NewsElijah McClain | 360 In-Depth Coverage


Elijah McClain case: Coroner questioned on cause of death in amended autopsy report

Posted: 3:46 PM, Dec 05, 2023
Updated: 2023-12-06 10:38:23-05
Elijah McClain

Two paramedics are at the center of the third and final trial in the case of Elijah McClain's 2019 death, and both defendants face charges of reckless manslaughter, criminally negligent homicide and assault, plus sentence enhancers.

McClain, 23, was stopped by officers with the Aurora Police Department (APD) on Aug. 24, 2019 and following a violent encounter, died a few days later.

Aurora Fire Rescue paramedics Peter Cichuniec and Jeremy Cooper are accused of injecting a significant amount of ketamine into McClain. Medical experts have previously testified that he was given a higher dose of ketamine than recommended for somebody of his size. In previous trials, prosecutors said the carotid hold, which was applied by police before paramedics arrived, played a key role in his death, while defense attorneys argued that the cause of death was only the ketamine, and McClain would have survived the police encounter without the injection. The ketamine led to cardiac arrest. McClain was declared brain dead and died Aug. 30, 2019.

Trial for Elijah McClain could affect all health care workers

Previously, a jury found APD Officer Randy Roedema guilty of criminally negligent homicide and third-degree assault, and former APD Officer Jason Rosenblatt, who was fired by the department less than a year after McClain's death, was acquitted of all charges. In the second trial, defendant APD Officer Nathan Woodyard was also found not guilty.

The trial for Cichuniec and Cooper is expected to last about a month.

Scroll down to read updates from the Dec. 5 proceedings.

Tuesday, Dec. 5

Day 5 proceedings began with Aurora Police Sgt. Dale Leonard, who returned to the witness stand after testifying at the end of Monday.

Sgt. Leonard, a 20-year veteran with the force, was the acting supervisor at the scene where Elijah McClain encountered police and was questioned by defense attorneys as to his actions before and after Aurora Fire Rescue (AFR) Paramedics Peter Cichuniec and Jeremy Cooper arrived.

Sgt. Leonard, who later arrived after officers restrained McClain but before AFR came on scene described McClain’s demeanor stating that “early on” he was making sense but “spoke less as time wore on.”Asked by counsel if he requested former Aurora Police Officer Randy Roedema “to get off McClain” after he was “slammed” to the ground, Sgt. Leonard replied “I did not” and never asked the handcuffs to be removed to allow him to move because “he (McClain) just assaulted my officers, I wouldn't have done that.”Sgt. Leonard said he was told that McClain had reached for an officer’s gun.

When asked by defense if “you told fire that Elijah McClain was clearly on something” Leonard testified “I believed him to be so, yes.”

He also testified “correct” when asked if he was told McClain was exhibiting unusual strength in the struggle with officers and had no reason to not believe what officers were telling him.

Sgt. Leonard said he wasn’t aware of any conversation in which paramedic Cooper asked to have McClain’s handcuffs removed prior to him being placed on a gurney before being taken to the ambulance.

He said he believed McClain was suffering from excited delirium, was aware that the 23-year-old had vomited and passed that information along to the first responding Aurora Fire Rescue paramedic.

After redirect, witness Leonard was dismissed.

The People then called Michael Lamb, a forensic toxicologist at NMS Labs which performed analysis on Elijah McClain’s blood samples after his death.Lamb testified that NMS Labs testing of McClain's lab work revealed 1.4 nb/mL (nanograms per milliliter) of ketamine taken from a blood draw around 40 to 45 minutes from when the ketamine was injected by Aurora paramedics. He stated cannabinoids were also found in McClain’s system.

When asked if there’s any reason to believe marijuana would make ketamine more dangerous when administered, Lamb testified “not to my knowledge.”On cross-examination, Lamb was asked if the ketamine results in McClain’s blood were abnormally high; he replied “I don’t think so” and that the amount administered could be described as “a therapeutic dose” of ketamine.

Asked if he was aware of any fatalities associated with the level of ketamine given to McClain he testified “I’m not sure, there may be fatalities” and that there are many factors to consider in how the drug could interact with a person including “amount given to them, the way it was given, IV or another way, someone’s size,” among other factors.

Lamb testified in the prior McClain trials to NMS Labs’ procedures and what he found analyzing the blood work.

Lamb was dismissed from the witness stand and the court took its mid-morning break.

Court resumed with the people calling Dr. Steven Cina, a forensic pathologist who was contracted to perform autopsies with Adams County.Dr. Cina performed the autopsy on Elijah McClain and issued the final autopsy report in November 2019 and later released an amended autopsy report in 2021.“In my final report he died of complications of ketamine administration following forcible restraint,” Dr. Cina testified.Along with the autopsy and toxicology findings, Dr. Cina described other information he used to arrive at an opinion on McClain’s cause of death. “A combination of medical records, witness statements including police and people involved in this whole incident, and there was a lot of video tape, body cam footage I was able to eventually review,” he said.

Dr. Cina testified Mcclain’s brain showed signs of deprivation of oxygen “for a period of time” and that his lungs showed signs he “inhaled vomit” either before or after the administration of ketamine.

McClain’s first autopsy report, released on November 7, 2019, listed a cause of death as “undetermined” and Cina said he ruled out excited delirium, but noted one of McClain’s coronary arteries was smaller than normal. “It was about 1 to 2 millimeters in diameter, where normal I’d say for his size would be about 3 to 4,” Cina testified, adding he saw no evidence McClain had suffered a heart attack or heart disease.

Dr. Cina was asked by prosecutors to testify to which video footage he referenced in making his determination and to provide the jury insight into the first autopsy report.

“Initially I had requested all of the body cam footage, but wasn’t able to get that. Several months after his death we issued an initial report which said the cause and manner of death were undetermined because I like to have all of the information available before I say something conclusive,” he said. “Over the course of the next couple of years actually, more information came to light. I feel that I saw all the body camera footage and that enabled me to reach a final cause and manner of death.”Dr. Cina was asked by Anne Joyce, an assistant attorney general, to explain the difference between the first and amended autopsy report.

“I determined the cause and manner of death to be undetermined because I don’t think I had a full picture of what was going on. At that time I said intense physical exertion and a small coronary artery were contributory,” Cina began. “Since then, the investigation showed he was actually a distance runner and in good shape, so I don’t believe the coronary artery really played a factor. I believe he was born with just a small artery and had different capillaries serving that portion of the heart.”

After the initial report was released, Dr. Cina said he received additional body-worn camera footage that further informed his decision in the amended report. “Following his restraint, he was in a situation where he seemed pretty worn out, pretty exhausted, he was still kicking his feet to some degree and making some noises. When he had his sleeve pulled up to give the ketamine injection he reacted to that,” said Cina. “When he got the shot itself, he really didn’t flinch but within 2 minutes of getting the shot he went from that sort of worn out state to being on a stretcher where it looked like he was in severe respiratory distress.”

Cina described that McClain’s breathing was agonal and in minutes “he did go into respiratory arrest and cardiac arrest.”

Looking at the body-worn camera footage, Cina said he determined that ketamine was a factor following restraint.

“It was just too much for this person at that time. He just didn’t tolerate it well and he stopped breathing,” he testified.

In the initial report, Cina highlighted a contributing factor of intense physical assertion and narrow left coronary artery. “From the body footage I did have, there was evidence of intense physical exertion which can result in some degree of lactic acidosis or hypoxia, we don’t know how much lactic acidosis or how much hypoxia, but after a struggle or intense workout, it’s not unusual to have some lactic acidosis,” said Cina.

He further explained what the contributing factor means in relation to McClain’s cause of death.

“It’s not something that caused death in and of itself, but it contributed to death,” he said.He said after receiving more witness statements, body cam footage and medical records he was able to arrive at McClain’s cause of death months after the initial report.

On cross-examination, Cichuniec’s defense attorney questioned differences between the 2019 autopsy report showing undetermined cause and manner of death to the amended report in 2021.Dr. Cina was asked why in that earlier report, he didn’t address needing more footage. He testified “I thought I had all the info I was going to get” adding that the cover letter of the initial autopsy report stated “are what we know at this time and could be amended if more information shows up.”

Asked why In the many months between the first report and amended autopsy filing he hadn’t inquired further on the status of additional video footage, Dr. Cina testified “I wasn’t going to keep nagging.”

The court took its lunch break and Dr. Cina’s testimony was expected to resume during the afternoon.

After the lunch break, the defense for both Cooper and questioned Cichuniec questioned Dr. Cina about his the degree of confidence in his amended autopsy report and whether he could testify beyond "a reasonable degree of medical certainty" that his findings were accurate, to which Cina responded that he wouldn't publish a report he wasn't 100% confident in.

The defense also tried to argue that McClain's cause of death was "excited delirium," a controversial and widely rejected diagnosis characterized by agitation, aggression, acute distress and sudden death.

But Dr. Cina testified in court that everything he saw after being provided additional body-worn camera footage following McClain's first autopsy report ruled out such diagnosis as cocaine and other drugs often associated with the condition were not present in his system at the time of death.

The defense then moved on to McClain's toxicology report that found a high dosage of ketamine in his blood at the time of his death. During questioning, the defense tried to paint a picture that be not for the restraint by Aurora officers, McClain wouldn't have suffered a series of events that were made worse by the administration of ketamine that night.

Dr. Cina disagreed.

"For Mr. McClain, at that time, that level (of ketamine) was too much for him to handle. I believe the ketamine pushed him to cardiac arrest," he said, but added he could not guarantee that had the restraint not been in place at the time paramedics arrived, he would have survived.

Cina ended his testimony saying he believed the administration by paramedics that night contributed to the unarmed Black man's death.

The next witness called by the People to the stand was Ryan Walker, a firefighter and paramedic for Arvada Fire who at the time of McClain's arrest was a paramedic for Falck Ambulance, which contracts with Aurora Fire Rescue to respond to emergency calls.

Walker testified on matters of "medical control," which basically means that as Falck responds to calls of service, it is ultimately Aurora Fire Rescue paramedics who are in charge of decision-making once first responders arrive to the scene.

Asked to recall the events of the night, Walker testified that Aurora paramedics — among them Cooper and Cichuniec — told them "ketamine would be needed" to subdue McClain that night.

After several lines of questioning from both the defense and the People, Walker also testified he was worried that McClain had vomited while wearing a ski mask once he learned that information after arriving at the scene. When asked why, Walker responded that he was worried because "of the danger of aspiration" (inhaling fluids that could go to his lungs).

The witness was excused.

The next witness to testify Tuesday afternoon was Laverne Amir, a supervisor of APD's Crime Scene Unit. She testified on several duties of her department and what she observed and took photographs of during McClain's arrest, including McClain's jacket that night before she was excused after cross examination and redirect by the defense and prosecutors, respectively.

After Amir's testimony, the next witness to be called to the stand was Alicia Ward, an officer with the APD with over five years of service in the force.

Ward — who was not one of the first responders to arrive at the scene the night of McClain's deadly encounter with police — was asked about what she saw once other APD officers called for back-up to assist in the man's arrest.

Ward testified that she didn't see McClain struggle or be aggressive toward police officers once she got to the scene, but that she did see him move at different times as if trying to gain control from the restraint by officers at the scene.

When asked if McClain could talk, Ward only testified that she heard McClain making grunts or moaning sounds.

Court proceedings stopped for the day and the jury was asked to arrive by 8:30 a.m. Wednesday to continue listening to testimony.



Elijah McClain | Complete 360 In-Depth Coverage

1:10 PM, Sep 19, 2023

Denver7 in-depth coverage of Elijah McClain case