In a lawsuit filed in July 2025, Jack Nastahowski, a Stamford resident, accuses Greenwich police and Emergency Medical Service personnel of causing serious health consequences after they forcibly injected him with ketamine during a May 28, 2023 incident. Nastahowski, who had been struck in the head earlier that evening and was visibly agitated, refused ambulance transport. The lawsuit alleges that emergency responders forcibly pinned him against an ambulance and injected approximately 400 mg of ketamine—a powerful sedative—against his will.

Per the complaint, this injection led to acute respiratory failure, the need for mechanical ventilation, aspiration pneumonia, and six days of hospitalization, including intensive care. Nastahowski suffered long-term physical, emotional, and psychological harm. The suit claims the responders overlooked pre-existing risk factors—namely severe sleep apnea, a related implant, and recent opiate ingestion—The plaintif’s attorney said the care was “below the standard of care” for pre-hospital settings”. and that “The defendants simply wanted to sedate the plaintiff so that the ‘incident’ would be over, the plaintiff would ‘shut up,’ and all defendants could move on with their evenings,” according to the lawsuit.

The plaintiff is now seeking damages in excess of $15,000, while the defense has requested time to investigate, with a response expected by September 15, 2025

Lessons Learned: Protocols and Patient Safety Must Come First
This lawsuit is a stark reminder of why protocols—especially in emergency medicine—exist. Here’s what went wrong and how we can uphold best practices:

1. Proper Assessment of Medical History
Emergency interventions must include evaluation of pre-existing conditions.

In this case, sleep apnea and implanted devices, plus recent opiate use, should have prompted caution or alternative strategies.

Deviation from thorough screening increases risk of severe adverse events.

2. Informed Consent and Patient Rights
The use of ketamine here was non-consensual—a “chemical restraint” under duress.

Even in rapidly evolving situations, ethical and legal boundaries are clear: involuntary sedation requires urgent medical justification and must align with both policy and law.

Responders must exhaust non-pharmacologic interventions and document clear rationale before administering sedatives against a patient’s will.

3. Appropriate Dosage According to Weight and Condition
Administering 400 mg of ketamine without tailoring to the patient’s size and health status opens significant risk.

Best practice requires weight-based dosing, and special caution for respiratory-compromised individuals.

4. De-escalation and Respectful Restraint Practices
The switch from advisory to physical restraint escalated tension and eliminated agency.

Protocols should favor verbal de-escalation, collaborative transport plans, and limiting physical force to what is strictly necessary and minimally invasive.

5. Documentation and Accountability
Detailed documentation of decisions, alternatives considered, and patient condition is essential.

Inadequate records can hinder later review, risk patient safety, and expose responders and agencies to liability.

For Patients and Providers: Tips to Safeguard Safety and Rights
Patients/Advocates Emergency Responders/EMS/Police
✅ Share known medical risks (e.g., sleep apnea, allergies) when possible.

✅ Always screen for pre-existing conditions and medications.

✅ Request clear explanations for urgent treatments.

✅ Document interventions, consent (or lack thereof), and patient response thoroughly.

✅ Ask about less-invasive alternatives before sedation.

✅ Prioritize verbal de-escalation and safe restraint techniques.

✅ Know your rights—forceful sedation must be justified medically and legally.

✅ Use weight-based dosing and adjust for special conditions.

✅ Review and adhere to protocols; continuous training on restraint ethics and chemical sedation is essential.

Closing Thoughts
Although this case is a rarity and not all of the information is available, this should be a cautionary tale. Emergency medical interventions are fraught with complexity. If first responders bypass vital protocols—whether through omission of medical history, failure to obtain consent, or administering inappropriate dosages—the consequences can be dire.

Following established protocols, ensuring respect for patient autonomy, and documenting each step calmly and thoroughly protects not only patients, but also the professionals who serve them. When the priority is doing what’s right for the patient—ethically, medically, and procedurally—the goal of care remains clear and justifiable.

This lawsuit reminds all stakeholders—paramedics, police, EMS directors, legal advisors, and patients—that adherence to professional standards isn’t optional—it’s lifesaving.

Hopefully we find out more information!

Stay Safe,

Scott