Nationwide, EMS personnel have taken to using ketamine, a controlled substance often used as a horse tranquilizer, on suspects as support for law enforcement during police calls. 

The use of ketamine during police calls gained national attention in 2020 when Elijah McClain – a massage therapist who sometimes played violin for stray cats – was killed in Aurora, Colorado when a paramedic injected him with ketamine after police had choked him out. He went into cardiac arrest on the way to the hospital and died a few days later. 

Although media attention to the issue has declined since McClain’s death, EMS departments across the country, including in Charleston, SC, have continued using ketamine as a go-to method of restraint in support of law enforcement, with many departments increasing their use of the drug rather than decreasing it. 

What is Ketamine? 

What is ketamine? 

Also known as Special K, Cat Valium, Kit Kat, K, Super Acid, Super K, Purple, Special La Coke, Jet, or Vitamin K, it is a powerful sedative that is often used for anesthesia. It is a controlled substance used by ravers and others as a “party drug.” It is sometimes used as a date rape drug by rapists. Therapists are exploring its potential to treat depression in patients. 

And paramedics are using it, without medical supervision or training in anesthesiology, to sedate suspects who resist arrest, who are agitated, or, sometimes, who simply disagree with police officers – resulting in injuries and deaths at the hands of EMS workers and police. 

How Does Ketamine Affect the Body?

The DEA describes ketamine as a “general, short-acting anesthetic with hallucinogenic effects. Sometimes used to facilitate sexual assault crimes.”

It can have various effects on different people including: 

  • Hallucinatory effects that last 30-60 minutes,
  • Distortion of sight and sounds, 
  • Feelings of calmness and relaxation,
  • Relief from pain, 
  • Immobility (paralysis),
  • Amnesia,
  • The person’s body feels out of control,
  • Agitation, 
  • Depression, 
  • Unconsciousness, 
  • Hallucinations, and 
  • Flashbacks. 

Although a trained anesthesiologist may be able to predict a patient’s reaction to the drug based on their medical history and other factors, EMS workers are using it differently in support of law enforcement – a predetermined dosage unit injected by non-physicians for non-medical use. 

Ketamine is Being Used by Police to Sedate Suspects

What’s wrong with using ketamine to sedate unruly suspects on a police call? Where do I begin? 

One thing that all uses of ketamine, legal and illegal, have in common is that the user consents to use the drug – except when 1) it is used for date rape or 2) it is used by police and EMS workers. 

When ketamine is used as an anesthetic or to treat depression, it is done by medical professionals who first study a patient’s medical history to determine 1) whether the drug is safe to use on the patient and 2) what the appropriate dose is based on factors like the patient’s age, height, weight, and medical history. 

EMS workers on a law enforcement call, on the other hand, know nothing about their “patient’s” medical history or other drugs they may have taken that could interact with a dose of ketamine. Rather, they use the drug as a convenient tool to subdue a suspect who is aggressive, non-compliant, or just complaining about law enforcement’s treatment of them. 

In this context, it’s not much different than hitting a suspect over the head to calm them down, using a “carotid hold” (choking the suspect), or injecting them with heroin. 

“Excited Delirium”

EMS workers and police use the term “excited delirium” to describe a “medical emergency” that they claim justifies injecting a person with ketamine, but, in many cases, the person is simply protesting the actions of law enforcement. 

To be clear, the American Medical Association (AMA) has said that “excited delirium” is not a medical diagnosis, and the AMA “opposes the use of ketamine and other sedative/hypnotic agents as a pharmacological intervention for agitated individuals in out-of-hospital settings to chemically restrain an individual solely for law enforcement.”

The term “excited delirium” has been disporporionately applied to people of color throughout our nation’s history, and “is a misappropriation of medical terminology, used by law enforcement to legitimize police brutality and to retroactively explain certain deaths occurring in police custody.”

Is Ketamine Use in Support of Law Enforcement Medical Malpractice? 

No, because the drug is not being prescribed for medical purposes. 

It is being used as a chemical restraint, often at the direction of law enforcement. When an EMS worker injects a suspect with ketamine during a police encounter, the ketamine is not being used for medical treatment, and its sole purpose is to sedate a suspect to make them more manageable for police officers. 

It’s not medical malpractice, but it is gross negligence and an intentional battery on the part of EMS and law enforcement. 

Ketamine Overdoses

A person can overdose on ketamine when it causes their heart rate to spike, “leading to cardiac damage and arrhythmias.” It can also cause blood pressure to spike, and it can cause strokes. These effects can be avoided if the doctor administering the drug finds the proper dosage unit based on the patient’s characteristics and medical history. 

It is also possible to “underdose” on ketamine – when a patient has a history of psychosis or schizophrenia it can cause increased anxiety levels and heart arrhythmia. This means that, for some people, no amount of ketamine is a safe dose. 

Yet, despite the growing number of deaths and injuries caused by its use, unqualified EMS workers continue to use the drug in support of law enforcement as a chemical restraint with no input from physicians or anesthesiologists and no medical history for the person they are injecting. 

Use of Ketamine by Police in Charleston, SC

Even before McClain’s high profile death, James Britt was killed in Mount Pleasant, SC when EMS workers injected him with “the maximum allowable amount” of ketamine – he stopped breathing a few minutes after objecting to EMS workers “giving him any medicine or doing anything to him.” 

Britt’s death was ruled a homicide by the Charleston County Coroner’s Office, which said the death was caused in part by “restraint asphyxia and the toxic effects of ketamine.”

Charleston, SC was the state’s biggest user of ketamine in recent years, administering the drug an average of 172 times in 2018 and 2019, although the drug’s use in Charleston decreased to 98 times in 2021. 

Greenville, SC is now the state’s top user of ketamine, administering the drug 206 times in 2021. 

Although the media has reported on some ketamine abuses by Charleston County police and EMS, no state agency tracks ketamine deaths or adverse reactions when it is used during police calls. 

A bill introduced last year would make it a misdemeanor offense for law enforcement or EMS to “inject ketamine into a criminal suspect as a means to incapacitate him,” but the bill is currently in committee and not likely to get a vote. 

Questions About Use of Ketamine as a Chemical Restraint? 

Ketamine is a dangerous drug, and its overuse as a chemical restraint by EMS and law enforcement may be grossly negligent, constitute the use of excessive force, constitute a violation of due process, may accompany wrongful arrest or malicious prosecution claims, and may give rise to claims under the SC State Tort Claims Act (SCSTCA) and 42 USC § 1983

The Charleston, SC civil rights attorneys at the Boles Law Firm can help you to determine liability, gather the evidence you will need in court, negotiate with the government, and recover the maximum compensation that you are entitled to under state or federal law for your injuries.

Call us at 843-576-5775 to schedule an appointment for a free consultation at our North Charleston or Walterboro offices or send us a message through our website.

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