At least 15 people died in Texas over a decade following a physical encounter with police during which medical personnel also injected them with a powerful sedative, an investigation led by The Associated Press has found.

Several of the fatal incidents occurred in Dallas and its nearby suburbs. Other cases were documented across the state, from Odessa to Austin to Galveston.

The deaths were among more than 1,000 that AP’s investigation documented across the United States of people who died after officers used, not their guns, but physical force or weapons such as Tasers that — like sedatives — are not meant to kill. Medical officials said police force caused or contributed to about half of all deaths.

It was impossible for the AP to determine the role injections may have played in many of the 94 deaths involving sedation that reporters found nationally during the investigation’s 2012-2021 timeframe. Few of those deaths were attributed to the sedation and authorities rarely investigated whether injections were appropriate, focusing more often on the use of force by police and the other drugs in people’s systems.

The idea behind the injections is to calm people who are combative, often because of drugs or a psychotic episode, so they can be transported to the hospital. Supporters say sedatives enable rapid treatment while protecting front-line responders from violence. Critics argue that the medications, given without consent, can be too risky to be administered during police encounters.

Texas was among the states with the most sedation cases, according to the investigation, which the AP did in collaboration with FRONTLINE (PBS) and the Howard Centers for Investigative Journalism.

The Texas cases involved the use of several different drugs intended to calm agitated people who were restrained by police. Most of them were administered by paramedics outside of hospitals.

Those included the two earliest deaths documented by AP that involved the use of ketamine — men who died in 2015 in Garland and Plano. A third case involving ketamine involved a man who died in Harris County in 2021.

The most common drug used in Texas during the incidents was midazolam, a sedative that is better known by its brand name Versed. Eight cases involved injections of the drug, including one in 2018 in which a paramedic rapidly gave two doses to a man who was restrained by officers in Bastrop.

AP’s investigation shows that the risks of sedation during behavioral emergencies go beyond any specific drug, said Eric Jaeger, an emergency medical services educator in New Hampshire who has studied the issue and advocates for additional safety measures and training.

“Now that we have better information, we know that it can present a significant danger regardless of the sedative agent used,” he said.

Sedatives were often given as treatments for “excited delirium,” an agitated condition linked to drug use or mental illness that medical groups have disavowed in recent years.