There’s no place to begin. An absolutely shitty story.
Poor bloody bloke.
Bastards all round.
This was a very sad case that got very little publicity compared to other cases.
Thank you for calling out the reporters in this. That article was disgusting and I hope saying so has a chilling effect on the writers’ careers.
What seems especially ugly about the “zOMG chilling effects!” stuff is that the ‘chilling effect’ being fretted about seems like both a completely normal constraint you’d want medical types to have in mind(it’s not exactly news that what makes anesthesiology a skilled specialty is the requirement that the patient wake up largely undamaged; so of course you’d want anyone dispensing anesthetics to be worrying about safe doses, respiratory depression, etc) but one where there’s no obvious downside:
What if the paramedics had just stood back and fretted about liability? The poor cops would have had to face the menace of an outnumbered, outweighed, and restrained guy being conscious?
There probably are some cases where the risks of inaction are such that you want medical types to rush in, even under less-than-ideal circumstances; because their intervention will, on the balance, be positive(contrived example, I assume that dragging people out of burning vehicles without being 100% sure that all spinal stabilization measures are in order is preferred, since being burned alive is a real downer compared to possible nerve damage); but in this case what was the upside for their patient?
(edit: not sure I as clear as I would like: TL;DR the fundamentally damning thing here seems to be medical professionals using their tools to as pharmacological tasers rather than acting in the service of their patient. It’s certainly possible to commit malpractice while doing real medicine; but it’s impossible to not commit malpractice when you are just assaulting someone by incidentally medical means. That seems like a fairly obvious thing you’d want chilled. This isn’t about anesthesiologists living in fear about juries second-guessing their dosage decisions; it’s about the fact that assault isn’t medicine.)
Yes. “First do no harm” is drilled into every health care provider. This SHOULD have a chilling effect on any paramedic who thinks they’re deputized as state sanctioned tranquilizers. The “diagnosis” they used to justify drugging him was folklore, not an actual condition. Over sedation can certainly make life easier for police and paramedics, but it’s at the expense of the general public, and they should be chilled at the thought of overdosing someone every time they administer a drug.
This is the part to me that completely nullifies any suggestion that this may impact the future reasonable actions of first responders:
Defense attorneys argued that the paramedics followed their training in giving ketamine to McClain after diagnosing him with “excited delirium,” a disputed condition some say is unscientific and has been used to justify excessive force.
EMTs are not generally supposed to be making medical diagnoses, and they sure as hell aren’t supposed to be making ones that aren’t widely accepted. They are supposed to take whatever actions they need to take to save a patient’s life, and stabilize them enough to get them to the hospital. Their decision to sedate him had nothing to do with medicine. They were just trying to knock him out to make him easier for the police to handle. And that’s not their job.
So yeah, actually, I hope this does have a chilling effect on first responders. I hope it makes them think twice before putting a patient’s life at risk just to suck up to the cops.
And I owe @snigs a coke.
First, do no harm.
ETA @snigs - I owe you a fizzy beverage, too, apparently.
At least it wasn’t a diagnosis of drapetomania?
Paging @docosc - to the best of your knowledge- is there any good reason for EMS to be handling ketamine without a prescriber present?
Given the LD50 of Ket, these fuckers must have been pretty keen with the old syringes to boot. At 100mg/ml solubility and well over 4g needed for a lethal dose?
Ketamine is a great drug in peds, the kids find the hallucinations entertaining, you don’t supress supress respiration, it can be given orally and it takes a boatload to get in trouble. In adults, used alone, it is fucking horrifying. The hallucinations can be terrifying and in a kid who is already scared, i can only think they used it with malicious intent. In short, in this situation, no. The longer answer is that they fucking tortured him to death. Imagine being flung into your worst nightmares, so bad it literally scares you to death. I doubt they hit the LD50. They didn’t need to.
We’re journalists! We don’t need no steenkin’ facts!
… “excited delirium” is a condition that is usually diagnosed after the fact by the police union
… Occam’s Razor might suggest the cops beat the kid to death and threw the medics under the bus
It’s all on body cam. It was the ketamine that killed him.
it’s usually called by the police on the scene, and - in colorado amd other states - they’re the ones who have been giving that diagnosis to ems
it looks like it’s going to be removed from the police’s hands starting next week
The Virginia Law Review looked at 166 in-custody deaths between 2010 and 2020 and found that 56 percent attributed “excited delirium” to Black and Latino victims. Critics say the diagnosis is often used to absolve law enforcement from culpability when someone dies in custody.
“If you look at the racist descriptions they use against Black people … it’s a legal justification for a racial stereotype"…
it reminds me of the “but he was on pcp” claims from the 80s.
Jesus Christ! This poor guy.
Thx and Merry Xmas doc.
Thank you for this. This story needs to be spread far and wide.
Either he’s a detained person and is in the “care” of the police or he’s a patient and the care is given over to the paramedics with all that entails. You can’t have both.