Elijah McClain - medics charged

[DrParasite]

Point 1: Perhaps the officer could have simply observed Elijah instead of making direct contact. Perhaps they could have sent a social worker along or instead of an officer. Perhaps nobody should have been dispatched, as case law has set the precedent that police have no duty to respond. Perhaps many things should or should not have happened. I think that perhaps Elijah should not be dead.

Hindsight is awesome. and we can play the "whatif" game all day. what if the officer didn't investigate the suspicious person, and just let him go; and 20 minutes later he pushed a grandmother into the path of a moving bus? what if they sent a social worker, and when the social worker made contact, he pulled out a handgun and put 3 bullets into their chest? what if no one was dispatched, and then Elijah broke into the caller's house, assaulted her and her family, and kidnapped her 3 year old daughter? of course, none of these things happened (and hindsight tells me none of them would have happened), but the officers didn't have the benefit of hindsight when the situation started.

Point 2: Depends on the circumstance. We are not privy to everything the investigators will be so anything said here is largely speculation based off incomplete information. I do feel that this person did not need to die for walking down the street listening to music and not harming anyone.

Here is a whatif for you... what if Elijah and calmly spoke to the officers, answered their questions, and complied with their investigation? Perhaps he would not have died that night? No one was trying to kill Elijah... that was not their intent. And this is a tragedy, likely brought on by a medicinal error, with a contributing factor of the victim's own actions during the interaction with police.

This entire situation is a stain on our country's police and EMS forces, and we should be doing everything we can to earn the public trust back, or things are only going to get worse for us, not better. Anything that happens to the medics or officers involved are the result of the system we've implemented. It's on us to create improvements to the system if that is resulting in no-win situations for first responders.

So what are you saying? cops should stop responding to suspicious person calls? if the person is violent, cops should just let them do their thing? EMS should interfere with law enforcement actions? social workers should take the place of LEO in investigations? EMS should have been sent to investigate instead of LEO?

It's very easy to say the cops suck, are racist, are bad at their job when you haven't been in their shoes. I've never been a cop, so in 99% of the situation, I give them the benefit of the doubt, because I am not willing to do their job. Ketamine is a drug that is used all over the country; was it used inappropriately here? maybe, but should an isolated misuse of a medication result in everyone not being able to use this (normally) safe medication?

This is a BAD situation, one where the facts don't support criminal charges (which is why the AG didn't charge them when it first happened), but due to political motivations, the local DA decided to charged these professionals. And when they are found not guilty, there will be riots and protests in the streets of racism, when the truth is, a criminal court is not the right place for this to be adjudicated, because the facts don't support the charge. Hopefully the public will learn from this, and realize they often play a greater role in these poor LEO interactions than PD training levels.

 

[gclol]

You forget that the kid was autistic and doesn't function or interact with law enforcement like a atypical person? The cops messed up and don't know how to interact with special needs clients and the medics messed up up for not doing a proper assessment. Everyone screwed up in this call

 

[FiremanMike]

So I think we all (myself included) have become bogged down on a tangent of this case.

Back to the original point, we have scenario where the medics showed poor crew resource management, an incomplete assessment, a possibly incorrect application of an existing sedation protocol, and a patient death. It is extremely important to note that the autopsy was inconclusive and showed no correlation between the ketamine and the patients death.

Based on the body cam and report, there is no indication that the medics were acting with malice or intent, but we still have felony indictments against EMS.

The implications of this case for everyone’s future practice are huge.

So the original question stands. When should medical mistakes transition to criminal liability?

 

[mgr22]

So I think we all (myself included) have become bogged down on a tangent of this case.

Back to the original point, we have scenario where the medics showed poor crew resource management, an incomplete assessment, a possibly incorrect application of an existing sedation protocol, and a patient death. It is extremely important to note that the autopsy was inconclusive and showed no correlation between the ketamine and the patients death.

Based on the body cam and report, there is no indication that the medics were acting with malice or intent, but we still have felony indictments against EMS.

The implications of this case for everyone’s future practice are huge.

So the original question stands. When should medical mistakes transition to criminal liability?

That's a good summary. I think most of us can relate to pressure involving the different missions of law enforcement and EMS. Perhaps there should be more joint training -- something that acknowledges the issue and suggests how to handle it. I'm thinking of Crew Resource Management in aviation as an example of radical changes to critical communication between coworkers.

I think the answer to your question is "Only if there's intent," but I'm not a lawyer.

 

[Tigger]

I agree that I would have attempted to play the “good medic, bad cop” game to see if we could get him to comply. With that said, I can see how it played out - they show up, cops still pinning him down and said they’ve been fighting him for several minutes, corroborated by the on scene firefighters. He probably should have questioned this, but everything we know about group dynamics and social psychology explain why he didn’t.

Sucks that you lost ketamine for sedation, it’s still a useful tool..


What types of runs are they dispatched on? It doesn’t seem to me that they’d be sent on a suspicious person call..

Also of note, fire is ALS and has control of the scene always. The ALS ambulance is just a ride to the hospital, AFD will maintain care enroute should anything “ALS” be done. From a system perspective, the Falck crew has no obligation to provide an assessment. The Ketamine was given by an AFD paramedic, they just used the ambulance’s controls.

Here the “people not acting right” calls will get a behavioral unit if available. It would really depend how the dispatch put it in, but the guy walking down the street acting oddly will often get a cop and social worker response and patrol will often request it if they aren’t enroute anyway.

 

[FiremanMike]

Also of note, fire is ALS and has control of the scene always. The ALS ambulance is just a ride to the hospital, AFD will maintain care enroute should anything “ALS” be done. From a system perspective, the Falck crew has no obligation to provide an assessment. The Ketamine was given by an AFD paramedic, they just used the ambulance’s controls.

Here the “people not acting right” calls will get a behavioral unit if available. It would really depend how the dispatch put it in, but the guy walking down the street acting oddly will often get a cop and social worker response and patrol will often request it if they aren’t enroute anyway.

That’s interesting, thanks for the insight on their system.

Who were the providers that were charged, were they off the fire truck or ambulance?

 

[Tigger]

That’s interesting, thanks for the insight on their system.

Who were the providers that were charged, were they off the fire truck or ambulance?

Fire engine. Not sure what if anything happened to the Falck crew.

 

[FiremanMike]

That’s interesting, thanks for the insight on their system.

Fire engine. Not sure what if anything happened to the Falck crew.

So, for the sake of debate..

In my world, visual observations of combative behavior would be considered a key initial assessment point for moving towards chemical restraint. So I don't think it's fair to say that NO assessment was done.

 

[Tigger]

So, for the sake of debate..

In my world, visual observations of combative behavior would be considered a key initial assessment point for moving towards chemical restraint. So I don't think it's fair to say that NO assessment was done.

I suppose. But no effort was made to engage with the patient. I want to establish some sort of baseline if I can. This isn’t possible with every situation but in this case I feel that with a patient that isn’t just screaming insistently like some “excited delirium” (wait can’t use that term in CO anymore) that attempting to determine mental status before sedation is appropriate.

 

[FiremanMike]

I suppose. But no effort was made to engage with the patient. I want to establish some sort of baseline if I can. This isn’t possible with every situation but in this case I feel that with a patient that isn’t just screaming insistently like some “excited delirium” (wait can’t use that term in CO anymore) that attempting to determine mental status before sedation is appropriate.

100% agree and that would be my approach as well..

 

[CCCSD]

You forget that the kid was autistic and doesn't function or interact with law enforcement like a atypical person? The cops messed up and don't know how to interact with special needs clients and the medics messed up up for not doing a proper assessment. Everyone screwed up in this call

utter BS.
How long have YOU been a Police…?
Thought so.

 

[Rano Pano]

I understand there’s a few points of the call that have been discussed back and forth in this thread, but does ANYONE actually disagree that ketamine was administered inappropriately due to Elijahs presentation during administration?

 

[ffemt8978]

I understand there’s a few points of the call that have been discussed back and forth in this thread, but does ANYONE actually disagree that ketamine was administered inappropriately due to Elijahs presentation during administration?

The question in this thread is do inappropriate actions rise to the level of criminal liability, especially when there are other avenues (regulatory, licensing, civil, etc) available?

 

[Ensihoitaja]

That’s interesting, thanks for the insight on their system.

Fire engine. Not sure what if anything happened to the Falck crew.

This came out over 6 months ago, but it seems the Falck medic pretty effectively washed his hands of the situation.

The Aurora Fire Rescue medic “administered 500 mg Ketamine IM to (patient’s) R deltoid prior to discussing (patient’s) weight and proper dosage with Falck medic,” the report said. “(Patient) had not been seen by Falck medic prior to administration of Ketamine due to darkness as well as multiple APD officers being on top of (patient).”

Having worked in that system once upon a time, I remember documenting things like that. Nothing this high profile, though.

 

[Tigger]

I understand there’s a few points of the call that have been discussed back and forth in this thread, but does ANYONE actually disagree that ketamine was administered inappropriately due to Elijahs presentation during administration?

Are you saying it was not appropriate to sedate this patient? I think it might have been, just not not the way they went about it here. If you feel that someone in law enforcement custody is in grave danger of harming themselves, sedation is probably warranted. The cops arent just going to let him go.

 

[Rano Pano]

Are you saying it was not appropriate to sedate this patient? I think it might have been, just not not the way they went about it here. If you feel that someone in law enforcement custody is in grave danger of harming themselves, sedation is probably warranted. The cops arent just going to let him go.

That’s exactly what I’m saying. When you say “just not the way they went about it here” are you not saying the same thing?

I’m not quarterbacking the call for Aurora, Falck or any other provider for that matter but the initial use of Ketamine was clearly inappropriate.

 

[Rano Pano]

The question in this thread is do inappropriate actions rise to the level of criminal liability, especially when there are other avenues (regulatory, licensing, civil, etc) available?

I think we’re seeing in the last several years they do. I don’t agree with it. I don’t think it’s very hard presently to be thrown in a situation with little information and make a incorrect tx or oversight accordingly.

 

[Tigger]

That’s exactly what I’m saying. When you say “just not the way they went about it here” are you not saying the same thing?

I’m not quarterbacking the call for Aurora, Falck or any other provider for that matter but the initial use of Ketamine was clearly inappropriate.

It is inappropriate to sedate a patient without attempting an assessment, yes.

 

[Tigger]

The question in this thread is do inappropriate actions rise to the level of criminal liability, especially when there are other avenues (regulatory, licensing, civil, etc) available?

If a provider willfully causes harm to patient, then yes. One of the ways a provider could do this is willfully choosing to not monitor a patient that you just administered ketamine to (which I have no idea if that happened in this instance). That is what I hope this trial will establish. If they just sedated him, through him on the cot, and then at some point much later recognized that he was doing poorly/in arrest because they made no attempt at assessment or monitoring, I suspect these charges will hold.

 

[FiremanMike]

If a provider willfully causes harm to patient, then yes. One of the ways a provider could do this is willfully choosing to not monitor a patient that you just administered ketamine to (which I have no idea if that happened in this instance). That is what I hope this trial will establish. If they just sedated him, through him on the cot, and then at some point much later recognized that he was doing poorly/in arrest because they made no attempt at assessment or monitoring, I suspect these charges will hold.

The way I read the report is that they gave the ketamine, waited for it to start to take effect, moved him to the cot, then noticed the cardiac arrest..