State health panel recommends continued use of ketamine, despite pleas from Aurora council member

(AP Photo/Teresa Crawford)

AURORA | More than three dozen emergency medical entities across the state on Monday were recommended to continue providing ketamine to people believed to be experiencing excited delirium, the debated medical condition used to describe people who exhibit severe agitation.

The state’s Emergency Medical Practice Advisory Council on Monday recommended the approval of a slew of renewal and transfer waivers for various medical providers to use the sedative on people believed to be experiencing symptoms such as hyperthermia and increased strength.

Additional health officials will still have to formally sign off on the council’s waiver suggestions, several of which were made with added conditions. No waivers were recommended for denial, a spokesperson confirmed.

The size of the entities granted the waivers varied greatly, from the South Metro Fire Rescue Authority to the ski patrol team at Loveland Ski Area. Bandimere Speedway in Morrison was also granted a renewal waiver.

The only new waiver granted was to Southwest Health Systems, a hospital group in the southwest corner of the state.

That came despite pleas from Aurora City Councilperson Nicole Johnston, who spoke at the public meeting of the health council and asked officials to pause granting any new waivers.

“I recognize that ketamine can be involved in a variety of contexts, such as strokes and seizures and in in patient diagnostic settings,” Johnston said. “I personally do not support the use of ketamine in police involved incidents but I recognize that the board implementing a total ban today is unlikely … My ask of you today is to put a moratorium on new waivers while you further examine the issue and potentially put standardized systems in place. I also ask that you suspend existing waivers for 90 days in the use of law enforcement involved EMS responses.”

The 11-member council did not heed Johnston’s requests.

First responders’ use of ketamine in Colorado has been the subject of increased scrutiny following the death of Elijah McClain, the 23-year-old Black man who was injected with the drug in north Aurora after a passerby described him as “sketchy” last August.

Aurora Fire paramedics overestimated McClain’s weight by nearly 80 pounds and injected him with 500 milligrams of the sedative after officers had placed him in a now-banned chokehold, according to documents released by the 17th Judicial District Attorney’s office. McClain was taken off life support in a hospital six days later.

A growing number of health officials have questioned the dosage of ketamine given to McClain, who weighed 143 pounds at the time of his death. Paramedic Jeremy Cooper, who injected McClain, later told prosecutors that he estimated McClain weighed 220 pounds.

Cooper and a pair of other Fire personnel were named as defendants in a lawsuit filed on behalf of McClain’s estate Tuesday.

“Defendant Cooper observed Elijah directly for several minutes prior to the arrival of the private ambulance,” the complaint filed in federal District Court reads. “He had every opportunity to make an appropriate weight estimate, but failed to do so.”

Local Fire officials have said paramedics treated McClain appropriately.

State health officials have been granting health agencies waivers to use ketamine since 2013, though Aurora Fire didn’t begin using the substance until January 2019.

The city’s current waiver is valid through next June and was not up for renewal at the recent meeting.

Local officials used the drug 18 times in the city last year and twice in the first six months of this year, according to a spokeswoman for the local fire agency.

Medical officials across the state administered ketamine 902 times between Jan. 1, 2018 and June 30 of this year, according to state data. Nearly 17% of those incidents had some sort of complication reported.

Such complications clocked in at an even higher rate last year, when 24% of the 457 ketamine doses given across the state resulted in some sort of problem. More than half of the issues were due to hypoxia, or oxygen deprivation.

Aurora Mayor Mike Coffman has said the city is currently in the process of re-examining its policies surrounding ketamine. The drug will also be the focus of a city probe into McClain’s death that will be headed by a Washington D.C.-based civil rights attorney. An unnamed medical expert will look into the ketamine administration.

The state health department last month also launched a new probe into the ketamine used on McClain on Aug. 24, 2019, according to a department spokesperson.

“The Colorado Department of Public Health and Environment received numerous complaints, beginning on June 24, that provided additional information regarding a ketamine administration in August 2019,” Peter Myers, occurrences section manager for the state organization, wrote in an email sent July 28. “The department launched a complaint investigation which is currently ongoing.”

State health officials have suggested that the state may tighten it’s ketamine regimens in the near future, though it’s unclear what that may look like.

The health council is tentatively scheduled to meet again for a quarterly meeting on Nov. 5.