Both Aurora Fire paramedics on trial for the death of Elijah McClain took the stand in their defense during Monday’s hearing.
Peter Cichuniec and Jeremy Cooper are accused of administering the wrong dose of ketamine to McClain. Medical experts have testified that McClain was given a higher dose of ketamine than recommended for somebody his size. McClain was declared brain dead and died Aug. 30, 2019.
"This call was a little different because I saw three officers struggling more than the thousands of combative calls I've been on," Cichuniec said.
The prescribed dose of ketamine is 5mg per kilogram of body weight. By that recommendation and Cichuniec's estimation of McClain's weight, McClain would've gotten 425mg of ketamine. However, the paramedics gave him 500mg.
Cichuniec testified that AFR was instructed during ketamine training to administer 300mg for small patients, 400mg for medium-sized patients, and 500mg for large patients.
Slothouber pulled up the agency's protocol in front of the jury during his cross examination. The document only included the 5mg per kilogram dosing. However, Cichuniec said they were verbally told to use the 300, 400, 500mg outline during training.
During his redirect examination, Cichuniec's defense attorney asked if the witness had ever administered ketamine and if he was aware of the potential fatality involved with the wrong dosing. To which Cichuniec responded, "No. We were told numerous times this is a safe, effective drug... and it will not kill them."
Both Cichuniec and Cooper agreed McClain was suffering from excited delirium, according to Cichuniec's testimony Monday.
Under AFR protocol, when a paramedic determines a patient appears to be experiencing excited delirium, "the only treatment we can do is ketamine," Cichuniec testified.
"Excited delirium could kill you. If we don't work fast, he could die," Cichuniec said during redirect.
The AFR protocol instructed paramedics excited delirium patients " have a life-threatening medical emergency" with some or all of the symptoms listed in the training.
"Of theses symptoms, how many does the patient have to have?" Lowe asked his client.
"At least one," Cichuniec answered.
The prosecution has called into question how the paramedics could've known McClain was experiencing excited delirium when they appear to stand back when they first arrive on scene and don't ask McClain any questions.
"Back in 2019, we had no policy. Until [the patient comes] out of handcuffs, it's APD's scene. They're in control," Cichuniec testified.
During cross examination, the prosecution countered with the question, "How can you inject him with ketamine while he's in handcuffs" then?
Cichuniec's response was, "that's the medication he needs to be come our patient."
According to AFR, the next step to treat patients experiencing excited delirium is put on soft restraints, as opposed to hard restraints like handcuffs Aurora police were using.
AFR did not have soft restraints, ketamine or a stretcher on board the engine at that time, Cichuniec said.
They had to wait for an ambulance.
"The City of Aurora has no ambulances from our fire department, so we contract with FALCK Rocky Mountain," Cichuniec explained. "We needed our tools, and they weren't there."
The prosecution has drawn attention to Cichuniec leaving the scene several times through the course of the trial.
As the lieutenant on scene, Cichuniec said it was his responsibility to communicate with the ambulance.
Cichunied started in March of 2006 as an EMT and then became a paramedic in 2007, he testified Monday. Cichuniec then became a lieutenant for about five years before being promoted to a captain in 2020.
When Cichuniec's team arrived at the scene of McClain's arrest on Aug. 24, 2019, Cichuniec said, "I was the highest rank and made the decisions for the crew."
Cichuniec testified he walked up to see if Evergreen Street or Billings Street to the north were open to get the ambulance quickest access to McClain, given the amount of police cars parked right in front of the scene.
He said he kept walking back up the street, leaving McClain, to check on the ambulance. Cichuniec testified it seemed like it was taking a while for it to arrive.
By the time the ambulance arrived, Cichuniec said he told the paramedic on board the FALCK ambulance that he and Cooper had agreed to draw up 500mg of ketamine. Then, he and the EMT on board took the stretcher to the scene.
Cichuniec was dismissed from the witness stand, and the court took an early lunch break. The trial is expected to resume at 12:45 p.m.
After the lunch break, Cooper took the stand.
He testified that he followed the excited delirium protocol after observing McClain.
"With what I was observing, you know, kind of going down that agitated protocol," Cooper said. "And again, with what I was observing, and kind of the behavior of both Elijah and the officers, I was thinking this was more excited delirium than just an aggressive patient."
Cooper said he chose to leave McClain alone for a short time to de-escalate the situation. He claims he was concerned that getting involved right away would cause further harm to his patient.
"Just trying to make sure that he stays in a good position, to try to de-escalate things until [the ambulance] can get there," he said.
The 500 mg of ketamine administered to McClain was based on what Cooper estimated his weight to be, around 200 pounds, he testified in court. Prosecutors allege Cooper over-estimated the dosage.
"Collectively, we decided that was the excited delirium protocol and ketamine is the one drug of choice that we can use to help that," he said.
Prosecutors also challenged him on apparent discrepancies from his initial statement to police — made in September of 2020 — and what he testified to in court on Monday, such as McClain allegedly fighting and resisting the whole time, even on the gurney --- something Cooper said he misspoke on cross-examination.
Prosecutors also questioned why equipment that may have been beneficial in the treatment of McClain was left on the engine.
Court is expected to resume Tuesday.
