Amid ketamine controversy, Hennepin Healthcare says state board will review cases

Promising accountability and more transparency, Hennepin Healthcare said the state's Emergency Medical Services Regulatory Board will examine cases involving Minneapolis police officers allegedly urging paramedics to sedate people with ketamine.

At a special meeting Friday, Hennepin Healthcare's board of directors said the state review and other community outreach would make the hospital's research processes more transparent and help rebuild trust with the public following weeks of controversy over the hospital's use of ketamine.

Dr. William Heegaard, chief medical officer for Hennepin Healthcare, told the board he started this process by meeting with African-American clergy members this week to discuss their concerns. The hospital has suspended its research on ketamine, and will halt other clinical trials that also use a "waiver of consent," meaning patients are automatically enrolled without their consent, and can only opt out later. The hospital is examining its 447 active studies to determine how many this will include, said Heegaard.

Hennepin Healthcare has also requested two independent examinations in the aftermath of the ketamine controversy, including one that will investigate cases in which police officers allegedly requested paramedics use the drug.

"If there are mistakes that we made, you've got my word as CEO that we're going to own up to it," said Dr. Jon Pryor, the top executive for Hennepin Healthcare. "We're going to find out what the root cause is, and we're going to make sure that we correct it and hold people accountable."

The meeting marked the latest response to a Minneapolis police oversight investigation that questioned whether paramedics, at the urging of police officers, inappropriately used the sedative while responding to calls involving agitated or intoxicated people. The Star Tribune obtained a draft copy of the report and published excerpts earlier in June. The city of Minneapolis has appointed former Acting U.S. Attorney General Sally Yates to investigate whether police officers acted inappropriately in these encounters.

Heegaard has repeatedly defended the hospital's actions and the research as medically justifiable and in line with federal standards. But he and other members of the hospital board acknowledged at the Friday meeting that they must do a better job in bringing transparency to their research.

"As we go through our review process, we know we will find opportunities for improvement," said Heegaard. "And honestly, if we don't, we're not looking hard enough."

Several board members raised questions about the safety of ketamine. Hennepin Healthcare's research in recent years has found ketamine can lead to a higher risk of medical complications than other sedatives, including one study that concluded that 57 percent of patients given the drug needed to be intubated afterward.

Heegaard said ketamine is one of three sedatives that Hennepin Healthcare paramedics carry, and its quick onset makes it more desirable in situations when time is of the essence in encountering severely agitated patients.

Hennepin County Commissioner Peter McLaughlin, who called the research "unconscionable and unethical" in a joint statement earlier this week, questioned whether the hospital was appropriately assessing the risk-benefit to the patient. "Just 'fast' — that is not the only variable that we ought to be looking at," he said.

McLaughlin also repeated concerns about the use of ketamine in situations that involve police, and how the public — particularly communities of color — have responded fearfully to reports about the ketamine drug trial.

Heegaard said he's heard these concerns in recent talks with the public. "People of color are wondering, is it convenience?" said Heegaard. "And I think that's a fair question."

"I think convenience is a polite way to put it," replied McLaughlin.

Hennepin Healthcare is also searching for a third party to examine how it can improve its research and clinical protocols, and is looking to other hospitals for ideas on transparency.

Andy Mannix • 612-673-4036