So, I wanted to have a level-headed discussion about this case. I’ve been loosely following it since it happened, and I’m curious to see what others think of it, perhaps hear from folks who followed it more closely.

For those out of the loop, here’s the JEMS article on it: https://www.jems.com/patient-care/two-co-paramedics-found-guilty-in-death-of-elijah-mcclain/

The tl;Dr is this: Aurora fire medics are dispatched to assist Aurora PD with a combative patient they believe is in an altered mental state. Aurora FD EMS crews identify this patient as qualifying for their excited delirium protocol based on PD and patient presentation, and administer the maximum dose of ketamine allowed under their weight-based dosing (which was well over what Elijah weighed). Now, there’s other details (this IS a tldr), but after the ketamine, the patient goes into respiratory and cardiac arrest and is eventually declared. The paramedics involved were found guilty of negligent homicide. The FD has stood by their paramedics, saying that they followed their policies appropriately.

Let me lead with this: it seems to me that McClain’s case was a foreseeable (albeit low likelihood) and unfortunate outcome that was the cumulative result of many lesser individual poor choices on the part of both law enforcement and EMS. We lack the personal context to really appreciate those choices, I think, and we’re left to armchair quarterback those decisions with only the information available to us. I do believe that Mr. McClain should still be alive, and likely would be under different systems-level conditions, such as training and clearly defined interdepartmental operations protocols. Personally, I disagree with the conviction based off of my current understanding of the situation. My current understanding of the facts does not persuade me of the presence of gross, nevermind criminal, negligence on the part of the EMS crew. There absolutely is a conversation to be had here about PD leveraging field sedation and integrating field emergency care as a compliance and law enforcement tool as opposed to a healthcare response to a medical emergency. There’s another conversation to be had about systems-level choices that likely influenced this outcome. I think that just throwing these guys in jail fails to accomplish anything on those fronts, and, as such, is a false justice.

So, I’d like to ask you guys for your thoughts. Was it preventable? Was the conviction helpful? What can be done to prevent this in future, if anything, and what’s your take-away?