A bill seeking to limit the use of ketamine on Thursday moved one step closer to clearing the House after lawmakers gave it preliminary approval after tacking on amendments to narrow the scope of the legislation.

“We are looking to limit the use and when it is being used in a prehospital setting with law enforcement there, that we have the proper guardrails to ensure that a paramedic can do their job without undue influence and ensure the safe administration of ketamine, if it is in fact appropriate,” said Rep. Leslie Herod, D-Denver, who is the prime sponsor of House Bill 1251 along with Rep. Yadira Caraveo, D-Thornton.

The use of ketamine, a so-called chemical restraint, has been increasingly called into question in recent years after a Black man, Elijah McClain, died while in the custody of the Aurora Police Department in 2019.

McClain was stopped by police who had received a 911 report of suspicious behavior. He had been walking the few blocks home from a convenience store after buying iced tea for his brother. He was wearing a face mask and listening to headphones, which his friends told the Aurora Sentinel was likely why he did not immediately answer officers when they asked for him to stop.

Body-worn cameras show that police used a now-banned carotid choke hold on McClain during a struggle. Once inside the ambulance, he was given a dose of ketamine by Aurora Fire paramedics. He went into cardiac arrest on the ride to the hospital and was taken off of life support six days later.

McClain’s death was invoked a number of times as the House debated HB 1251, but the bill sponsors stressed his reaction to the ketamine injection was not an isolated incident. Herod highlighted data from the state Department of Public Health and Environment, the agency responsible for issuing waivers to paramedics to use ketamine, showing that of the 455 people injected with ketamine in the field, 109 experienced complications.

“If I had any kind of procedure that I was performing as a pediatrician where one in four of my patients were going to suffer a serious reaction and probably end up going to the hospital, I can guarantee you I would not be a pediatrician anymore,” added Caraveo, the legislature’s only medical doctor.

Much of the 3½ hours of debate on the bill on the House floor focused on amendments. Caraveo and Herod put forward measures they pitched as efforts to more narrowly tailor the bill while keeping the overall intent the same while Republicans, led by Rep. Terri Carver of Colorado Springs, made efforts to strip away aspects of the bill they found objectionable, with little success.

A bulk of the GOP objections centered around two provisions. The first, brought by amendment, sought to reinforce that the chemical restraint should not be given at the behest of law enforcement by changing the language in the bill to say officers “shall not use, request, direct or unduly influence the use of ketamine.”

Republicans said the term “unduly influence” was overly broad and worried it would lead to a breakdown in communication between emergency responders and police officers.

“We heard over and over again in testimony that you are going to chill the speech, interaction, information, discussion, going on between police officers and EMT on the scene when you have uncertainty,” Carver said.

Democrats countered the definition of that term, which they also added to the bill via amendment, came directly from Black’s Law Dictionary and was a standard legal term.

But the main objection from GOP lawmakers was directed toward the consequences of undue influence on a paramedic’s use of ketamine, which under the bill could result in criminal charges for the law enforcement officer for violating the state’s laws on use of force.

“I don’t think words should ever be considered excessive force,” said. Rep. Marc Catlin, R-Montrose. “If that were the case, there’ve been a number of days in this building where words were excessive force from both sides of the aisle, yet we don’t hold ourselves to that same standard.”

But Rep. Kerry Tipper, D-Lakewood, argued her GOP colleagues presented those arguments “in a vacuum” without considering the practical applications.

“We’ll ask the EMTs, ‘Were you unduly influenced? Did you feel like your independent professional judgment was overwritten by the power and authority of that police officer?’ ” she said. “And if that EMT says yes or no, that’s evidence that they were not unduly influenced.”

Herod closed by saying she was surprised by the direction the debate went in, “noting officers’ words do in fact matter.”

“If law enforcement asks you to do something, you are supposed to comply,” she said. “We’ve heard that time and time and time again. That’s not unless you’re a paramedic — that’s period.”

She added that “ketamine is being used as an excessive use of force in the field and if it is used inappropriately at the direction of law enforcement, there should be repercussions.”

Despite the GOP objections, the bill cleared consideration by the chamber and is now eligible for a final vote. Should it pass, the legislation would still need to work its way through the Senate, where it is being sponsored by Democratic Sens. Rhonda Fields of Aurora and Julie Gonzales of Denver.