Minneapolis police should create protocols for officers dealing with emotionally disturbed people, receive training on how to work with emergency responders and establish rules for their involvement in clinical research, according to recommendations presented Thursday by city police oversight staff.

Six weeks after the Star Tribune obtained and reported on a draft study focused on the use of ketamine during emergency calls, the Office of Police Conduct Review released the final version to the public and presented its findings to City Council members.

Similar to the draft, the report details several occasions where Minneapolis police officers urged paramedics to sedate people with ketamine, and in some cases held the person down during the injection.

The popularity of ketamine as an emergency sedative was revealed in police reports, its use soaring from two incidents in 2010 to 62 last year, according to the report.

Of these cases, 40 percent of the people were black, 39 percent white and 10 percent American Indian, according to the report. Seventy-two percent were men, and the most common age groups were 18-24 and 24-34 years old.

At Thursday's meeting of the council's Public Safety and Emergency Management Committee, Imani Jaafar, Minneapolis' director of police conduct review, commended the department for issuing a memo in May instructing officers to not suggest medical treatment to paramedics.

The report called for further changes. Two of the seven recommendations addressed the role of police officers in clinical research, such as the city's responsibility to inform the public and visitors that an encounter with police and paramedics could draw them into emergency medicine studies.

Following the Star Tribune's report on the unpublished draft, City Council members directed the city's Department of Civil Rights in a mid-June meeting to complete and present the report on Thursday.

At the time, city officials, including Minneapolis Police Chief Medaria Arradondo, said the draft contained inaccuracies, and he called its unauthorized publication "irresponsible." The report released Thursday included fewer details but highlighted most of the same issues as the draft.

In response, the Office of Police Conduct Review will take steps to prevent draft reports from being disseminated, Jaafar said.

In response to June reports about the draft study, the council asked for an independent review of the report, and Minneapolis Mayor Jacob Frey hired former Acting U.S. Attorney General Sally Yates to perform a separate investigation.

The police oversight investigation focused on incidents where police and paramedics both responded to emergency calls, and whether Minneapolis officers urged paramedics to sedate people. The report cited four examples in which officers appeared to deviate from protocol and in some cases asked for ketamine by name or requested paramedics bring it to the scene.

In one case, police responded to a call about a possibly suicidal individual. They found the person asleep at home and placed him or her in handcuffs, and then an officer made an injection motion and laughed before paramedics injected the person with ketamine, the report said.

In another incident from the report, police restrained a suspected jaywalker, who called the officers profane names. "The individual actively resists arrest and scratches one of the officers before being handcuffed, hobbled, fitted with a spit hood, strapped down to a stretcher and loaded into an ambulance," the report stated. One officer then punched the person in the face, and paramedics injected ketamine, despite the person's objections. Afterward, one officer referred to ketamine as "the good stuff."

In a different case, a man who had been sedated with two shots of ketamine became nonverbal, and an officer said "he just hit the K-hole," referring to the powerful effect of the drug. The report documented instances of people suffering serious medical complications after being injected with ketamine, and many were intubated afterward to help them breathe.

Some people were enrolled in a Hennepin Healthcare clinical study that compared the effectiveness of ketamine and midazolam, another sedative, in emergency situations. The report documented one case of a paramedic talking about the study to an officer. The report questioned "whether a medical study involving the injection of a sedative was being conducted in Minneapolis on Minneapolis residents with the assistance of city of Minneapolis employees and whether policy­makers knew of the study."

Jaafar told council members Thursday her office asked whether Minneapolis officials knew about the study, and it appeared no one did.

Hennepin Healthcare has suspended its ketamine study and other research amid ethical criticisms over its "waiver of consent" practice, meaning it does not require prior consent from enrolled patients. Dr. William Heegaard, chief medical officer for the hospital, said the research is in line with federal regulations and ethical protocols. He said he's reviewed the cases and believes paramedics acted appropriately. Still, the hospital has asked for an outside examination and has pledged to create more transparency around future clinical research.

On Wednesday, the consumer rights nonprofit Public Citizen submitted a complaint to the Food and Drug Administration and Office for Human Research Protections, claiming the hospital put patients at unnecessary risk during two ketamine trials. The group asked the federal agencies to launch investigations into the hospital and patient safety board that approved the studies.

At Thursday's meeting, Council Member Steve Fletcher suggested that the city join the Public Citizen complaint.

Andy Mannix • 612-673-4036