CHARLESTON COUNTY, S.C. (WCSC) - The use of a powerful sedative by first responders has been questioned across the United States after a Colorado man died after being injected with it.
Elijah McClain died last year after paramedics in his hometown of Aurora administered ketamine, a drug that is increasingly being used by EMS departments in the Lowcountry.
“It’s an important tool for them,” Keith Borg, MD, PhD of the Medical University of South Carolina said.
“But like any tool, if not used properly, it could get you into a lot of trouble very quickly,” the MUSC doctor added.
Roughly a month after McClain’s death, James Britt, Jr. was injected with ketamine by Charleston County EMS outside Mount Pleasant’s Snee Farm community.
Lawyers for Mount Pleasant’s municipal government claim that the call to EMS and subsequent injection occurred after Britt allegedly caused minor injuries to both himself and an officer. They claim he was intoxicated near a disabled car.
Britt died about a week later. The Charleston County Coroner’s Office ruled his death a homicide, saying it was caused in part by “restraint asphyxia and the toxic effects of ketamine.” His family has since received a $3 million settlement from the Town of Mount Pleasant.
Britt was one of 515 people who were given ketamine by Charleston County paramedics over the past three years, though the Coroner’s Office said that Britt’s death was the only one that they have investigated over the last five years in which ketamine was a contributing factor.
Borg says that ketamine can be used by paramedics at a scene for several reasons, such as putting a breathing tube in, lessening an individual’s pain, or for sedating patients who are agitated or difficult to control, possibly because of mental illness or drug use.
“You’re standing there on the side of the road, or the bridge, or in their home in a very tense environment for EMS,” Dr. Borg said. “You’re making a very powerful decision to give them a very powerful drug for their safety, but also for yours. Transporting these patients is a threat to EMS and a threat to everybody. But it is one of the toughest decisions pre-hospital providers have to make.”
The South Carolina Department of Health and Environmental Control says ketamine was administered 467 times in the first six months of 2020 by paramedics across the state for a number of listed reasons, the most common of which was “psychiatric problem/abnormal behavior/suicide attempt.”
In the first half of 2020, ketamine was used by EMS in the Upstate’s Greenville County more times than anywhere else in the state, according to DHEC. The second highest usage was in Charleston County.
Charleston County declined a request for an interview regarding their use of ketamine, citing possible litigation.
Live 5 Investigates found that the use of ketamine by paramedics throughout South Carolina varies significantly. For instance, EMS departments in Georgetown, Richland, and Williamsburg counties do not administer ketamine at all.
“If I felt I didn’t have an appropriate training environment, if I didn’t have an appropriate staff that was comfortable and that I could use to do continuing education as well as review with, then it’s probably not something I would recommend them using,” Borg said.
Locally, there has been an uptick in ketamine administration by EMS agencies in Colleton, Berkeley, and Dorchester Counties.
Colleton County Fire-Rescue started carrying ketamine in late 2018 and administered it eight times that year. In response to a Freedom of Information Act request, the agency said it then used ketamine 10 times in 2019 and 18 times so far in 2020.
Berkeley County says their EMS department began using ketamine in 2017, administering the sedative four times that year, 60 times in 2018, 96 times in 2019, and 62 times between the beginning of 2020 and early October. The county acknowledged that there is controversy surrounding the use of ketamine, but said in response to questions that “we’re not aware of any concerns that have been substantiated clinically.”
A Dorchester County spokesperson said that the use of ketamine by EMS was authorized in July 2016 and that it was administered 13 times by the end of that year. Ketamine was then used 26 times in 2017, 30 times in 2018, 28 times in 2019, and 46 times between January and September 2020.
Back in Charleston County, the law firm representing the family of James Britt, Jr. says that he is greatly missed by his wife and son, calling his death “tragic and avoidable.”
“Jamie had his face pressed into the pavement, handcuffed behind his back, and in leg shackles when the paramedics injected him with a lethal amount of this dangerous tranquilizer drug,” the McLeod Law Group said in a statement to Live 5 Investigates. “As evidenced by this and the many other similar incidents across the country, there is no place for the use of ketamine in this kind of setting.”
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