Denver Health paramedic sedates patient in violation of state rules and law

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DENVER (KDVR) – A Denver Health paramedic violated a new state law by sedating someone with ketamine while the patient was handcuffed and in Denver police custody.

“I’m appalled, and I’m angry,” said Anthony Sleets, who was sedated with the drug in July, one day after Colorado House Bill 21-1251, aimed at prohibiting and preventing this type of scenario, was signed into law.

The ketamine administration also occurred after the state health department suspended all ketamine waivers that would have given paramedics permission to administer the drug to extremely agitated people outside of a hospital setting.

“Where is the training? And where is the due diligence in regard to people’s rights?” Sleets said.

What the new ketamine law prohibits

The new law, which took effect when Colorado Gov. Jared Polis signed it on July 6, prohibits paramedics from using ketamine “to subdue, sedate, or chemically incapacitate an individual for alleged or suspected criminal, delinquent, or suspicious conduct.”

According to police body camera video obtained by the Problem Solvers, someone on the scene told Sleets he was receiving the drug because Sleets was “trying to assault some paramedics, and we’ve got to keep you calm.”

Sleets, who was not arrested or charged for any crime during the incident, denied attempting to assault a paramedic.

“I did not assault no paramedics,” he said during the ordeal.

The law also prohibits paramedics from administering ketamine in the presence of law enforcement officers if there is no “justifiable emergency.”

Excited delirium, a controversial term used to describe someone who is experiencing extreme agitation, is not a justifiable medical emergency, according to the new law. 

But someone listed “excited delirium” and “overdose” on Sleets’ medical record, signed by two medical providers.

The moments leading up to the sedation

When the emergency medical service providers were on scene, police body camera video shows them approaching Sleets while he was handcuffed and being restrained by two police officers. 

The officers were directing Sleets in which direction to release the saliva he had collected in his mouth.

“Spit on the ground,” one officer said. “Spit on the ground,” another officer said. “Can I spit it out?” said Sleets, to which the first officer responded, “Spit to the left side.”

Sleets, who was wiggling in his cuffs, spun to one side and released the spit in a direction that was away from any person.

Immediately, a paramedic approached Sleets and administered the drug.

“Hold up man. What are you doing?” Sleets screamed. “What are you doing man? What are you shooting me with?”

Sleets also yelled, “I didn’t consent to this. What are you doing?”

Denver Health’s response

“At the time that this happened, our Denver paramedic was following exactly the instructions and medical direction that I give them,” said Dr. Kevin McVaney, the medical director for Denver’s Emergency Medical Response System.

McVaney said he was surprised when the Colorado Department of Public Health and Environment suddenly suspended the waiver that grants permission for ketamine to be used on agitated patients, in a pre-hospital setting, on the day the law took effect.

“We anticipated an opportunity, after the law was passed, to have some rulemaking and understanding about what would be appropriate behavior. It was a surprise to me that the waiver was suddenly suspended,” he said.

In the months prior to the incident, McVaney provided extensive testimony and participated in multiple hearings about the proposed ketamine bill at the state capitol.

“I feel like I was there every step along the way,” he told the Problem Solvers, explaining that he had begun to prepare his paramedics in the spring of 2021 for changes to their protocols should the law take effect.

McVaney said some of those altered protocols included training for paramedics to calculate a patient’s weight, to be able to adequately prepare the proper dose of ketamine and to develop a “comprehensive approach” to handling an agitated patient.

The proposed ketamine bill passed the state’s General Assembly and was signed by the Senate and House presidents on June 22 and was sent to the governor the same day.

On July 6, Denver Health received a letter from CDPHE saying, “Since the administration of ketamine by paramedics is only authorized pursuant to a waiver from the Colorado Department of Public Health and Environment (Department), the Department must take action to be in compliance with the new law. Consequently, effective upon the signing of HB21-1251, the Department is suspending all waivers for ketamine for Excited Delirium and/or Extreme Agitation.”

Polis signed the bill into law on July 6.

McVaney said Denver Health held meetings and released training videos and written training content the day after the bill signing, but the ketamine was not pulled from rigs until Thursday morning, July 8.

“It would have been dangerous to immediately try to change an entire care system on such short notice,” McVaney said.

“I am OK that (the paramedics) did their best under the circumstances and protocol and medical permission that they had at the beginning of their shift,” McVaney said. 

McVaney said he did not believe anyone should be disciplined for the incident but said he would be “happy to face any discipline that any reasonable person thinks is appropriate,” he told the Problem Solvers. “I feel like I have done nothing but pour my heart and soul and my profession into this role of taking care of vulnerable people in really difficult circumstances.”

Sleets said he plans to take further action.

Key legislator reacts

Rep. Leslie Herod, who fought for the new law after she learned about Elijah McClain’s 2019 death and a handful of other questionable incidents uncovered by the Problem Solvers, said she believes Denver Health should face consequences for this incident.

“I think they absolutely should be held accountable,” she said. “The law is clear, and they were part of drafting the law … the entire way along.”

Herod said the medical professionals had “ample time” to put new, appropriate protocols in place, especially since Denver Health was so actively involved in the legislative process.

“I may feel a little bit differently if it was an agency in rural Colorado who had no idea what was happening at the capitol,” Herod said. “I know that CDPHE sent notifications out statewide. I know this was a conversation that was very public, and quite frankly, this ‘we did not know’ just doesn’t hold water in this instance.”

She said she was also unclear whether law enforcement had a duty to intervene during the ketamine administration.

According to the Denver Police Department, officers in the video did not “direct, or unduly influence the use of Ketamine…nor did they compel, direct or unduly influence an emergency medical service provider to administer Ketamine,” which the law prohibits.  

“Officers were exercising reasonable care for the health and safety of Mr. Sleets,” said Andrea Webber, a records administrator for the Department of Public Safety.

The initial encounter

Police encountered Sleets in a hotel parking lot near the 16th Street Mall on July 7. They had received a call regarding a disturbance, in which the reporting party alleged Sleets had been found passed out in the parking structure.

The woman who reported the incident told police she nudged Sleets’ foot to awaken him, and he “tried to lunge.”

Sleets told the Problem Solvers he believed he was unconscious because he had been previously assaulted. When he was awakened, someone sprayed mace in his face, he said.

When police encountered him, Sleets was changing his shirt in his car.

Police officers told Sleets they were going to transport him to detox, but Sleets insisted to the Problem Solvers that was dehydrated, not intoxicated.

He resisted and struggled with officers when they tried to place him in the back of the patrol car.

Eventually, paramedics were called to the scene.

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