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Nurse takes patients pain-killers

By junkbox, Feb 11, 2011 | Updated: Feb 11, 2011 | | |
  1. junkbox
    Sarah Casareto allegedly shot up painkiller meant for a patient in surgery and told the suffering man to "go to your beach...go to your happy place."

    The patient screamed and writhed in agony during surgery at a Minneapolis hospital. Nurse Sarah May Casareto allegedly told him to go to his "happy place" and to "man up" because she couldn't give him more medication.

    Casareto had already shot herself up with some of the fentanyl she checked out for the patient, according to charges filed Wednesday.

    Registered nurse Casareto, 33, of Forest Lake, is charged in Hennepin County District Court with theft of a controlled substance, a felony. The alleged theft occurred Nov. 8 at Abbott Northwestern Hospital, in connection with a patient's surgery for kidney stones.

    The charges say the patient got only 150 of the 500 micrograms of fentanyl reserved for his surgery. The patient, identified in the complaint only as L.V.K., told police the pain felt like "very long needles going through my skin and down into my kidneys," He said hospital staff had to hold him down to finish the procedure.

    Staff later told police that they were suspicious of Casareto during the operation because it was unusual for a patient to experience so much pain, and Casareto acted intoxicated, stopped attending her patient and even fell asleep.

    Confronted, she resigned rather than comply with the hospital's order to take a drug test, but she later admitted to police that she's dependent on pain medication, according to the criminal complaint. County Attorney Mike Freeman said the investigation isn't over, but he declined to say whether authorities believe other patients may have been victimized.

    Casareto did not respond to messages left at her home seeking comment.

    Patient went to police

    The kidney-stone patient reported his ordeal to police Dec. 4, prompting an investigation. It's unclear whether the hospital independently reported the episode. Freeman said the hospital had contact with authorities, but he declined to say when.

    Told of the allegations against Casareto, hospital spokeswoman Gloria O'Connell said: "It doesn't sound like something that we would want to happen to one of our patients. This isn't the kind of behavior we would want in our hospital."

    She declined to comment on when the hospital reported the problem or to whom.

    "Whenever there is a suspicious situation, we look into it," O'Connell said. "We investigate. We have procedures to protect patients." She added that Abbott has "safeguards in place" to guard against employee theft of drugs.

    Hospital officials also declined to discuss why doctors and nurses would continue operating on a patient who appears to be in extreme pain.

    David Kanihan, a spokesman for Abbott's parent organization, Allina Hospitals and Clinics, said that in general, "the decision to stop a procedure would rest with the physician and the care team involved in the procedure. I can't address how a decision was made in any specific case."

    'Go to your beach'

    According to the complaint, the patient said his doctor told him he would not feel pain during the procedure, which involved inserting a tube through his back and into one of his kidneys. The patient said that before the surgery, Casareto told him: "You're gonna have to man up here and take some of the pain because we can't give you a lot of medication."

    A technician who assisted in the surgery later told police that when the patient screamed and moaned, Casareto advised him to "go to your beach ... go to your happy place."

    The doctor and other staff told police that Casareto slurred her words and seemed unsteady. Later, they found she had empty syringes with labels peeled off, a violation of hospital policy, in the pockets of her scrubs.

    Freeman said that if Casareto is convicted, prosecutors will ask for prison time rather than the probation called for by sentencing guidelines.

    "Obviously she has a severe addiction to pain medication, for which we can empathize," Freeman said. "But you can't empathize with stealing from a patient who needs the medication." He said Casareto is "not nursing now, and no medical group is ever going to let her get near them without a whole lot of rehab."

    Fentanyl is an opium-based medication used almost exclusively by hospitals for anesthesia because it is powerful and fast-acting. It's considered 80 times stronger than morphine and highly addictive.

    Casareto has been licensed as a nurse in Minnesota since 2006, according to the Minnesota Board of Nursing. There is no record of her being disciplined. A board spokeswoman said that because of privacy laws, she could not confirm or deny whether any complaints have been filed against Casareto.


    By ABBY SIMONS, MAURA LERNER and PAUL WALSH, Star Tribune
    Last update: February 10, 2011

    http://www.startribune.com/local/115663559.html

Comments

  1. junkbox
    I have just been informed that I need to link the source, i had removed it from my post because when i went to post it, it said that i cant post links yet, due not reaching 50 posts yet. I do apologize about that. I read these and thought another person on DF might enjoy.
  2. Phenoxide
    If true then this is absolutely disgusting and she'd be deserving of a long stint behind bars. Addiction is no excuse for becoming inhumanly cruel. I just have no empathy for someone that can stand by and watch someone writh in pain and knowingly deprive them of medicines just because they have a habit to feed.

    I hope they throw an attempted murder charge on top because that guy could easily have gone into shock and died having such a procedure without something to numb the pain.
  3. junkbox
    Your absolutely right Phenoxide! Her level of apathy is sickening. "Go to your beach, go to your happy place" ? whaaat the fuck! What a bitch!! How do you possibly find a "happy place" while ur kidney's are being jabbed at by very long needles? You took his happy place place!
  4. Moving Pictures
    there was that one nurse who was doing it and she was shooting herself up with the filled syringes and gave like 10 patients hep c because she used the same rig on herself that she did on the patients.. She got 15 years or something.
  5. junkbox
    That's absolutely HORRIBLE!
  6. Smeg
    This is exactly the kind of case that can cause bloody awful confidence issues, and consequences for all health professionls who are entrusted with medication intended for patients.

    One local or national incidence of reported alleged malpractice, like the one(s) described, can have very negative repercussions on the trust invested in the vast majority of all nurses, doctors and other clinicians who are entirely ethical, compassionate, honest and dedicated to their work.

    Red and his colleagues, in his place of work, feel sensitive, compromised and upset about the bad name that can be attached both to them as indviduals as well as the professional bodies they belong to and represent because of occasional betrayers/abusers of positions of trust from within their own clinical disciplines.
  7. mickey_bee
    One major question I have to ask is - Why was action not taken when the patient began writhing around and screaming in agony?

    Obviously this is a minor procedure, so there was only that one useless cow for an anaesthetist, but every member of staff involved in the operation should have realised there was something very seriously wrong far before deciding to hold the patient down like in an 18th century amputation.

    It's the job of all the medical staff involved in the procedure to check on the patients wellbeing and lifesigns.

    Even when a patient has been fully put to sleep it can be clear if the pain medication isn't working, despite paralysis - a rapidly increased pulse, sweating, and other general observations of the patient by the anaesthetising staff.

    To get to the point of having to hold the poor fucker down while you probe his kidneys - you don't need to go to medical school to know that that is not sufficient anaesthetising, and that the process should be abandoned asap, so further study can be done as to what went wrong, and the patient can be brought back to comfort.

    I see this as failings on far more than one level - the senior member of staff involved is not just incharge of himself, but his entire team, and the patient. It is his/her responsibility to ensure that all of the staff working on that team are up to scratch, and not nodding off while the patient's screaming.......
    This is poor on more than one level.
  8. Auramyna
    It's not that uncommon: Once, my boyfriend had an operation on his wrist and the nerve block didn't take effect. He reckons he was in so much agonising pain that tears were running down his face and his hand was constantly shaking totally out of his control. And all the doctor could say was "Stop Moving!" They refused to stop the procedure or give him more medication.

    Doctors can be pretty narrowly focused on 'the procedure' or whatever. But nurses are trained to pick up vital signs that are indicative of pain and to advocate for their patient!

    As for the nurse in the story, you would have to be pretty cold hearted to do that to someone who is having an operation! (Or to anyone.) Surely there are plenty of wasted drugs she could have diverted if she was that desperate.

    Or for example, dilute the 150mcgs so it appears to be 500mcgs and give it. Then request another bolus to be prescribed as obviously it isn't working. Although that could have a downfall as the patients tolerance is lower than what is documented. Hence it could lead to an overdose if they received that dose in the future.

    At least she is getting help now...
  9. Potter
    Having read more then one account by people who were not given proper anesthesia, I feel that drawing and quartering is a perfectly suitable punishment for anyone complacent to such an atrocity. There is no point in "rehabing" such a monster, they should be treated as the dogs they are.
  10. Spucky
    AW: Re: Nurse takes patients pain-killers

    And what shall we do with the Society who create "this Monster"?

    We need to face Reality, there are so many addicted People in our Health-System
    and a Nurse is just the weakest Link!

    :(
  11. Potter
    Society does not "create" addicts, nor do most high functioning addicts steal directly from patients.

    What sort of world do you wish we lied in Spiucky? You constantly yell that the modern medical systems are vast conspiracies hell bent on making and keeping people ill, but you never offer anything close to a viable alternative. Would you like us to go back to the dark ages with 50% infant mortality rates?
  12. mickey_bee
    To be fair, I do understand that the level of concern is much lower when doing routine procedures like this - it is very different to when someone is fully put to sleep and there's an actual team of anaesthetists. An operating team for serious procedures are like a ballet almost - everyone knowing their task and time and place.

    When it comes to operations which are nasty, but aren't going to kill you, and routinely give no problems, then the staff are alot more likely to just push through and try and get it over with - but still, there's a point, and this is beyond it.

    When I was younger I broke my arm badly and had it held together with pins. After a few months the time came to remove the pins - which they assured me wouldn't hurt, as the bone is repelled from the metal pins. However, during the operation I'd bled more than usual - especially in one place cos the f**king pin had gone directly through a big vein - meaning that for the months it was in a cast, all that blood had clotted and connected the pins with the bones and tissue.
    They still just got the pliers out though, despite my screams lol. When I left the room after it was over everyone on the ward was staring at me, lol.
    Despite that, I feel that that was completely justified, as it's a rare occurrence in itself, and although the pain was f**king intense, the whole thing lasted little more than a minute.

    This sounds far beyond that however, if someone's screaming and writhing in agony, then unless there's no other option or it's an extremely brief procedure, the operation needs to be aborted and reassessed.
    But even prior to that the head of staff needs to check the competence of those working with him/her.
  13. mickey_bee
    Swiy seems to miss out on the irony of his own comment.

    You talk about striving to move away from the 'dark ages' whilst at the same time claiming that this addict should be, 'treated like the dog she is', - that's hardly an enlightened viewpoint.....

    Although a custodial sentence is pretty much inevitable, people have to realise, that prison doesn't stop someone using and wanting drugs. You can't force an addict off drugs, it's been tried for centuries, to the point of the Chinese executing hundreds of thousands of opium addicts on the spot around the turn of the 20th century - it doesn't work.
    An addict can only get off drugs when deep down they want to, and most people, given help and support, don't want to spend their lives hooked to something, a slave to something.

    The only way you can stop things like this happening is by moving out of the dark ages and treating addicts like dogs, and instead, treating them as people who have a medical condition. Improved harm-reduction, improved access to, and a more flexible, wider array of maintenance treatments, improved access to rehab facilities - these are the ways out of the dark ages. These are the ways to help stop this kind of thing happening.

    Be careful not to let passion override logic - alot of people make that mistake.
  14. Piglet
    I suggest that they give her a nalmefene implant without first giving a reduction cure. An Australian team have made a 3 month implant!
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