Here is all of the bodycam footage.
I really don't know what to make of this. I've watched it a lot, and am not sure how I would approach this if I was called to this. My initial impression was that this was not a patient I'd have wanted to sedate. There wasn't a clear medical reason for how the patient presents and the police stated they had applied a carotid control hold, which would have made me a bit nervous especially considering how long the patient has been restrained in a medically less than desirable position for. It seems that EMS made no attempt to de-escalate the situation at all. Who knows if they would have had any effect, I know personally with similar patients I've had some luck just being a different person and not a cop when talking to them and they chill out a little bit. It also appears that no assessment was attempted prior to medication, which is not cool. If the patient won't cooperate that's one thing, but you have to try to get some sort of baseline. In general I struggle with what the right course is when law enforcement calls us when someone continues to resist arrest. It is inevitable that people will not want to be arrested, does that mean this must be solved pharmacologically? I think the answer to that is probably not.
While by their guideline a med error was made (5mg/kg), at the time my system a few miles away was flat dosing everyone with 500mg (also not good). While the dose is unnecessary, I think if 300mg had been given the same thing would have happened.
We don't really know what happened in the ambulance in terms of how fast the arrest was noted. Really we don't know if he was even awake when he was medicated. Any sedation requires close monitoring, did that happen? If monitoring willfully did not occur in a proper timeline, that would meet the requisites of negligence.
If I was going to sedate this patient, I would have made much more of an effort to control the scene, which this crew didn't do. Minimal direction to the officers, no verbalized plan, no apparent plan ready to care for the patient. That's not criminal, but it's not setting anything up for success.
Of note, in Colorado we can no longer administer Ketamine for agitation.