Medical Restraint causing death!!
“Paramedics Cooper and Cichuniec also face a second-degree assault with intent to cause bodily injury, one count of second-degree assault for recklessly causing bodily injury by means of a deadly weapon (ketamine) and one count of second-degree assault for a purpose other than lawful medical or therapeutic treatment for administering ketamine to McClain.” https://coag.gov/press-releases/9-1-21/
When do chemical restraints become illegal? This article is a brief look at the liability of medics that are involved in a medical take-down.
Issues relating to the police, deaths in police custody, methods of physical restraint and the culpability and liability of the police in general fall outside of the ambit of this article. Very often however, the police are the means of effecting physical restraint even in hospital or paramedic situations. When the police are involved in a medical take-down that goes wrong, they usually initiate their actions at the request of the doctor or department that has called them in for assistance. Once action starts, the Police if involved are responsible for physically restraining the person while the medics are responsible for administering the “deadly weapon” chemical restraint like ketamine.
“Paramedics Cooper, 46, and Cichuniec, 48, also each face a charge of second-degree assault with intent to cause bodily injury, a count of second-degree assault for recklessly causing bodily injury by means of a deadly weapon (ketamine) and one count of second-degree assault for a purpose other than lawful medical or therapeutic treatment for administering ketamine to McClain.
The two paramedics additionally face two counts of crime of violence for each of the assault charges.”
Paramedics and Emergency Department doctors are the usual clinicians that make decisions on medical take-downs. They however, are not the only clinicians that may find themselves in the position of being involved in a medical take-down or being the one calling for it. Psychiatrist and other doctors working in the mental health arena (including substance abuse and detoxification units) are also prone to requiring the authority they have to order a medical take-down and to be involved in such.
Nurses are often involuntary clinician participants in a take-down, sometimes required to assist in physical restraining and the application of some types restraints, as well as sometimes being the clinician injecting the deadly weapon into the person being restrained.
The anatomy of a take-down is complex. There usually has to be somebody with the necessary authority to be able to order a take-down. There is formed the first level of complexity of take-downs- Who is the responsible person for ordering a take-down when things go wrong?
There are many people involved in a takedown. Different locations mean different occupations and means being used in take-downs. Outside of the hospital setting it will usually involve the police, security guards, the general public, and or paramedics. In residential aged care facilities, it may involve security guards, nurses, doctors, paramedics, other staff members and even relatives and other bystanders. In hospitals, the emergency department is probably best suited for dealing with a take-down. Even though mental health units are au fait with dealing with violent and aggressive patients,they are usually woefully staffed,in adequately trained, and not safe to even attempt a medical take-down. Other hospital departments including theatres and ICU’s, are usually inadequately resourced for a safe medical take-down.
The complexities of responsibility, culpability and liability then coalesce into a broth of allegations, damages, and legal outfall that go on for years and sometimes decades. For the sake of brevity I will limit this article to hospital settings outside of the emergency department where an involuntary restraint situation may develop. I will use the article referred to, to define the various levels of responsibility and legal culpability that is associated with a takedown. This chain of responsibility is replicated in other take-down situations.
“McClain was walking to a convenience store to purchase tea the night of Aug. 24, 2019, when someone called 911 to report a suspicious person. The three Aurora police officers contacted McClain as he returned home.
When McClain refused to stop walking, the officers tackled him to the ground, handcuffed him and used a carotid chokehold to block the flow of blood to his brain. Officers ignored McClain’s pleas to leave him alone. Paramedics injected him with 500 mg of ketamine, a powerful sedative, before taking him to the hospital.
McClain suffered cardiac arrest on the way to the hospital, where he was later declared brain dead. He died Aug. 30, 2019, after being removed from life support.”
The first layers would be the Institutions or Authorized entities involved that are responsible for the situation. In the case at hand it was the Police Department that employed the Officers involved in what sounds like the gruesome subjugation of a black teenager in race mad America. The Paramedic service shares responsibility for its employees who participated, in what most ED doctors regularly ordering take-downs would say, was an overzealous usage of a large amount of ketamine and a reckless disregard for the safety principles of restraint. There will be a layer of responsibility for the persons in charge of the various departments like Directors, CEO’s and Managers to maintain a safe service and to ensure properly trained and experienced employees are employed. There will be a separate layer of responsibility for the person in charge of each department involved. In this case it would be the 3 man police team and the 2 man paramedic team pre-hospital. The hospital would inevitably become involved being the place where final treatment, continued illegal retraining and death eventually occurred.
Most advanced jurisdictions have criminal and civil sanctions available against health workers, hospital administrators, Hospital Board members and Directors, and they may be reported to multiple regulatory bodies in most States and Federations.
The practice of medicine is treacherous at times, and once the vortex of legal issues starts surrounding any death or takedown within an institution, whether it be physical or chemical, it can be all-consuming, career and soul destroying for the doctors, nurses or paramedics involved. It can also prove to very expensive to institutions especially if their medico-legal insurers decide that any actions were outside of their cover and refuse to indemnify for damages. Any death within an institution can precipitate a series of civil suits against the institution and its Board especially if there is an allegation of negligence or administrative or management ineptitude.
High risk positions must be clearly defined and understood. Individual responsibilities should also be understood and properly remunerated and indemnified.