A Colorado paramedic was sentenced Friday to five years in prison for the death of Elijah McClain in a rare prosecution of medical responders that has left officials rethinking how they treat people in police custody.
The convictions of Peter Cichuniec and a fellow paramedic sent shock waves through the ranks of paramedics across the U.S. and thrust their profession into the acrimonious fight over social justice sparked by the 2020 murder of George Floyd by Minneapolis police.
Cichuniec and Jeremy Cooper were both convicted in December of criminally negligent homicide for administering the sedative ultimately blamed for killing McClain, a 23-year-old Black massage therapist, in 2019.
Cichuniec was also found guilty of the more serious charge of second-degree assault for giving a drug without consent or a legitimate medical purpose. Jurors concluded the assault caused serious bodily injury or death, which required that he be sentenced to at least five years in prison.
Firefighter union officials criticized the state's prosecution of Cichuniec and said it was discouraging firefighters from becoming paramedics, decreasing the number of qualified personnel in emergencies and thereby putting lives at risk.
Paramedics to be sentenced after conviction in McClain case
Elijah McClain died in 2019 from "complications of ketamine administration following forcible restraint,” according to an amended autopsy report.
McClain's death received little attention initially but gained renewed interest as mass protests swept the nation in 2020, with his name becoming a rallying cry for critics of racial injustice in policing.
McClain was stopped by police after a 911 caller reported he looked suspicious walking down the street waving his arms and wearing a face mask on Aug. 24, 2019, in the Denver suburb of Aurora. McClain, who had been listening to music with earbuds, seemed caught off guard when an officer put his hands on him within seconds of approaching him. That began a struggle including a neck hold and a restraint that lasted about 20 minutes before McClain was injected with 500 milligrams of ketamine. He suffered cardiac arrest on the way to the hospital and was taken off life support three days later.
Experts testified that the sedative ultimately killed McClain, who was already weakened from struggling to breathe while being pinned down after inhaling vomit into his lungs during the struggle with police.
The case highlighted gaps in medical procedures for sedations of people in police custody that experts said must be addressed so more deaths can be prevented.
The sole police officer convicted in McClain's death, Randy Roedema, was convicted of criminally negligent homicide. He was sentenced to 14 months in jail in January. Two other officers who were indicted were acquitted following weekslong jury trials.
Cooper, who is scheduled to be sentenced in April, faces a sentence that could range from probation to three years in prison.
McClain, a 23-year-old Black massage therapist, was forcibly detained by police in the Denver suburb of Aurora while walking home from a convenience store. After officers claimed McClain was resisting, the paramedics injected him with the sedative ketamine. He went into cardiac arrest on the way to the hospital and died three days later.
The conviction of the paramedics and one of the police officers brought a small measure of justice to the victim's family. Yet the case has also highlighted gaps in medical procedures that experts said must be addressed so more deaths can be prevented.
"We failed to realize just how dangerous the restraint and chemical sedation of these individuals can be," said Eric Jaeger, a paramedic and EMS educator in New Hampshire. "For better or worse the criminal convictions are focusing attention on the problem."
The response includes revisions to patient protocols aimed at elevating how seriously ketamine injections are treated — or avoiding them altogether when alternative drugs are more appropriate.
Some departments now require comprehensive patient assessments before and after ketamine injections. They've also cautioned against using ketamine on people being restrained by police in a prone position — which increases the chances for fatal complications by making it harder for patients to breathe — and stocked medicine kits with alternative sedatives. And they've reminded their paramedics not to defer to police when making medical decisions.
In the McClain case, "a lot of these basics were not done," said Peter Antevy, medical director for several Florida fire departments.
"Everyone kind of assumed people just do them. But more and more you’re seeing with the advent of body cameras that people aren’t doing these things," he said. "We need to put the basics in black and white."
The changes have come relatively swiftly within a profession in which it can take up to a decade for the latest medical research to filter down to paramedics on the front lines, Jaeger said. Nevertheless, since McClain's death, Jaeger has documented five similar cases involving patients dying after receiving ketamine, most recently a 29-year-old man in Baltimore last summer.
In Aurora, the paramedics' indictment is blamed by union officials for prompting some medical responders to scale back their duties.
The day after the verdicts, Aurora's fire chief temporarily suspended a requirement that firefighters also serve as paramedics, fearing the convictions would lead to a mass exodus of personnel.
So far about 10% of the department’s certified paramedics have taken a pay cut and are no longer working as paramedics, reverting to the role of emergency medical technicians, or EMTs, who cannot provide advanced lifesaving measures.
Fire Chief Alec Oughton said enough paramedics remain for every ladder truck and engine to have an assigned paramedic.
But the president of the International Association of Fire Fighters union said the convictions put lives at risk in the city because EMTs aren’t qualified to provide lifesaving drugs, such as for patients suffering heart attacks.
"The legacy of Attorney General Phil Weiser is there is going to be less paramedics to respond to people who need help,” said union president Edward Kelly, referring to the state attorney general tasked by Colorado's Democratic governor with reinvestigating McClain’s death in 2020 following protests over the killing of George Floyd.
No one was initially charged in McClain’s death, mostly because the first autopsy report could not conclude why he died. The autopsy was updated in 2021 — after Weiser convened a grand jury to examine the case — and it found McClain died because he was given ketamine after being restrained by police.
Kelly said ketamine did not kill McClain, noting the autopsy report's finding that the amount of the drug found in his system was at the low end of what is normally considered safe.
A 2021 study co-authored by Antevy examined 11,000 instances of patients receiving ketamine over a yearlong period. The drug was a possible contributor to just two deaths outside a hospital setting, the researchers concluded.
"Ketamine when used safely and correctly is a lifesaving medication," Antevy said.
Paramedic Peter Cichuniec — the senior medical responder on the scene during the altercation with McClain — faces a mandatory yearslong prison sentence during Friday's hearing before a state judge.
A jury in December found him guilty of criminally negligent homicide and felony second-degree assault — the most serious verdict handed down against any of the first responders indicted in the case. The assault conviction carries a sentence of between five and 16 years in prison.
Police had stopped McClain following a suspicious person complaint. After an officer said McClain reached for an officer’s gun — a claim disputed by prosecutors — another officer put him in a neck hold that rendered him temporarily unconscious. Officers also pinned down McClain before paramedic Jeremy Cooper injected him with ketamine. Cichuniec said it was his decision to use the drug.
Prosecutors said the paramedics did not conduct basic medical checks, such as taking McClain's pulse and monitoring his breathing before administering the ketamine. The dose was too much for someone of his size — 140 pounds, experts testified.
Defense attorneys for the paramedics said they followed their training in giving ketamine after diagnosing McClain with "excited delirium," a disputed condition some say is unscientific and has been used to justify excessive force.
