NewsElijah McClain | 360 In-Depth Coverage


Elijah McClain case: Jury hears insight from pulmonary critical care physician and forensic pathologist

Aurora Police Officer Nathan Woodyard is charged with reckless manslaughter and criminally negligent homicide in the death of McClain.
Posted: 1:18 PM, Oct 19, 2023
Updated: 2023-10-19 19:29:00-04
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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 Oct. 19 proceedings.

Thursday, October 19

Thursday morning began with the prosecution continuing its examination of Dr. David Beuther, a pulmonary critical care physician at National Jewish Health who took to the stand on Wednesday afternoon. He has been involved in the McClain case since 2021.

Ann Joyce, assistant attorney general with the Colorado General Attorney's Office, asked him questions. She started with inquiries about the X-rays of McClain's lungs taken at the hospital. Beuther said in one of the initial X-rays, McClain's whole right lung was full of fluid when it is supposed to be full of air. There are a lot of reasons that could happen, but it is highly suggestive of massive amounts of aspiration into the lungs, he testified. He added that he knew McClain had aspirated that day, and not beforehand, because McClain could not have walked around with a lung full of fluid.

The lung expert said he does not know how much of the aspiration happened when police initially encountered McClain compared to the struggle with police or the ambulance ride. But he said he does know that some aspiration happened early in the interaction with law enforcement officers because of McClain's mask and the obvious stomach contents in it.

Elijah McClain case: Pulmonary critical care physician testifies how McClain aspirated during police encounter

“He certainly aspirated at the very beginning of this episode while having the mask on," he said.

Beuther was shown a body-worn camera (BWC) video in which McClain was on his side, and was asked if McClain could have a clear airway in that position. Beuther responded that it was hard to say based on the video, but it looked like the man's breathing would have been moderately to severely impaired. He also noted that McClain did not move around much before the ketamine injection, which spoke to his lower level of consciousness and severe impairment to cough and clear his airway. Beuther said McClain might have had some fractional ability to clear his airway at that point, but after the injection, that ability dropped to zero.

In another X-ray photo shown in the courtroom, Beuther explained that there was not only whiteness in the right lung — indicating fluid — but also some in his left lung.

Part of Beuther's job includes filling out death certificates, which he did after McClain died. This included giving an opinion on the cause of death. He recalled that he listed the cause of death, to a reasonable degree of medical certainty, as a combination of several factors. The most severe factor was ketamine, which "knocked out his ability to breathe completely," Beuther said. But there was also the combination of events before the ketamine, including aspiration, decrease in oxygen level and mental status, his inability to cough and counter the aspiration, and his acidosis, he said. Lactic acidosis is caused when working muscles' need for oxygen outweighs what is available, resulting in lactic acid, and is most often cleared by stretching, deep breathing, relaxing the muscles and hydration.

In one word, Beuther said McClain's cause of death would be ketamine because it is likely that without that drug, he would have survived, Beuther said, though there was still a severe risk of hospitalization and possibly death without the ketamine.

“When your lung function is so severely compromised and you have other factors that make you more sensitive to it, the chances of you not surviving that ketamine dose are much higher," he explained.

During a cross-examination, defense attorney Megan Magdalena Downing, who is representing Woodyard, began by confirming this was the first criminal matter Beuther had testified in.

Beuther said McClain did not appear to have any trouble breathing as seen from the surveillance footage from the Shell station, where he bought iced teas before walking home and encountering police. He acknowledged that a video can only show so much, though.

When asked about medical reports, Beuther said that while they are only done in a hospital or clinical setting — and not at an active police scene — a big part of his job is to observe the patient and it can be helpful to see their condition before medical personnel can step in. He said he could tell from the BWC video that at times, McClain was breathing less than 10 times a minute and did not appear to be working hard to breathe. Beuther said this is something he can say with high confidence without having been at the scene to measure McClain's vitals.

Downing then asked some questions about Beuther's two medical reports for McClain — one from June 2021 and a supplementary one in May 2023. Beuther said the second report was done because he was able to see the mask, which he did not know was available to him in 2021, there was a revised death certificate, and there was more expert testimony he could include. However, he stressed that his opinion, and the physical evidence, had not changed in the second report.

Downing moved on to ask the doctor questions about three conditions officials have said McClain had prior to his death — lactic acidosis, hypoxia and aspiration. She also asked about testing for the three conditions. Beuther explained hypoxia can be tested for in various ways but there is no perfect test for it, there is no test for aspiration (though X-rays can support it), and lactic acidosis can be measured via blood test.

Downing asked if it was impossible to know the exact time McClain experienced aspiration. Beuther responded that he felt very confident it occurred early, when the mask was still on McClain's face, and that there were multiple subsequent episodes.

Downing confirmed that after the mask was removed from his face, including after the aspiration event into the mask, McClain is heard talking in full sentences to police in the BWC footage.

She asked about the recovery position McClain was put in, saying he was put on his left side, but most of the aspiration evidence was in his right lung. Beuther responded that what matters is the position he was in at the exact time of the aspiration.

When prompted, Beuther said the aspiration alone did not cause McClain to die. In addition, the officers' carotid holds — the first unsuccessful one and second successful one — did not kill him, as the autopsy found no damage to his neck. Had McClain received more immediate medical attention before the ketamine, he would have likely survived, the lung expert testified.

Beuther said the series of events increased the risk to McClain's health ahead of the injection, which made the drug "more deadly." The injection was about 1.7 to 1.8 times higher than what it should have been, he said, calling it "abnormally high." He testified that the drug is dangerous only when used on the wrong type of patient or situation and when adequate monitoring is not in place. It's a drug only given to patients who truly need it, he said.

Downing asked if McClain stopped breathing after the injection, and Beuther said yes.

Downing then began to discuss the ambulance ride to the hospital. During the transport, paramedics put a tube into McClain's throat and lung. Beuther said there is a little balloon that inflates to keep the tube in place and prevent further aspiration. A small internal camera showed that fluid was coming out of McClain's lungs when the tube was inserted, which is something Beuther called direct evidence of aspiration. When Downing asked if CPR was performed before the tube was inserted, the doctor said yes.

Beuther confirmed that after McClain got to the hospital, he underwent the X-rays. At this point, his heart had stopped pumping, which causes an effect on a person's ability to breathe, he said. Downing confirmed with him that this would result in fluid in his lungs.

Downing then rested.

In the redirect, prosecutor Joyce asked the doctor if he believed paramedics did not do what they should have done. Beuther said yes. The paramedics should have been alerted to the fact that McClain had shortness of breath, trouble breathing, had vomited, and had a deteriorating mental state, he said.

He also testified that if McClain had been healthy and given the same dose as ketamine that he was administered that night, he likely would have died.

In a round of quick questions, Joyce concluded by asking if Beuther would need a test to know if McClain had thrown up in his mask, said "I can't breathe" or said "Please help me." Beuther responded no.

The court broke for its lunch recess at noon.

Forensic pathologist provides insight into McClain's autopsy and reports

At 1:30 p.m. Thursday, the ninth witness for the people was called to testify. Dr. Steven Cina introduced himself as a contracted forensic pathologist for Adams County, meaning he does autopsies for the coroner.

He also testified in the prior trial on Oct. 3 for Roedema and Rosenblatt.

He explained that autopsy findings can be helpful in trials and his role is to explain medical terminology in a way that will help the jury, though he was clear to say that it was not his responsibility to find a defendant guilty or not guilty.

Cina said the information he received prior to his Sept. 3, 2019 autopsy of McClain was mostly from the officers' narrative.

“Deaths in custody are always high-profile, so I try to get all the information possible," he explained.

Cina said he requested any video from the scene that APD had, including related BWC footage. He said he ended up getting some video evidence in 2019, but received more before he amended his autopsy report in 2021. The second batch of video showed the ketamine injection, and McClain having agonal breathing and "actively dying," Cina said. He did not see that video in 2019.

The first autopsy report was released on Nov. 7, 2019 and McClain's cause of death was listed as "undetermined." In that report, Cina said he had ruled out excited delirium. He did note that McClain had a slightly smaller than normal coronary artery, which carries blood to the heart — something he was likely born with. This was only mentioned because there was no cause of death and he wanted this to stand out as a possibility.

He was able to use McClain's admission blood — which is the blood drawn from a patient when they initially get to a hospital — to examine as part of his report. Cina learned McClain had been using marijuana and had a therapeutic level of ketamine in his blood on the evening he died. His lungs showed evidence that he had aspirated vomit at some point, which was "relevant" to the case, and other evidence of asthma in the lungs, which was "potentially relevant," Cina said. But at the time, there was no "smoking gun," he said.

Looking at McClain's body during the 2019 autopsy, Cina counted 10 different facial abrasions, all of which were starting to scab. He also had abrasions on his wrist that were common if somebody was struggling against handcuffs or if a person was pulling on the arms of a handcuffed person, Cina said.

McClain's right lung weighed about 510 grams, when it should have been 300, and the left lung was 400 grams, when it should have been about 200, he said. When he looked at McClain's brain, he said it was deprived of oxygen long enough for neurons to start dying and the cerebellum had started to liquefy because it had received so little oxygen.

McClain was an organ donor, so his organs were removed and shipped to either recipients in need or to research facilities.

In 2021, Cina released an amended autopsy report, which is typically made when there is new information that could substantially change the cause or manner of death. The decision to amend McClain's autopsy came from both Cina and the Adams County coroner, but nobody else, Cina clarified.

“I believed it was the right thing to do now that I had a cause of death," he said.

In that second autopsy report, he listed the cause of death as "ketamine administration following forcible restraint." The smaller coronary artery became irrelevant at this time, he said, especially since McClain was an active runner. His other arteries were likely making up for that one, Cina said.

He explained that the restraint prior to the ketamine injection could have contributed to McClain's susceptibility to the drug, but he could not say for sure. Similarly, Cina could not connect the carotid hold to a possible nausea reaction which could cause vomiting and then aspiration. Because Cina could not determine without doubt that the circumstances before the ketamine injection led to McClain becoming more susceptible to the drug, Cina could not rule the manner of death as a homicide. It remains undetermined.

He also said an overdose would require about 20 times the amount of ketamine that McClain had in his system, though it appeared it was still too much for his biochemistry at the time. He confirmed McClain did not have a ketamine allergy.

Prosecutor Slothouber asked Cina about lactic acidosis, and the forensic pathologist explained if McClain had been handcuffed and intensely exerting himself, that could lead to the acidosis.

In a cross-examination led by defense attorney Downing, Cina said he has testified as a forensic pathologist between 350 and 400 times, typically for the prosecution.

He acknowledged that he disagreed with fellow forensic pathologist Dr. Roger Mitchell, who found McClain's manner of death to be a homicide, though he was not involved in the autopsy himself. Mitchell testified in the trial for Roedema and Rosenblatt on Oct. 5. While Cina said he believes police officers' actions could have caused McClain's death, Mitchell believed they had.

They also picked apart the exact phrasing of the listed manner of death: "ketamine administration following forcible restraint." Cina explained he was careful with his wording to say "following forcible restraint," and not "because of forcible restraint" or "in addition to forcible restraint."

When prompted, Cina explained that some people become nauseated after the carotid hold, which could have led to McClain vomiting. Had he inhaled and aspirated the vomit, the carotid hold could have contributed to hypoxia. And if that was the case, the ketamine may have had a stronger effect on him, given his condition. But Cina said he cannot prove that. What he was confident in is that the ketamine had killed McClain.

After a brief redirect, the judge said the court would be in recess until Friday morning.

Day 1 — Tuesday, Oct. 17
Day 2 - Wednesday, Oct. 18
Day 3 - Thursday, Oct. 19 (this story)


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