MPD Involvement in Pre-Hospital Sedation Office of Police Conduct - - PowerPoint PPT Presentation

CITY OF MINNEAPOLIS

MPD Involvement in Pre-Hospital Sedation

Office of Police Conduct Review Civil Rights Department

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July 26, 2018

PCOC

Police Conduct Oversite Committee

~ Public Appointed ~

MCO 172.80

Program Reviews

• Evictions and Calls for

Service

• Domestic Violence

Response Research and Study

• Mental Health and

Policing – Preliminary Study results Program Reviews/Audits

• MPD Involvement in

Pre-Hospital Sedation

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OPCR

Office of Police Conduct Review

~ MDCR Staff ~ MCO 172.90

Introduction

• Audit authority
• Purpose
• Greater implications

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Timeline

• Internal Audit’s Body Worn Camera Review
• OPCR Complaint
• Analysis Period [Winter, 2017 – Spring, 2018]
• Video analysis
• Police report review
• Policy research
• Draft Report
• Draft Report Dissemination
• Final Report

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Report Contents

• Ketamine
• Method
• Data
• Case Studies
• Recommendations

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Ketamine

• What is ketamine?
• Hennepin County conducted multiple studies
• Study findings

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Risk Assessment

• No corresponding MPD policy
• Officers are assisting in administration of sedatives

without formal guidance

• Officers participating in decision-making regarding pre-

hospital sedation

• Importance of controls
• Hennepin County ketamine policy
• Profound agitation

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Data Analysis

• Analysis Process
• Methodology created in advance
• Not intended to capture every instance in which a

sedative was administered

• Big picture of what is creating potential risk,

frequency of events, common trends

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Results

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2 3 8 6 14 35 62 10 20 30 40 50 60 70 2010 2011 2012 2013 2014 2015 2016 2017

MPD Reports Citing Ketamine Administration

Data Analysis

• Date, Time, Location
• Computer Aided Dispatch (CAD) Problem, Offense listed in report
• Whether body camera recordings captured the incident
• Whether the call was coded as emotionally disturbed person (EDP)
• Whether MPD discussed ketamine prior to the arrival of EMS
• Whether the decision to use ketamine was captured on video
• Whether MPD specifically called for ketamine
• Whether MPD assisted EMS when the ketamine injection occurred
• Whether the individual resisted either passively or actively
• Where the injection occurred (street, ambulance, hospital)
• Whether the individual was restrained and if so, how
• Whether the individual was a minor
• Whether the individual was reported to have used intoxicants prior to the injection
• Demographic information

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Results

• Observations from BWC recordings or reports from

2016-2018:

• 76 instances of officers assisting EMS professionals

during ketamine injection

• 8 instances in which officers were involved in decision-

making

• No instances of MPD officers administering ketamine

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Video Analysis

• Work of Video Analyst
• Locate and review BWC footage for MPD incidents to

assist in the investigation of police complaints and provide data for OPCR audit projects.

• BWC video provides important context to police

incidents that is not otherwise captured in standard police reports.

• Hundreds of hours of review were completed in order to

fully assess what was happening so recommendations could be made and what is happening could be understood.

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Case Studies

• Common Use Case
• An MPD incident which appeared to be exemplary of the

type of incident in which pre-hospital sedation would commonly be found.

• Exception Cases
• Four cases which appeared to be exceptions to the type
• f incident in which pre-hospital sedation would

commonly be found, and which raised questions about how and when it is being used, particularly from the perspective of MPD involvement in administration.

• Information vetted by City Clerk

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Common Use Case

• Individual is being restrained by private security when

MPD arrives.

• Individual is unable to verbally communicate beyond

screaming, “1, 2, 3!” repeatedly.

• Individual is physically resisting.
• MPD officers not involved in pre-hospital sedation

decision-making.

• Individual is sedated prior to being loaded onto a

stretcher.

• Once sedated, individual is placed into an ambulance

and transported to HCMC.

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Exception Case 1

• MPD responds to a call involving an emotionally

disturbed person.

• Individual is restrained by MPD officers and does

not physically resist.

• Officer is familiar with ketamine, and specifically

requests it to be used throughout the incident, and mentions the use of sedation to the individual several times.

• In this instance, EMS professionals do not sedate

the individual.

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Exception Case 2

• Individual appears to be intoxicated, requesting

medical attention, specifically an asthma inhaler.

• MPD officers restrain the individual, who does not

physically resist.

• MPD assists EMS professionals load the individual
• nto a stretcher.
• Once inside the ambulance, the individual is given

ketamine.

• MPD officers are not involved in decision making

regarding pre-hospital sedation

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Exception Case 2

• Per the corresponding police report, the individual

stops breathing and is taken to the HCMC STAB Room.

• After transport, an MPD officer discusses sedation

with an EMS professional who states that they are doing a study on agitation, and had to give the individual ketamine.

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Exception Case 3

• Individual has had numerous interactions with MPD.
• Individual is restrained prior to being injected with

ketamine.

• MPD officers are not involved in decision-making

regarding pre-hospital sedation.

• Individual verbally objects to being injected with

ketamine, but is ultimately injected.

• Body camera video ends before transport to HCMC. It is

unclear if the individual receives additional injection(s).

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Exception Case 4

• MPD and EMS professionals respond to an EDP call.
• The individual appears to be confused, possibly

intoxicated.

• The individual is handcuffed, and restrained in a

stairs chair to be taken from the residence.

• MPD participates in the decision-making regarding

pre-hospital sedation.

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Exception Case 4

• The individual is given three injections of ketamine.

An EMS professional states that the third injection is over the dosage for the individual’s size. However, a second EMS professional authorizes the third injection.

• MPD and EMS professionals discuss that they will

need to intubate the individual after the injection.

• Per the corresponding police report, the individual

stops breathing and their heart stops.

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Case Studies: Conclusion

• Analysis showed that Minneapolis Police Officers

are involved in pre-hospital sedation in a variety of ways.

• Lack of policy for officers leaves no controls or

guidance on the proper interaction with EMS professionals who are administering pre-hospital sedation.

• Case studies paired with data show the need for

recommendations to be made on controls.

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Recommendations

• MPD should create a policy covering appropriate

actions with EMS professionals and requirements for writing reports and reporting to a supervisor when assisting EMS professionals.

• COMPLETED: See MPD Policy 7-350 EMERGENCY

MEDICAL RESPONSE

• Officers should be provided guidance for its

implementation.

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Recommendations

• MPD should explore additions to the Policy and

Procedure Manual regarding interactions with emotionally disturbed persons.

• MPD should establish a protocol with Hennepin

County surrounding any potential future involvement in medical research.

• City leadership should explore options for

notification of medical research involving constituents and visitors.

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Recommendations

• City leadership should request answers to any

remaining questions about the use of ketamine

• utside the scope of this report.
• OPCR will establish document control processes to

prevent unauthorized disseminations.

• COMPLETED: See Appendix 6 OPCR Document Controls

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Closing Statement

• Receive and file report
• OPCR directed to publish report

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