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At times, police and emergency medical personnel must deal with difficult, even combative suspects. Most citizens would agree that authorities should use reasonable strategies to get them under control — to protect both the suspects themselves and those around them.

But using a powerful tranquilizer to subdue already-restrained suspects — a practice described in a city of Minneapolis draft report — raises troubling questions and merits outside, independent review. According to a Star Tribune news story on the draft report ("Mpls. cops ordered suspects drugged," June 15), on multiple occasions and at times at the direction of Minneapolis police officers, Hennepin Healthcare EMS workers injected suspects with the sedative ketamine.

Some of the suspects subsequently suffered heart or breathing failure, and several had to be intubated after receiving the drug, according to the Office of Police Conduct Review, a division of the city's Department of Civil Rights. After reviewing video footage of officer interactions with suspects, the OPCR wrote the draft and shared it with city and police officials in May. The draft is not final and was not intended to be made public. However, a Star Tribune reporter obtained a copy.

Research into the drug, including some conducted by Hennepin Healthcare (formerly Hennepin County Medical Center), shows that ketamine can be effective when used to sedate and transport agitated or combative suspects to a hospital. Hennepin Healthcare has been a national leader in researching the drug.

Ketamine, also known as "Special K," is a common club drug, with side effects that include delirium, quickened heart rate and respiratory problems, especially in high doses. Minneapolis Police Department materials classify it as a "date rape" drug. The number of documented ketamine injections during Minneapolis police calls increased from three in 2012 to 62 last year, the report found.

In May, police officials issued a department order stating that officers "shall never suggest or demand EMS Personnel" use a sedative on a suspect, according to the report. That was an important step, but the public deserves more answers to the questions raised — including whether the drug was being used appropriately.

In a statement Thursday, Hennepin Healthcare chief ambulatory officer Kelly Spratt told the Star Tribune that the draft report contained inaccuracies, although he was not specific. He also said that the four specific cases mentioned in the report were "medically justified" and that ketamine has "fewer side effects than other drugs and can ultimately save lives."

In a brief meeting on Friday with the Star Tribune Editorial Board, Mayor Jacob Frey reiterated what he told the newspaper on Thursday: "Cops shouldn't direct medical professionals on health-related issues, and medical professionals shouldn't listen to them."

The Department of Civil Rights should complete a final report on its investigation and make it public as soon as possible. In addition, Frey should follow the lead of Hennepin County officials, who said Friday that they would ask a third party to review the cases described in the draft report.