FORT COLLINS, Colo. (AP) — A Colorado court reversed homicide convictions against two paramedics on Thursday in the 2019 death of Elijah McClain, a Black man who was pinned down by police and injected with a fatal dose of ketamine.

McClain’s final words — “I can’t breathe” — foreshadowed those of George Floyd a year later in Minneapolis, and the Colorado man’s name became part of the rallying cries for social justice that swept the U.S. in 2020.

The appeals court ordered new trials for Aurora Fire Rescue paramedics Jeremy Cooper and Peter Cichuniec. McClain, 23, had been forcibly restrained and put in a neck hold by police, who stopped him in response to a suspicious person complaint as the massage therapist walked home from a convenience store in the Denver suburb in 2019.

Criminal charges against paramedics and emergency medical technicians involved in police custody cases are rare. As McClain’s death and others raised questions about the use of ketamine to subdue struggling suspects, this prosecution sent shock waves through the ranks of first responders across the U.S.

A jury in 2023 found Cooper and Cichuniec guilty of criminally negligent homicide following a weekslong trial in state district court. The jurors also found Cichuniec guilty of second-degree felony assault.

Cooper avoided prison and was sentenced to 14 months in jail with work release and probation. Cichuniec received five years in prison.

The appeals court upheld Cichuniec’s assault conviction, but faulted the instructions given to jurors with respect to the criminally negligent homicide charges before they deliberated. Thursday’s ruling sends their cases back to a lower court for a new trial on that charge.

Cichuniec was released early from prison in 2024 after a judge reduced his sentence to four years of probation. That judge, Mark Warner, cited “unusual and extenuating circumstances,” a part of Colorado’s mandatory sentencing law that allows a court to modify a sentence after a defendant has served least 119 days in prison. Warner said that Cichuniec had to make a quick decision the night of the arrest as the highest-ranking paramedic at the scene.

The Associated Press left a voice mail seeking comment with the attorney for McClain’s mother, Sheneen McClain. Other requests for comment were left with the paramedics’ lawyers and their union.

The paramedics’ defense attorneys argued they followed their training in giving ketamine to McClain after deciding he had “excited delirium,” a disputed condition invoked to justify excessive force that some say is unscientific. They also said prosecutors did not prove the sedative is what killed him.

Paramedics in Aurora had been trained to use the drug for the condition in 2018. State officials have since told paramedics to stop using excited delirium as a basis for administering ketamine.

An activist who befriended Sheneen McClain after they met at a protest said the appellate ruling was disappointing, and “one of the most divisive judicial decisions our state has experienced in recent memory.”

“It strikes at the heart of a question that Colorado continues to struggle to answer: When a Black life is taken under circumstances that shock the conscience of the public, what does accountability truly mean?” said MiDian Shofner, CEO of the Epitome of Black Excellence and Partnership.

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Gruver reported from Fort Collins and Brown from Billings, Montana. Thomas Peipert contributed reporting from Denver.