DENVER (KDVR) – Aurora Fire Rescue’s medical director, Dr. Eric Hill, consulted with a Minnesota emergency physician in June about issues related to the use of ketamine to sedate agitated patients, according to a June email obtained by the FOX31 Problem Solvers.
“I am a (sic) EMS medical director in the Denver area in Colorado. I have some issues regarding EMS sedation and use of force that I am dealing with in my city,” Hill wrote in an email to Dr. Jeff D. Ho. “Dr. Jeff Beckman recommended I contact you since you have dealt with these in your city in the past. I would very much appreciate a phone call if you have time.”
Hill is named individually — along with the City of Aurora — in a civil rights wrongful death lawsuit filed by Elijah McClain’s family this summer. McClain died in August 2019 after receiving a 500 mg dose of ketamine after a struggle with police.
Ho, whose medical license indicates he works at Hennepin Health Medical Center, has studied and written about ketamine use for excited delirium, the extremely agitated state cited in state guidelines as the condition for which paramedics are permitted to administer ketamine in Colorado.
In 2017, Hennepin County first responders were also the subject of an investigation in which the Minneapolis Office of Police Conduct Review discovered some medical providers were sedating agitated people who were in police custody. According to Minneapolis government records, Ho served as the chief medical director of Hennepin EMS at the time and noted that “Hennepin County EMS was engaging in a study on the use of pre-hospital sedation involving ketamine during 2017-2018.”
In the email exchange with Hill, Ho supplied various articles and research materials and said, “It is sometimes hard for people you are explaining this to to understand that in really agitated, exertional states, people can get critically ill quite quickly.”
In a separate email he wrote, “…people in extreme agitation die when police and EMS authorities are not even around so it cannot be an automatic association that you have to have the police present or EMS has to give sedation for the person to die.”
The FOX31 Problem Solvers obtained dozens of other emails sent to or from Colorado Department of Public Health and Environment (CDPHE) officials during June and July, revealing more from their conversations related to ketamine ahead of the state’s August announcement that CDPHE would review the waiver program that paves the way for paramedics to administer the drug.
In one email, Dr. Jeremy DeWall, who identified himself in his email signature as the CEO of Wilderness & Emergency Care Consulting, PLLC and as a staff physician at UCHealth Pikes Peak Regional Hospital, sent a message of support for the use of ketamine in by “well-trained” paramedics to calm violent patients who are a danger to themselves or others.
In his email to Dr. Jeff Beckman, the medical director and associate division director for CDPHE’s Health Facilities and Emergency Medical Services Division, he said, “This letter is being sent by myself at the request of the Teller Regional EMS Council…Please send this to whomever appropriate at the State level for consideration.”
He attached a letter, dated July 8, 2020, showing support for a 2018 position paper drafted by a consortium of metropolitan EMS medical directors to say, “we…strongly support the use of medications to calm delirious and/or violent patients who are a danger to themselves or others. We endorse the use of appropriate sedative medications, including ketamine, when administered by well-trained paramedics who are functioning under carefully designed medical care protocols. Patients and EMS workers are safer as a result.”
There are several emails sent to and from Beckman including, a few in which he references Dr. Randall Clark, an officer with American Society of Anesthesiologists, who has publicly expressed concerns on the organization’s behalf over how paramedics are administering ketamine and how patients are being monitored.
“I hope he understand excited delirium is indeed a true medical emergency with high mortality,” Beckman wrote to a pair of physicians, Dr. Daniel Willner and Dr. Fred Severyn.
In a separate email, Beckman wrote, “the excited delirium and extreme agitation posing significant risks from a potential medical emergency is where media, ASA, etc, are missing the boat.”