DENVER — The union president for Aurora’s firefighters and paramedics says his members do not want to use a sedative that the Aurora Medical Center’s medical director has recommended for use by paramedics on agitated patients three years after Elijah McClain’s death.
Earlier this month, Dr. Eric Hill, the medical director for the Aurora Medical Center, told Aurora leadership that the drug droperidol would soon be added to paramedics’ tool kits for use.
It is a sedative that is used as a tranquilizer most commonly, which differs from the anesthetic ketamine. Hill said the drug is used by paramedics across the metro area, and medical experts whom Denver7 Investigates spoke with said the drug is safe when it is used in the appropriate context as a sedative.
The drug has a 2001 black box warning after some patients who were administered it suffered cardiac issues – but those cases mostly stemmed from instances in which patients were given higher doses than were commonly given, according to Dr. Chris Colwell, the chief of medicine at San Francisco General Hospital and the former medical director at Denver Health Medical Center.
“To not have the ability to appropriately sedate a patient when that is necessary, I think really does represent a risk to those patients and to providers, and, in some cases, to the public and others as well,” Colwell said.
In a statement Wednesday, Aurora Fire Rescue said adding droperidol to the kits would align the department with others in the metro area and with standards of care across the country, calling the drug “one of the best options … to care for some of our patients.”
“We were extremely thoughtful about adding a new sedative medication to our EMS Protocols. Department leaders have worked with the Consent Decree Monitor, their subject matter medical expert, their Community Advisory Council and local internal and external stakeholders to facilitate dialogue and create opportunities for education before adding this new medication,” the department said in a written statement.
But Travis Pulliam, the president of Aurora Fire Fighters Local 1290, which represents about 400 AFR firefighters and paramedics, said he and the union members he represents are concerned about the new drug being put into use while two paramedics still face manslaughter charges in McClain’s death, and says that the union was not consulted on the changes.
“It’s almost like déjà vu now. They’re rolling out a new sedative that they’re saying is safe. It’s safe to give, and this will be good for the public and for firefighters. And we still haven’t got through the first trial,” Pulliam said. “Our stance, too, is if they’re going to give us a sedative, we need some sort of protections for our membership for legal aspects.”
He said the union was not part of the decision=making process surrounding the new drug, and that his union members are now confused about when they should and shouldn’t be using it once it is put into use.
“We currently have a sedative in the drug box that’s been there for decades. And we just don’t necessarily understand why they’re in such a hurry to bring out another one,” Pulliam said. “There hasn’t been an incident since the ketamine has been taken away from us, so we don’t understand the urgency to bring back another one – especially rolling it out as fast as they are and without consulting the firefighters that are the ones that have to be administering it.”
McClain died after he was administered a dose of ketamine that was much higher than it should have been because of his weight and after officers put him into a carotid hold. He went into cardiac arrest and died days later.
The drug Pulliam is referring to paramedics already using in Aurora is midazolam, which is also a sedative, but which can also slow people’s breathing when combined with alcohol.
Hill told the city council earlier this month that droperidol has a “better safety profile” for patients, especially who might be intoxicated with alcohol
“It’s just saying that if you suspect someone is having an alcohol intoxication or the head injury patients, those patients do better, based on the best evidence we have in medicine, that they do better overall, which is why that is being implemented,” Hill said. “This is a widely used medication across the state of Colorado. Every Denver metro agency uses this approach as well.”
Hill told the council that he and other officials had been discussing using the new drug for more than a year and that individual trainings were done in May with firefighters and paramedics.
The use of droperidol would be monitored the same as other sedatives that are in use, Hill said. He reviews calls himself to be sure any medications are being used appropriately and according to protocol and being documented correctly, then submits the information to the consent decree monitor.
But Pulliam said he is not satisfied because the two former paramedics, Jeremy Cooper and Peter Cichuniec, still face charges after McClain’s death.
“We were told one thing that it’s safe, that, you know, other departments use it. They use it on a regular basis and there’s no problems with it until there is,” Pulliam said. “And then two of my members are standing trial for murder and several other charges, and just telling me that it’s a safe medication and other departments do it, that just doesn’t cover it for me.”
He says paramedics have been telling him they wonder if they will have to administer the drug if they are told to, and if they would get in trouble for not doing so.
“Our goal, and what we always say is, our No. 1 goal is to go home to our families. Well, if you’re given medications that put you on trial, you might not go home to your families for years if found guilty,” Pulliam said, adding that droperidol “raises the same concerns we had with ketamine.”
City Council member Danielle Jurinsky echoed some of Pulliam’s concerns that have been relayed to her.
“There’s a doctor somewhere at some point that said ketamine was safe to use, you know, so I empathize with these firefighters. I stand with these firefighters,” she said. “I made a bold statement, and I’m gonna make the statement again to the firefighters of Aurora: Don’t inject anyone. Don’t inject anyone with these sedatives and go home. Go home to your families. There are other ways that we could deal with this.”
A panel of medical experts found, in a report published by the Colorado Department of Public Health and Environment last December, that ketamine was safe to use outside of hospital settings if it is used properly, though it also found that other medications could have been used in certain instances to attain the needed effects without using ketamine, and that ketamine may have been disproportionately used on marginalized populations and communities of color.
Still, Pulliam said he would like to see the move to add droperidol paused and his union members consulted with more before it is put into use. He claims they had voiced their concerns but were ignored by Hill and other leaders.
“A lot of the members are scared. It’s, you know, it’s the unknown. We were always told we work under the medical director’s license. We have protection from that,” Pulliam said. “And, you know, once two of your fellow firefighters get arrested and arraigned for the stuff that they did, it scares a lot of the members. They’re afraid to act and they’re afraid not to act. So it just puts us in a really bad spot. And then to add another medication, another sedative, just puts us right back where we started.”
Aurora Fire Rescue said Wednesday it continues to welcome feedback as the rollout continues.
“We have processes in place to regularly review every use of a sedative medication in our EMS system,” the department said.