it. You all are phenomenal. You are beautiful. And I love you. Try to forgive me … I just can’t breathe correctly.”
McClain’s death attracted only local attention, rallied by family and friends, until after the George Floyd case drew national notice of many similar deaths of black men and women at the hands of law enforcement personnel who allegedly overstepped their authority.
Eventually more than 3.5 million people signed online petitions asking Colorado governor Jared Polis to re-examine the case, which on November 22, 2019 had been closed without charges.
Polis on June 25, 2020 assigned Colorado attorney general Phil Weiser to investigate McClain’s death as a special prosecutor, to press criminal charges against the police officers involved “if the facts support prosecution,” Polis told media.
“Administered live-saving measures”?!!!
Aurora police officers Nathan Woodyard, Jason Rosenblatt, and Randy Roedema testified that McClain, who was listening to music as he walked, at about 10:30 p.m. on the night in question, ignored repeated requests from them to stop, and was carrying a plastic bag.
The bag, as it happened, contained a bottle of iced tea that McClain had just picked up at a corner store half a block away for his brother.
Officer Randy Roedema claimed McClain reached for one officer’s gun. All three officers then took McClain down to the ground, according to the police report. One officer put McClain in a carotid hold, meaning pressure is, applied to the side of a person’s neck to temporarily cut off blood flow to the brain.
“Due to the level of physical force applied while restraining the subject and his agitated mental state,” officers then called Aurora First Responders, who “administered life-saving measures,” according to media accounts based on the police report.
Police body cameras allegedly fell off
“Paramedics injected McClain with what they said was a ‘therapeutic’ amount of ketamine to sedate him, while officers held him down. McClain went into cardiac arrest on the way to the hospital,” summarized Claire Lampen of The Cut.
“One of the officers can also be heard threatening to set his dog on McClain if he “keep[s] messing around,” Lampen wrote. The officer claimed the 140-pound McClain “exhibited an extreme show of strength when officers tried to pin back his arms.
“Very little of the officers’ protocol can be seen, however,” Lampen added, “because all of their body cams allegedly fell off during the arrest.”
Officers Woodyard, Rosenblatt, and Roedema were placed on temporary administrative leave after McClain died, but were returned to normal duties after district attorney Dave Young informed Aurora police chief Nick Metz in writing that, “Based on the investigation presented and the applicable Colorado law, there is no reasonable likelihood of success of proving any state crimes beyond a reasonable doubt at trial. Therefore, no state criminal charges will be filed as a result of this incident.”
Rising use of ketamine by police
The use of ketamine to sedate McClain came against a backdrop of rapidly increasing use of the drug by first responders, both in Colorado and elsewhere in the U.S., even as ketamine has come under increasing restrictions abroad, including for veterinary use, because it is easily misused.
“Ninety fire departments and emergency medical service agencies across Colorado — including those in Aurora, Denver and Colorado Springs — have waivers from the Colorado Department of Public Health and Environment to use ketamine to treat excited delirium, according to data from the department,” reported Elise Schmelzer of the Denver Post on October 14, 2019.
“Law enforcement and medical professionals for years have struggled to safely handle those experiencing excited delirium — a sometimes fatal physical condition,” Schmelzer explained, that makes someone aggressive, unreasonable and seemingly impervious to pain.
“Excited delirium” is dubious diagnosis
But whether “excited delirium” is actually a medical condition distinct from the fight-or-flight response of a terrified person and/or from the effects of alcohol and drug abuse is in itself in debate.
The American College of Emergency Physicians has recognized “excited delirium” as a medical condition since 2009, despite admitting the difficulty of defining it.
Defenders of the use of the diagnosis “excited delirium,” often cited as a cause of deaths occurring in police custody, argue that the term has been medically described for more than 170 years.
Specifically, “excited delirium” is said to have been scientifically described since October 1849, when Luther Bell, a cofounder of the Association of Medical Superintendents of American Institutions for the Insane, dubbed it “Bell’s mania” in an article for the American Journal of Insanity.
Bell, however, specifically associated “excited delirium” with both delirium tremens, an extreme outcome of alcohol abuse, and several conditions which produce brain inflammation and high fever.
The American Psychiatric Association and World Health Organization do not recognize “excited delirium” as a distinct clinical condition.
“Use of ketamine should be approached with caution”
According to Colorado State Health Department guidelines, “Ketamine may be used for management of patients exhibiting such severe agitation that they are placing themselves and/or their providers in imminent danger. However, ketamine may be associated with high in-hospital intubation and ICU admission rates; therefore the use of ketamine should be approached with caution. Ketamine should not be used for patients who can be managed safely with traditional therapies.”
Continued Schmelzer, “Aurora Fire Rescue paramedics can use ketamine in the field to treat extremely agitated people, but Mari Newman, the attorney representing McClain’s family, said the 23-year-old was lying handcuffed and complacent on the ground when he was injected.
“Aurora Fire Rescue protocol for agitated and combative patients shows that ketamine only can be used if the patient is showing signs of excited delirium such as paranoia, hyper-aggression, hallucination, disorientation and overheating, according to the agency’s policies and procedures handbook obtained by the Denver Post, Schmelzer summarized.
“Agitation should be managed with conversation”
“Between August 2017 and July 2018, 427 patients in Colorado received ketamine for agitation, according to state data. Of those, about 3% had to be intubated before reaching the hospital because they struggled to breathe, and about 20% of all patients were intubated in the hospital,” Schmelzer wrote.
Therefore, Schmelzer explained, “The [Colorado state] guidelines state that paramedics should only intervene with ketamine if the person’s agitation is extreme and seems to stem from medical or psychological reasons. Otherwise, agitation should be managed with conversation or traditional medications such as benzodiazepines and anti-psychotics.”
Ketamine not internationally regulated
The World Health Organization Expert Committee on Drug Dependence recommended at the March 2016 meeting of the United Nations Single Commission on Narcotic Drugs that ketamine not be internationally regulated.
This followed the fourth World Health Organization review of ketamine use and abuse in ten years.
The WHO expert committee “concluded that ketamine abuse does not pose a global public health threat, while controlling it could limit access to the only anesthetic and pain killer available in large areas of the developing world.”
Pending proposals to more strictly regulate veterinary access to ketamine in 2015 prompted the American Veterinary Medical Association to repeatedly appeal to membership to submit letters of comment to the U.S. Food & Drug Administration supporting AVMA efforts to keep ketamine available.
“Date rape drug”
But ketamine possession was already banned or severely restricted by many and perhaps the majority of Convention on Psychotropic Substances member nations.
Most influentially, Russia banned ketamine entirely for five years, beginning in 1998, after it became notorious through illegal use as a date rape drug, and in connection with human trafficking, especially by the sex trade.
Similar legislation and regulations soon followed throughout eastern Europe.
First synthesized in 1962, ketamine received U.S. Food & Drug Administration approval as an anesthetic in 1970, and came into widespread use by U.S. military medical units to treat wounded soldiers in the field during the latter part of the Vietnam War.
Misuse of ketamine as a date rape drug was documented in the U.S. disco club scene soon afterward. Concern about the availability of ketamine gradually increased during the next two decades.
U.S. Controlled Substance Act
In July 2002 former Hornocker Wildlife Institute researcher Patrick Ryan, 51, was convicted on 36 criminal charges including kidnapping, aggravated battery with a deadly weapon, and 20 counts of rape.
Ryan had kept research assistant Jennifer Cashman heavily drugged for seven months in 1996-1997 by slipping ketamine and another animal tranquilizer, telazol, into her food at a bear research station in the Gila Wilderness of New Mexico.
Her subsequent civil suits against Ryan, Hornocker officials, the New Mexico Department of Game and Fish, and the drug makers were settled out of court. The terms were not disclosed.
While the widely publicized case was pending, the U.S. Food & Drug Administration in August 1999 placed ketamine on Schedule III of the U.S. Controlled Substance Act.
Joel Klutch says
Some obvious questions include 1) how much ketamine was administered, 2) in what form, and 3) over what period?
I realize you might not have the answers, but these are important factors if dealing with a powerful hallucinogenic like ketamine, and the info should be made readily available by the police department and/or those who administered the drug.
Merritt Clifton says
According to Bonnie Kristian of The Week, “The ketamine dose McClain received is not stated in the autopsy report, which notes instead that his blood ketamine concentration was at a normal therapeutic level, well below levels seen in ketamine overdose deaths. ‘Of note, in terms of a fatality,’ the report says, ‘the dosage administered or ingested is not as important as the resultant concentration of the drug in the blood.’ However, one comment heard in the body camera footage suggests the dose may have been 500 milligrams. That approaches the dose of 700 milligrams that would produce up to 25 minutes of full surgical anesthesia for someone of McClain’s reported weight of 140 pounds. It is also markedly higher than doses recommended for pain relief, which raises the question of whether the dose was intended to produce a second unconsciousness (as opposed to conscious lethargy or calm).”
I think the question is why can’t the cops use Valium or something less extreme, and in this case why did they use anything at all?
Susan McDonough says
I was a police officer for 26 years, I began my career in 1978 as a New York State trooper. I worked in the very rural areas of the Adirondack Mountains to the streets of NYC. I worked with police from all over New York state. Nowhere was I given ketamine to use for restraining defendants, nor did I ever see other officers use it.
I never saw any cops abuse people. At the end of the day, all we wanted was to go home to our families. We purchased Christmas gifts for poor people, had a State Police summer program for poor inner city and rural kids, and one senior investigator started up a home for abused women and children. I started a training program to work on animal cruelty. Troopers would help me feed orphaned animals that were brought to a station where I worked. One trooper brought people home when their cars broke down at night and opened his house to them.
There are over 600,000 police in the U.S. I’m not saying that there aren’t some bad ones. But we won’t help the mess we’re in if the focus of the news media and everything else continues to be “bad cops.” There are bad nurses, doctors, politicians, roofers, lawyers, etc. Most are decent people. I worked with white, black, Asian and Hispanic cops. We treated people the way they treated us. One story about a bad cop can always be found if you go digging through the millions there are in this world, while the kind things we do and did each day are being forgotten.
Merritt Clifton says
ANIMALS 24-7 graphics and social media editor Beth Clifton, my wife, is a former Miami Beach police officer. Sue McDonough’s career as a New York state trooper overlapped Beth’s at either end. Sue’s recollections of how police acted and were trained to act in that era coincide with Beth’s, and having then been a rural newspaper reporter in several communities adjacent to Sue’s beats, I can personally attest to the contributions that many police made then to community welfare––although I also helped to expose several cops who were serious bad apples. However, both Beth and Sue served during the heyday of “community policing,” an approach developed and taught in response to the police violence that was frequently documented during the protest era of the late 1960s and 1970s, some of which I also helped to expose and document early in my career. “Community policing,” which was eminently successful in reducing crime rates, was unfortunately superseded after the terrorist attacks of September 11, 2001 by the much more militaristic and authoritarian approach of today. Police recruited largely from military backgrounds are trained to fight terrorism and armed with heavy weaponry, including wheeled tanks, the likes of which Beth and probably Sue never saw in the police motor pools of their eras (a tank, for instance, isn’t especially useful for catching speeders.) Police during Beth and Sue’s era were taught that they were citizens and civilians, not an occupying army, and were taught to say “Please” and “thank you” as often as possible, not just to bellow orders. The police violence we are seeing all too often now is unfortunately a systemic and nationwide problem, resulting in part from the retirements of most of the generation of police who, like Beth and Sue, learned “community policing” with the emphasis on being members of the community they served. A return to authentic community policing is long overdue.
Corruption is now the rule rather than the exception.
That’s insane! As I believe you were a licensed animal control officer, as was I for a few years, you learn very quickly through training that:
1. Ketamine is an extremely dangerous drug that can easily be overdosed leading to the death of an animal.
2. A Huge number of people who are legally empowered to use tranquilizer guns and drugs such as Ketamine are totally unable to determine proper dosage, especially in a field situation ( many folks I trained with had only high school educations and never could figure out the weight to dose ratios needed for a non lethal dose). I would not be a bit surprised if this was the case with the Colorado EMTs.
Elizabeth Clifton says
Sue, I was two years after you, and I experienced much the same thing as you did.
As Merritt said, and I agree, community policing as a concept was an important goal on the Miami Beach police department and one of the reasons why mounted patrol, foot patrols, bicycle and ATV patrols were funded and staffed. At that point we didn’t even have a command vehicle, much less an armored tank. In the police academy we were trained for crowd and riot control, which primarily consisted of holding a line, pushing ahead, and being instructed not to react to a belligerent, insulting crowd.
At no time in the early 1980s were we taught to intentionally injure protesters with rubber bullets or paintball guns, and shock and smoke grenades were not utilized in the way we’ve been seeing the police use them in such a cruel and haphazard way! Each police trainee, including myself, had to experience what tear gas felt like by running through it. It was brutal, but when used appropriately for crowd control, tear gas is effective. At this point, to acknowledge the “good cops” is academic. The use of force by police has no boundaries. There is a total disconnect between officers and the public. Supervision and accountability has deteriorated to where the cops see themselves more as soldiers in a war zone then participants in a community. And have you noticed that it is primarily male police officers who are the worst offenders?
Training has gone down the tube, what little there is of it. Opportunists have been accepted into training programs who promote violence and create a wide crack between police and community. Police K-9s are so poorly trained that cities are having to pay out large sums of money to victims of their maulings. I will go so far as to say that police corruption is worse now than at any time in history. What the Donald Trump presidency has done is expose and pick at the wound that already existed in this country, filled with the pus of racism and the infection of white privilege.
Jamaka Petzak says
Police not being doctors or scientists would clearly seem unqualified to administer this drug, especially in light of its unknown effects on persons with medical issues such as Mr. McClain’s.
Mr. McClain was clearly a wonderful person. I wish I could have known him. And the world needs many more like him. Sharing to socials with gratitude, in grief, and in appreciation of his life and contributions.
I also wonder if it’s possible Mr. McClain was wearing the mask to help prevent the spread of Covid. I know I am not the only person who has seen people using a variety of makeshift face coverings when maybe the person didn’t have a medical mask handy.
Of course, African-Americans have also been harassed for wearing “official” medical masks in public places, which we’re all supposed to be doing! https://thehill.com/homenews/news/491986-black-americans-raise-concerns-about-being-profiled-for-wearing-masks-amid
Elizabeth Clifton says
Hi Lindsay. The date of Elijah McClain’s death was August 30, 2019 which was eight months before covid masking was suggested.
Ketamine is a fantastic drug used by veterinarians. It can be given intravenously or intramuscularly. It is relatively short acting, and it is quite safe when given at the proper dosage. It can be given to cats intramuscularly quite easily.
I wonder if what the police did led to the problem with ketamine. Was McClain conscious when ketamine was administered? In animals, if they are highly agitated when anesthetized, one has to be very careful, as the animal will at first seem to not respond to the anesthetic, and then become too deeply anesthetized, as more is given to get the desired effect.
@Su: Thanks for your comment. 500mg of ketamine is a large dose, and even more so if it’s administered in the manner described to someone with a slight build and low body weight like Elijah.
Ketamine’s a very powerful and extremely dangerous drug, and should not be used without a thorough understanding of its side-effects profile and other potential adverse reactions and ramifications, which can be quite serious and even fatal.
IMHO in this instance it was used entirely irresponsibly and inappropriately, especially considering the circumstances, the level and administration of the dosing, and the likely susceptibility for serious consequences of the “recipient”.
Julia Lewis says
I don’t see why they had to inject him with anything. He wasn’t a big man so they could have just held him still and spoken to him, then let him go. He was obviously harmless. I can’t see why someone even reported him. It’s all mad.