“Ketamine generally maintains normal pharyngeal and laryngeal reflexes and, therefore, permits spontaneous respiration. It slightly enhances or maintains normal skeletal muscle tone and is associated with cardiovascular and respiratory stimulation. These characteristics make it particularly useful in the emergency department setting for short-term procedures, especially as is often the case when a patient has not been “prepped” for an emergency procedure. Since there is no guarantee of maintenance of the pharyngeal and laryngeal reflexes, there can be no assumption that they will “protect” the airway. Additionally, there may be transient minimal respiratory depression if the medication is administered too rapidly or in too high a dose. Therefore, the physician must be ready to perform emergency intubation.” From the same article I linked earlier.
We can go back and forth all day, but ultimately they gave a medication that demanded a higher level of care than was provided and it was an appropriate sentence.