DENVER (KDVR) — The state health department disciplined two Denver Health paramedics after a Problem Solvers investigation found they injected a man with ketamine in violation of a state law that was enacted one year ago.

“The department received a complaint regarding the July 7, 2021, incident with an allegation of administration of ketamine by EMS personnel. The department was able to substantiate that a violation occurred,” Gabi Johnston, a spokesperson for the Colorado Department of Public Health and Environment, said in an email.

The health department launched an investigation after an attorney sent a complaint letter following our Problem Solvers investigation.

“We wanted accountability,” Ciara Anderson, an attorney working on the case, said.  

“From day one it seemed like it’s being swept under the rug,” Anthony Sleets said, the man who was sedated with the drug while police had him physically restrained. “I wouldn”t wish that on no one.”

In April, the department issued letters of admonition to two paramedics who participated in the incident, Damion English, and Jackson Williams. The department also said it provided information about its findings to the Department of Regulatory Agencies and to the City and County of Denver. However, when the Problem Solvers checked with Denver’s excise and licenses department, responsible for licensing ambulances, a spokesperson said they had not received any information about the incident.  

When the Problem Solvers asked to which department CDPHE forwarded its findings, CDPHE corrected itself. 

“As a courtesy, we sometimes refer findings to the various agencies that have regulatory jurisdiction over the individuals or entities we’ve investigated. Those agencies can then determine if they want to conduct their own inquiry into the investigated incident,” said Johnston. “Our investigation team asked staff to send referrals to Denver County, which has regulatory oversight for the ambulance system, as well as the Colorado Medical Board within the Department of Regulatory Agencies, which has oversight of physicians, including Dr. Kevin McVaney, the medical director involved in this incident.  When we researched your question, we discovered staff had not yet sent those referrals. We sent them today.”

“What happened to Mr. Sleets was not justice,” Anderson said. “And it’s not how any member of the community should be treated.”

Neither paramedic responded to an email request for an interview with the Problem Solvers.

However, the Problem Solvers obtained a disciplinary appeal letter written on English’s behalf. The letter, signed by Judith Benton, the Sr. Assistant General Counsel at Denver Health, objected to CDPHE’s findings and requested a hearing.

“There is no dispute that Mr. English, at the time of the administration of the medication, had no actual knowledge of the change in the law. He had received notice from no person or entity of this substantial change. He received no notice from CDPHE, he received no notice from any professional organization, and he received no notice from his employer. Also, notably, when he started his shift and during his shift, the ambulance he was operating and using was equipped with ketamine as it always had been. So, in real time, he had no notice or reason to know of this precipitous and substantial change. And yet, he is being subjected to this penalty,” the letter said.

As the Problem Solvers previously reported, the health department also issued a cease-and-desist letter to Dr. Kevin McVaney, the medical director for Denver Health’s Emergency Medical Response System who oversaw the paramedics.

“We have been advised that the State has taken an additional step in its administrative process. We will continue exercising our rights in this administrative process to support the Denver Health Paramedic Division and our employees,” April Valdez Villa, a spokesperson for Denver Health, said. “Denver Health remains proud of and confident in our employees’ training, experience and medical expertise and will continue the important work done each day to provide high quality care to our patients,” she said.

There is no indication of any additional discipline.

However, McVaney previously told the Problem Solvers he would be “happy to face any discipline that any reasonable person thinks is appropriate.”

The state department prohibited the use of ketamine, by paramedics, for agitated patients in a pre-hospital setting while it conducted a ketamine review. Although results of the review were released late last year, CDPHE said it has no current plans to allow this drug to be used by paramedics for this purpose again.

The drug is still permitted for pain management and the emergency management of airways.