Colorado’s public health department reopened its investigation into the use of ketamine on Elijah McClain after a torrent of requests prompted by international attention to McClain’s death in Aurora.

“The Colorado Department of Public Health and Environment received numerous complaints, beginning on June 24, that provided additional information regarding a ketamine administration in August 2019,” department spokesman Peter Myers said in an email. “The department launched a complaint investigation which is currently ongoing.”

The state department grants waivers to local first responders to use ketamine to treat extreme agitation in a non-hospital setting. About 90 fire departments and emergency medical service agencies in the state have such waivers.

The state previously reviewed the use of ketamine on McClain but didn’t find any reason to revoke the waiver granted to Aurora Fire Rescue.

McClain, 23, died Aug. 30 after he was violently arrested by Aurora police the week before. After McClain was handcuffed, paramedics injected him with ketamine in an attempt to sedate him and he suffered cardiac arrest during the ambulance ride to a nearby hospital. The Adams County coroner could not determine the cause or manner of McClain’s death and said the level of ketamine in his blood was at a therapeutic level, but that an unexpected adverse reaction to the drug couldn’t be ruled out.

An increasing number of Colorado emergency personnel are using the strong sedative in the field. Colorado guidelines for the use of the drug note that it has “significant potential for complications.”

Twenty percent of the 427 Colorado patients who were injected with ketamine for agitation between August 2017 and July 2018 were intubated in a hospital because they struggled to breathe, according to previous reporting by The Denver Post.

The health department’s new review is one of several initiated due to public pressure since McClain’s name became known across the world during widespread protests of police brutality. The Colorado Attorney General’s Office and the city of Aurora have opened new inquiries into McClain’s death, and federal law enforcement revealed in June that the FBI and the U.S. Department of Justice are also reviewing the case.

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