The final trial over the 2019 death of Elijah McClain is set to begin on Monday, and it is expected to delve into uncharted legal territory. This trial will focus on the actions of paramedics, rather than police officers, who are being prosecuted for administering an overdose of the powerful sedative ketamine to McClain after he was forcibly restrained by police. McClain went into cardiac arrest on his way to the hospital and was pronounced dead three days later.

The trial of the paramedics, Jeremy Cooper and Lt. Peter Cichuniec of the Aurora Fire Department, will be the first of several recent criminal charges against medical first responders to reach trial. This case could potentially "set the bar" for future cases involving medical first responders, according to Douglas Wolfberg, a former emergency medicine instructor and founding partner of a Pennsylvania law firm representing emergency medical services workers.

Initially, no one was charged in McClain's death because the coroner's office could not determine the exact cause of death. However, after the social justice protests in 2020 following the murder of George Floyd, McClain's case received renewed attention and an indictment was brought against the paramedics and three police officers involved in the incident.

The thinking about such cases has changed since George Floyd's murder, with political considerations now being taken into account. However, Wolfberg emphasized that this should not deny McClain's family the justice they are seeking.

Defense attorneys in the case have indicated that they plan to blame the police for McClain's death during the trial. The defense attorneys did not provide any comment on the charges their clients are facing.

The case against Cooper and Cichuniec includes charges of manslaughter, negligent homicide, and several counts of assault, all of which are felonies. Their role in McClain's death was a significant factor in the trials of the police officers involved. The defense attorneys for one of the acquitted officers brought in an expert witness who had been hired to work on the paramedics' case by state prosecutors. This witness, Dr. Nadia Iovettz-Tereshchenko, an emergency room doctor and former paramedic, testified that the paramedics' actions fell significantly below the expected level of care.

During the earlier trials of the police officers, prosecution experts testified that the ketamine ultimately caused McClain's death. The amended coroner's report in 2021 determined that McClain died because he was given too much ketamine, although the amount found in his blood was within the range considered safe. McClain's death occurred after he was stopped by police while walking home from a convenience store. The police stop quickly turned physical, with McClain being rendered briefly unconscious by a neck hold applied by an officer.

Cooper and Cichuniec's actions came under scrutiny as they stood near McClain and did not speak to him or conduct a thorough assessment before administering the ketamine injection. A report by experts hired by Aurora to review McClain's death found that he had not made any movements or sounds for over a minute before being injected.

Cichuniec, who was the supervisor of the paramedics' crew, asked medics from a private ambulance to prepare the ketamine injection for McClain. Cooper then administered 500 milligrams of ketamine, a dose appropriate for someone who weighed over 200 pounds, despite McClain weighing only 143 pounds.

The police officers' language during the incident also came under scrutiny, as it suggested McClain was experiencing excited delirium, a controversial condition that has been used to justify excessive force. Critics argue that the condition is unscientific and rooted in racism.

The city of Aurora reached a $15 million settlement with McClain's parents in 2021. The killings of McClain, George Floyd, and others led to legislation in over two dozen states, including Colorado, that placed limits on the use of neck holds by law enforcement. Colorado now also instructs paramedics not to administer ketamine to individuals suspected of having excited delirium.

The trial of Cooper and Cichuniec will undoubtedly be closely watched as it sets a precedent for future cases involving medical first responders. As society's thinking about these issues has evolved, the outcome of this trial will have significant implications not only for paramedics and first responders but also for the pursuit of justice in cases involving excessive force and medical negligence.