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Elijah McClain case: Doctor testifies paramedics "deviated from the standard of care"

Dr. Nadia Iovettz Tereschenko testified paramedics cannot reasonably expect most police officers to identify medical issues, make medical decisions unless they hold dual role
Posted: 1:04 PM, Nov 02, 2023
Updated: 2023-11-02 20:19:24-04
Elijah McClain

Denver7 is following the second of three trials in the case of Elijah McClain, a 23-year-old unarmed Black man who died a few days after he was violently arrested by Aurora police on Aug. 24, 2019.

Aurora Police Department (APD) Officer Nathan Woodyard is charged with reckless manslaughter and criminally negligent homicide in the death of McClain. Previously, a jury found APD Officer Randy Roedema guilty of criminally negligent homicide and third-degree assault. Former APD Officer Jason Rosenblatt, who was fired by the department less than a year after McClain's death, was acquitted of all charges.

Jury finds one Aurora officer guilty, one not guilty in 1st Elijah McClain trial

Woodyard, who is currently suspended from the APD, is accused of putting McClain in a carotid hold that rendered him unconscious before paramedics arrived to administer ketamine, a powerful sedative. The 23-year-old massage therapist encountered police on Aug. 24, 2019 after a person called 911 to report a “sketchy” man walking in Aurora.

Officers with the Aurora Police Department (APD) responded and put McClain, who was unarmed and had not committed a crime, into a neck hold. Paramedics administered the ketamine, which officials said led to cardiac arrest on the way to the hospital.

He was declared brain dead days later and died Aug. 30, 2019. A pathologist found he was given a higher dose of ketamine than recommended for somebody of his size and, as a result, he overdosed. The City of Aurora settled a civil lawsuit with McClain’s family in November 2021 for $15 million.

Woodyard, along with two paramedics who have yet to face jury trials, have pleaded not guilty to the charges against them in January 2023 in the wake of a grand jury indictment.

Two Aurora Fire Rescue paramedics — Peter Cichuniec and Jeremy Cooper — have trials beginning Nov. 17 and 27, respectively, for charges of reckless manslaughter, criminally negligent homicide and assault, plus sentence enhancers. The paramedics are accused of injecting a significant amount of ketamine into McClain, causing him to overdose.

Scroll down to read updates from the Nov. 2 proceedings.

Thursday, Nov. 2

After Woodyard's testimony Wednesday, his defense team brought Dr. Nadia Iovettz Tereschenko to the stand as an expert witness Thursday in paramedic roles, protocols, trainings and pre-hospital care.

Dr. Tereschenko used to be a paramedic herself and now works in emergency medicine at hospitals across the country.

She testified Thursday that her career experience includes a corporate position for Medcore, a company that staffs clinics at various employers. In that role, she acted as a medical director who decides protocols for other medical practitioners she oversaw, such as paramedics- a standard chain of command nationally, according ot Tereschneko.

"They can't just choose anything they carry on their ambulance or firetruck," Dr. Tereschenko testified.

They must develop a "working diagnosis" for the patient under the protocols set up by their medical director. Andrew Ho with the defense asked Dr. Tereschenko in her experience, if paramedics on the scene can disregard their guiding protocols on command from police officers on a scene. To which, she replied "no."

Ho asked Dr. Tereschenko to break down the difference between paramedics and law enforcement's role on the scene of an emergency in her experience. Police generally provide safety for the scene while firefighters and paramedics provide medical care, according to Dr. Tereschenko.

The Aurora Fire Department or paramedics can not reasonably expect a police officer to make medical decisions, Dr. Tereschenko confirmed when questioned by Ho. Unless someone in law enforcement holds a dual role as both a police officer and a paramedic, paramedics cannot reasonably expect most police officers to identify medical issues or make medical decisions.

Dr. Tereschenko explained that in preparation for her testimony, she reviewed the medical records in the Elijah McClain case, in addition to Aurora Fire Department and Falck paramedic training protocols. In her own experience and based on that material, she said paramedics are supposed to arrive at a scene and conduct a primary and secondary assessment of the patient. Those assessments include a physical examination of the patient and using a heart monitor and pulse oximeter to gather information about the patient's status. She said she did not observe a full assessment in the body-worn camera video from the officers on scene of McClain's arrest.

In Dr. Tereschneko's evaluation of the body-worn camera video, she said the paramedic care fell "significantly below" a reasonable standard of care.

In the officers' body-worn camera video, they can be heard giving the paramedics information about what happened with McClain prior to their arrival. Ho pointed to that moment and asked Dr. Tereschenko, if in her experience, that would supersede a paramedic's decisions. She replied, "No."

The defense broke for lunch and were scheduled to return at 1:30 p.m. Thursday.


After the lunch break, the defense continued questioning Dr. Tereschneko about the body-worn camera clips shown before jurors Thursday, in particular a clip which showed fluid coming from McClain's nose and mouth.

"Is that something that would raise red flags," Ho asked the doctor.

"Yes. The fluid is flowing from his nose and mouth," the doctor responded. "That shows he's not able to protect his airway, so it's up to others at the scene help clear his airways."

The doctor testified the fluid was concerning because McClain didn't seem to be reacting to it in any way, meaning he wasn't coughing, gargling or vomiting the fluid as the body does reflexively to clear someone's airway.

"Any prudent paramedic would say, 'that's not normal, we need to do something about it,'" Dr. Tereschenko said, adding someone trained in first response would have seen McClain's condition and reassess the situation to prevent any more fluid from getting back into his lungs.

When asked with respect to the failure to respond to McClain's worsening condition, Dr. Tereschenko testified that they "did not follow the standard of care," adding the paramedics did not provide the same care as would be expected by a prudent provider under similar patient circumstances.

When asked if ketamine was appropriate at the time of McClain's arrest, Dr. Tereschenko replied that "ketamine was not appropriate for McClain at the time."

The defense then rested their case and the judge released the jury for the day before letting them know he would expect them in court at 8:30 a.m. Friday before jury instructions were delivered.

Day 1 — Tuesday, Oct. 17
Day 2 - Wednesday, Oct. 18
Day 3 - Thursday, Oct. 19
Day 4 - Friday, Oct. 20
(No court on Monday, Oct. 23)
Day 5 - Tuesday, Oct. 24
Day 6 - Wednesday, Oct. 25
(No court on Thursday, Oct. 26)
Day 7 - Friday, Oct. 27
(No court on Monday, Oct. 30)
Day 8 - Tuesday, Oct. 31
Day 9 - Wednesday, Nov. 1


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