Report: Medics Didn`t Examine McClain Before Giving Ketamine

The Denver Post

Aurora police and paramedics made substantial errors at nearly every stage of their interaction with Elijah McClain and the detectives tasked with investigating the incident that led to the 23-year-old's death stretched the truth to exonerate the officers involved, an independent investigation found.

Aurora police officers did not have a legal basis to force McClain to stop walking, to frisk him or to use a chokehold on him, according to the the investigation commissioned by the city released on Monday.

Paramedics with the city's fire department failed to properly evaluate McClain — or even attempt to speak to him — before injecting him with a powerful sedative.

And the detectives assigned to scrutinize what happened that night "failed to meaningfully investigate" the incident, the report states.

The report from the detectives was relied upon by the department's force review board as well as the 17th Judicial District Attorney's Office, both of which cleared the officers of wrongdoing.

"The body worn camera audio, limited video, and Major Crimes' interviews with the officers tell two contrasting stories," the independent report states. "The officers' statements on the scene and in subsequent recorded interviews suggest a violent and relentless struggle. The limited video, and the audio from the body worn cameras, reveal Mr. McClain surrounded by officers, all larger than he, crying out in pain, apologizing, explaining himself, and pleading with the officers."

"It is hard to imagine any other persons involved in a fatal incident being interviewed as these officers were," the report continues.

Aurora city officials on Monday morning released the 157-page report on the death of McClain at the hands of city police and paramedics. The city hired a panel of investigators to examine the officers' and paramedics' decisions and make policy recommendations "to lessen the chance of another tragedy like this one from happening again," the report states.

The results of the city-initiated investigation are the first to be made public out of several ongoing investigations into McClain's death. The Colorado Attorney General's Office has asked a grand jury to look at the case and see if any criminal charges are warranted and the U.S. Department of Justice is also investigating whether officers violated McClain's civil rights.

McClain's mother, Sheneen McClain, said she was happy the report conclusively stated her son did nothing wrong and cleared his name. She called for the officers and paramedics involved to be fired and criminally prosecuted, as she has since her son's death in August 2019.

"I'm happy Elijah is no longer labeled a suspect, that he is labeled a victim," said McClain, who has filed a federal lawsuit against the city.

Three Aurora police officers detained McClain on Aug. 24, 2019, after receiving a 911 call about a suspicious person. When McClain refused to stop walking, the officers took him to the ground, choked him and handcuffed him before a paramedic injected McClain with ketamine, a powerful sedative. McClain suffered cardiac arrest on the way to the hospital, where he later was declared brain dead. He was taken off life support on Aug. 30, 2019.

During a City Council meeting Monday night, Aurora Mayor Mike Coffman thanked the investigators and said McClain's death was horrific and "remains a wound" in the city.

"We cannot move forward as a city unless we understand the problems that we have," Coffman said.

No Basis for Stop

The officers' mistakes began almost immediately when they stopped McClain after a 911 report of a suspicious person. The officers — Jason Rosenblatt, Randy Roedema and Nathan Woodyard — did not have reasonable suspicion that McClain committed a crime and therefore they had no basis to force McClain to stop walking, the report states. They also did not have a legal basis to frisk him or to tackle him to the ground, where the officers twice used a carotid chokehold to block the flow of blood to the brain.

"The officers' use of force did not appear to relent even after Mr. McClain was in handcuffs, becoming progressively more ill and less responsive, and surrounded by a large group of officers," the report states.

The investigators also found that Aurora paramedics failed to properly examine McClain before injecting him with 500 milligrams of the sedative ketamine — a dose based on a "grossly inaccurate" estimation of McClain's weight. Paramedics estimated he weighed 190 pounds but he actually weighed closer to 140 pounds. The paramedics for minutes watched police hold McClain on the ground but did not attempt to speak to McClain before injecting him, the report states.

"Aurora Fire appears to have accepted the officers' impression that Mr. McClain had excited delirium without corroborating that impression through meaningful observation or diagnostic examination of Mr. McClain," the investigators wrote.

The initial investigation into the incident led by the department's detectives in the Major Crimes Unit was also deeply flawed, the investigators found. The detectives failed to ask basic, critical questions of the officers involved in McClain's death and instead "the questions frequently appeared designed to elicit specific exonerating 'magic language' found in court rulings," the report states.

"In addition, the report of the Major Crime Unit stretched the record to exonerate the officers rather than present a neutral version of the facts," the investigators wrote.

The police commander who oversaw the investigation, Marcus Dudley, has since left the department to become police chief in Abilene, Texas. The police chief at the time of the incident, Nick Metz, announced his retirement from the department two months after McClain's death.

The detectives' findings were the basis of the decision of Dave Young, then the district attorney for the 17th Judicial District, to find the officers' actions were legally justified. The prosecutor's review of the incident also concerned the investigators.

"The District Attorney's review failed to assess the conduct of the officers against well-established legal standards and did not reflect the rigor of a police investigation that one would expect of any other inquiry into whether a crime had been committed," the report states.

Recommendations from the panel of investigators include overhauling the police department's accountability system and reviewing policy, training and practice regarding arrest standards and use of force. The police department should require more de-escalation training and empower its internal affairs bureau to initiate investigations without the chief's approval.

Independent Probe

Aurora government leaders commissioned the investigation on July 20 as McClain's 2019 death drew international attention. Widespread protests of police brutality against Black people exploded in the summer of 2020 following the killing of George Floyd by Minneapolis police and dozens of protests and vigils have been held in McClain's name.

"The report notes that the failures of Aurora's own investigation were the engine of a culture of brutality and lack of accountability in the city's police department, and discusses the department's lengthy, well-documented history of racist brutality," Mari Newman, the attorney representing McClain's father, said Monday in a statement.

The investigators' report said exactly what Aurora residents and McClain's family have said and known over the past year-and-a-half, said Candice Bailey, a friend of Sheneen McClain, a member of the city's Community Police Task Force and a community organizer.

"It was a damn waste of money," she said.

The investigation included a review of the city's relevant policies, procedures and practices, including how police and fire personnel interact with people, their use of force, their use of the sedative ketamine and how the city reviews incidents. The investigators' request to interview the officers and paramedics involved was declined, however.

The investigation was led by Jonathan Smith, executive director of the Washington Lawyers' Committee for Civil Rights and Urban Affairs. Smith previously led the section of the U.S. Department of Justice's Civil Rights Division that conducted the investigation into the Ferguson, Missouri, police department following the death of Michael Brown. The other members of the team were Roberto Villaseñor, a former police chief and founding partner of policing consulting firm 21CP Solutions, and Dr. Melissa Costello, an emergency medicine physician and EMS medical director based in Mobile, Alabama.

A city spokesman said Aurora officials would not answer questions from the press until after a City Council meeting Monday night. A news conference with the city manager, police chief and fire chief is scheduled for Tuesday morning.

One of the officers involved in McClain's death, Rosenblatt, was later fired by the department's next chief for replying "haha" to a texted photo showing other Aurora police officers re-enacting one of the chokeholds used on McClain at his memorial site.

The other two officers remained employed by the department, though in jobs that are not public-facing. Roedema is assigned to the forensic services unit and Woodyard is assigned to the electronic support section, a department spokesman said.

Smith is the second person commissioned by the city to investigate McClain's death. City Manager Jim Twombly first hired a former police officer turned lawyer to complete the review, but the city canceled the contract after city councilmembers raised concerns that the lawyer's investigation would be biased by his past law enforcement experience.