Police calls in Nashville result in injections of amnesia inducing drug.

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http://www.wsmv.com/news/16844880/detail.html

I-Team: Injection Used To Subdue Prisoners
Medical Expert Says Practice Is Troubling
Reported By Demetria Kalodimos

POSTED: 1:07 pm CDT July 10, 2008
UPDATED: 3:18 pm CDT July 13, 2008


NASHVILLE, Tenn. -- While the Metro police had banned the use of Tasers for a time, they still used a controversial method to subdue unruly people, according to an I-Team report.

Related Links: Contact the I-Team | Watch Story: Part I | Scroll Below To Comment | Video: Part II 




The city's policy to use the method, which calls for the injection of a drug into a person, came as a "total surprise" to people most would expect to know all about it.

For almost two years, Metro police have had the option of calling for a needle loaded with a strong sedative to control the most unruly people they encounter on the street. 

One of the doctors who came up with the protocol said it's the safest option out there and that it is used all over the country.

But many people said that the injection was news to them, and a top medical ethicist said it's a troubling precedent.

The drug is called Midazolam, which is better known as Versed. People who have had a colonoscopy have probably had a shot of the drug for the procedure.

"The drug has an amnesia effect, and we use that therapeutically because one of the nice ways to take care of the discomfort is to make people forget that they've had it," said biomedical ethics and law enforcement expert Dr. Steven Miles.

But the shots have also been used on the streets on people police said were out of control.

One of the first to get the shot administered to them was Dameon Beasley.

"Well, that night, I hadn't been properly taking my meds, you know, like I'm supposed to. I got so depressed that when I was up on the bridge running into traffic back and forth, cars dodging me, swerving, I ended up with two sharp objects in my hands. By that time, the police had arrived. I was charging them with these sharp objects trying to make them shoot me, actually yelling at them to shoot me," he said.

When a Taser didn't work on Beasley, police turned to a brand new protocol -- an injection of Versed. Officers called emergency medical personnel for the injection.

"I remember they were holding me down. There was maybe four or five on each side, and I remember they were calling for something, you know. Some guy came up on the left side and hit me with it," he said.

"I do know that whatever it was works immediately. I mean, you ain't got a chance if you are 300 pounds. It's like a horse tranquilizer. I don't care. You're gone. It's a wrap," he said.

Beasley said he had no idea what happened after he was injected.

"I woke up -- I don't know how much time had passed -- with a sergeant standing over me telling me to sign here. I didn't know what I was signing Ms. (Channel 4 I-Team reporter Demetria) Kalodimos. I just signed a piece of paper and was immediately right back out," he said.

Kalodimos reported that Beasley ended up at Metro General Hospital and was then put in psychiatric care. He was not charged in the incident on the bridge.

But Beasley's lawyer, a public defender, had no idea that Versed had been used to subdue him until Kalodimos told him about it.

Very few people seem to know about the almost 2-year-old policy, Kalodimos said.

The state's largest mental health advocacy group, Nashville's mental health judge, the Nashville Rescue Mission, the American Civil Liberties Union all said they had no knowledge of the use of the drug by police.

"I've talked to my colleagues around the country, and none of the people from the south to the north to the east to the west have ever heard about this kind of program, this kind of use where they basically force an injection upon an individual knowing nothing about his or her medical condition," said ACLU Director Hedy Weinberg.

"I can't tell you why those individuals don't know about it," said Dr. Corey Slovis, Nashville's emergency medical director.

Along with medical examiner Dr. Bruce Levy, Slovis customized a Versed policy for Nashville that is endorsed by a group of emergency medical experts called the Eagles.

"It's something that in the medical community and in the EMS medical community is very common. It's a given. When I surveyed the major metropolitan areas around the country, I think only two cities were not actively using it," Slovis said.

Some have asked the question about potential problems.

Miles said he also had never heard of Versed being used in this way.

"There is no research guideline. There is no validated protocol for this. There's not even a clear set of indications for when this is to be used except when people are agitated. By saying that it's done by the emergency medical personnel, they basically are trying to have it both ways. That is, they're trying to use a medical protocol that is not validated, not for a police function, arrest and detention," Miles said.

"The decision to administer Versed is based purely on a paramedic decision, not a police decision," Slovis said.

It's up to the officer to call an ambulance and determine if a person is in a condition called excited delirium.

"I don't know if I would use the word diagnosing, but they are assessing the situation and saying, 'This person is not acting rationally. This is something I've been trained to recognize, this seems like excited delirium.' I don't view delirium in the field as a police function. It is a medical emergency. We're giving the drug Versed that's routinely used in thousands of health care settings across the country in the field by trained paramedics. I view what we're doing as the best possible medical practice to a medical emergency," Slovis said.

Metro Government would not release the names of the eight other people who got Versed injections after police calls. A representative from Metro said that the information was protected in the way a medical record would be.

The representative said that only one person out of the nine had shown no improvement after the injection.

Versed was most recently used on a female in early June.

Three women of child bearing age have apparently gotten shots without consent, even though the package insert for Versed suggests that, "the patient should be apprised of the potential hazard to the fetus."

"A single administration to calm a wildly delirious patient down even if she's pregnant is much safer to the woman and her unborn child than being allowed to be delirious, hypothermic, hyperventilating and perhaps hypoxic," Slovis said.

"I would think that with enough people being able to tackle the person to inject them, there should be another way to try to subdue someone without putting an injection in their vein," Weinberg said.

The biggest side effect that is seen in more than 80 percent of those who are injected with Versed is amnesia.

The side effect raises the question of a person being able to defend themselves in court if they can't remember what happened.

"If they would've said I'd done anything after that shot, hey, I couldn't have argued that fact. I don't remember," Beasley said.

Kalodimos reported that while doing research for this report, she found a post on a paramedics Internet chat site that said, "One good thing about Versed is that the patient won't remember how he got that footprint on his chest."

"We're very careful in Nashville," Slovis said. "Every instance of Versed use is reviewed by the both medical director, myself, our head of EMS quality assurance. We make sure that our paramedics treat patients right."

Miles said it would have been appropriate to put the idea of using Versed before what's called an Institutional Review Board for study to anticipate problems before they pop up.

"It may well be that a protocol could be designed to test the use of Versed in handling agitated persons at the time of detention. I'm not going to say that's not possible, but at any rate, you do it under a condition where you collect data rather than simply just going ahead and doing the drug and waiting to see if problems to develop," he said.

Miles added that, "Doing medicine by the seat of your pants is not the way to develop new therapies."

Slovis said the shots are given as a medical treatment, not a police function, even though ultimately they aid in an arrest.