South Metro Fire Rescue finds ‘protocol was followed’ in self-review of ketamine case

Problem Solvers

CENTENNIAL, Colo. (KDVR) – Paramedics at South Metro Fire Rescue followed protocol when they administered ketamine to an intoxicated man who ended up hospitalized and on a ventilator last summer, according to the agency’s self-review of the incident.

“Based on this thorough and in-depth review of this incident, SMFR has determined that protocol was followed regarding the administration of ketamine,” Eric Hurst, the SMFR public information officer, said in a written statement. 

“SMFR’s conclusion is also supported by the Colorado Department of Public Health and Environment (CDPHE) who recently conducted their own independent case review of this incident and determined that the SMFR ‘paramedic’s administration of ketamine complied with the applicable Department and medical protocols, followed accepted standards of care, and was consistent with medical direction,’ per a statement from CDPHE.”

The case is separate from the one involving Elijah McClain, which occurred the same month in Aurora.

SMFR and the state reviewed the case after the FOX31 Problem Solvers reviewed body camera footage and found discrepancies in SMFR’s statements about how and why the drug would be used and what was seen in the video.

Officials from SMFR have declined to explain their findings or to provide clarity about the discrepancies discovered by FOX31. 

“As a result of all the documentation, footage and two internal reviews, South Metro’s EMS Chief John Curtis and South Metro Medical Director Dr. John Riccio stand by the statements made during the interview in October of 2019 that protocol was followed, and they have no additional comments to at this time,” Hurst said. 

Elijah McKnight, the man who was hospitalized for several days after the incident, said he wasn’t surprised by SMFR’s findings.

“What else do you expect when they do a self-investigation?” he said. “I’m upset that they’re not trying to take any accountability.” 

McKnight said he plans to speak about his experience during an upcoming Emergency Medical Practice Advisory Council meeting.  

“I definitely don’t think that protocol was followed. It actually wasn’t followed, and that’s a fact,” said McKnight.

The eight members of EMPAC – including physicians and emergency medical technicians – developed the state’s Ketamine Waiver Guidance and collectively provide recommendations to the state health department about whether or not to grant ketamine waivers that would allow the drug to be used as a sedative, to subdue extremely agitated patients experiencing a condition called excited delirium. 

The drug is not FDA approved for this use.

The waiver used by the SMFR medical director, John Riccio, is up for renewal consideration at the meeting next week. Approvals last three years, according to the Colorado Department of Health and Environment.

Meanwhile, medical groups like the American Society of Anesthesiologists have expressed concerns about Colorado’s ketamine protocols after learning more about McKnight’s case and the case of Elijah McClain, whose death after a police altercation and an injection of ketamine has been the subject of national protests and worldwide attention.

“This internal review found that the personnel on the scene followed the department protocols.  But we in the American Society of Anesthesiologists believe that the protocols themselves need to be reviewed based on the number of complications that are occurring with the currently approved process,” said Dr. Randall Clark, the first vice president of the organization.  

“The complication rate is unacceptable. These protocols are the responsibility of the Colorado Department of Public Health and Environment and we are working with their medical leadership to provide input on the review we have recommended,” he said.

State legislators on both sides of the aisle have also called for further public discussion about ketamine protocols in Colorado.

“I am pursuing this matter in the interest of public safety,” state Senator Rhonda Fields told the FOX31 Problem Solvers.  Fields serves as Chair of the Senate Health and Human Services committee. “I’m hoping I can resolve this without legislation through rule change, but if it cannot be done that way then I will be taking legislative action in 2021.”

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