MINNEAPOLIS — The Minneapolis Police Department instructed officers to ignore a watchdog report published by the city's civil rights division in 2018 that found several cases of police inappropriately asking paramedics to sedate uncooperative people during emergency calls, according to court testimony from the police department's former training commander.
At the federal trial of three former Minneapolis officers Monday, a defense attorney asked Minneapolis Police Inspector Katie Blackwell about a PowerPoint slideshow on "excited delirium," a controversial diagnosis that usually refers to a person experiencing a potentially fatal state of agitation. The training slideshow cited a draft of a report by the Minneapolis Office of Police Conduct Review critical of police asking paramedics to sedate people. But a footnote on slideshow dismissed the findings as a "reckless use of anecdotes" that will "prevent the saving of lives."
"What you train these officers is this draft report is wrong and uninformed?" asked Robert Paule, attorney for former officer Tou Thao.
"Yes," replied Blackwell.
Blackwell said "one of our medical professionals" leads the training on excited delirium, but that she and former Chief Medaria Arradondo had reviewed and approved the slideshow.
Six days into the trial, the Police Department's past training on excited delirium has become a central point in the defense's argument.
Blackwell told jurors last week that former officers Thao, Thomas Lane and J. Alexander Kueng defied their training when they helped restrain George Floyd on May 25, 2020, and Thao and Kueng failed their duty to intervene when Floyd became unresponsive. But on cross-examination, Paule showed several slides on the department's excited delirium training, which included video and photo images of officers pinning down suspects with their knees, similar to how officer Derek Chauvin detained Floyd. Last week, Paule pointed out many of the symptoms Floyd exhibited that day matched training on excited delirium symptoms.
Excited delirium has become an increasingly controversial diagnosis in recent years, as some medical and human rights officials have questioned whether it's overused to justify deaths in police custody, sometimes involving the use of a Taser. The American Medical Association has publicly opposed the diagnosis.
In a statement Monday, Minneapolis police spokesman Garrett Parten said the training "no longer uses the term excited delirium" in accordance with the American Medical Association's statement last year.
"The most recent, fall 2021 training delivered to all Department members by the physician, did not include the term excited delirium," said Parten. "MPD training emphasizes identifying altered mental status as a potentially serious medical emergency and obtaining EMS assistance as soon as possible. The planning to provide updated training to all MPD officers without the use of the term began shortly after the AMA's adoption of the policy."
In 2019, Elijah McClain, a 23-year-old Black man, died after being injected with ketamine while handcuffed by police in Aurora, Colorado. The police officers who detained him said McClain was erratic and exhibiting superhuman strength, signs associated with excited delirium. Critics say the paramedics appeared to be acting on behalf of police, and not their patient. The city of Aurora subsequently paused the use of ketamine.
The quote attached to the training, undermining the sedative report, is not attributed. But it's identical to a statement previously issued by Dr. Jeffrey Ho, medical director of EMS at HCMC. Ho moonlights as a law enforcement officer and has written articles endorsing excited delirium with funding from Axon Enterprise, Inc., the Arizona-based Taser manufacturer. In 2019, Ho left his position doubling as Axon's medical director after public officials called the relationship a conflict of interest.
In 2018, Minneapolis elected officials hailed the Minneapolis Department of Civil Right's sedative report as an exceptional example of the city's police oversight commission monitoring problematic behavior and recommending policy changes.
"Whether we discover that our officers directly ordered or had a legally inappropriate role in administering ketamine, what I can tell you is this feels like a violation of the spirit of our community," said then Council Member Steve Fletcher, after the Star Tribune published a story on a draft version of the report. "What most of us feel is recoil."
The report found police officers asking for ketamine by name when they called paramedics to a scene, though city officials say it's inappropriate for law enforcement to diagnosis medical intervention or specific drugs. The police issued a departmental order saying that officers "shall never suggest or demand EMS Personnel 'sedate' a subject."
"This is a decision that needs to be clearly made by EMS Personnel, not MPD Officers," the memo said."
The draft report referenced in the training, like the final report, showed a surge in popularity of ketamine as an emergency sedative mentioned in Minneapolis police reports, with its use soaring from two incidents in 2010 to 62 in 2017, and recommended police create clearer protocols for officers dealing with emotionally disturbed people.
The report called out several instances of police talking casually or joking about ketamine use. In one, police responded to a call about a possibly suicidal individual. They found the person asleep at home and placed him or her in handcuffs, and then an officer made an injection motion and laughed before paramedics injected the person with ketamine, the report said.
In another incident from the report, police restrained a suspected jaywalker, who called the officers profane names. "The individual actively resists arrest and scratches one of the officers before being handcuffed, hobbled, fitted with a spit hood, strapped down to a stretcher and loaded into an ambulance," the report stated. One officer then punched the person in the face, and paramedics injected ketamine, despite the person's objections. Afterward, one officer referred to ketamine as "the good stuff."
In a different case, a man who had been sedated with two shots of ketamine became nonverbal, and an officer said "he just hit the K-hole," referring to the powerful effect of the drug. The report documented instances of people suffering serious medical complications after being injected with ketamine, and many were intubated afterward to help them breathe.
In response to community calls for an outside investigation, Mayor Jacob Frey hired former acting U.S. Attorney General Sally Yates to conduct a separate review of police and sedatives. But the Minneapolis City Council cut the contract short, calling it too expensive to finish and repetitive of the civil rights division's report.
Yates' report preliminary report found 10 instances in which officers showed "a high degree of familiarity" with the powerful sedative ketamine, many of them expecting that simply calling paramedics would result in a person being sedated. Officers then took a "concerning level of participation in conversations with EMS regarding" injecting people with ketamine during emergency calls.
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