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.