Abbott Northwestern patient left 'writhing in pain' sues

"Hi, love," Sarah May Casareto greeted Larry V. King as he lay on a gurney before surgery. As they wheeled down the hall, he recalled in court records, she told him that he'd have to "man up" because they couldn't give him a lot of medication.

The next 57 minutes of surgery were excruciating, according to a lawsuit filed Tuesday in Hennepin County District Court that accuses the drug-addicted former nurse of skimming his narcotics, which left him "writhing in pain" during a medical procedure for kidney stones last year at a Minneapolis hospital.

The lawsuit filed by King, a Carver County sheriff's deputy, follows the same scenario laid out by prosecutors who charged Casareto, 34, in February with felony theft of a controlled substance for allegedly stealing the powerful painkiller.

Casareto, of Forest Lake, entered an Alford plea of guilty Sept. 1 to a fifth-degree controlled substance crime for possessing Fentanyl, a high-powered painkiller, and was sentenced to probation in connection with the Nov. 8 incident at Abbott Northwestern Hospital. The plea enabled Casareto to maintain her innocence while acknowledging ample evidence to convict her.

The suit, which seeks at least $50,000 in damages, alleges that she was "negligent and careless" in her care for King, 57, of Bloomington. The suit also names Abbott as a defendant.

It contends that Abbott "knew or should have known [before the procedure] that Casareto was exhibiting drug-seeking behavior and that she had become dependent upon narcotic pain medications." It also notes that Abbott officials knew that she had failed "on at least six different occasions" to properly handle patients' pain medication obtained from the hospital pharmacy.

King's attorney, Tony Nemo, called the lawsuit reflective of "a growing problem" that should draw closer scrutiny to drug diversion, or the theft of medications intended for patients.

"One of the things I know Mr. King is hoping is that this case may cause Twin Cities hospitals to reveal procedures and protocols to, if not prevent, at least minimize this problem in the future," he said.

The Casareto case and others involving medical staffers have prompted Minnesota hospitals to join with the Drug Enforcement Administration, local police and health regulators in recent months to improve security measures. The new coalition hopes to recommend tougher controls early next year. State regulators say drug pilfering by doctors and nurses isn't new -- but the latest cases come with a disturbing wrinkle, leaving some patients in excruciating pain as they are robbed of needed medications. In the past year, seven nurses and aides have been caught stealing narcotics from hospitals and nursing homes across Minnesota to feed their own habits or to sell drugs on the street.

Casareto's attorney, Brian Toder, said Wednesday that he believes the lawsuit is no more valid than the criminal charges, which did not result in a conviction. Once Casareto's three years of probation is over, the case will be expunged from her record.

Hospital spokeswoman Gloria O'Connell declined to comment on the suit, saying, "We can't talk about pending litigation."

The suit did not name the surgeon, Dr. Subbarao Inampudi, as a defendant because he "began the procedure with the reasonable assumption that [Casareto] would follow his orders and administer" the painkiller as he directed, Nemo said Wednesday.

According to the lawsuit, King said that his doctor told him he would not likely feel pain during the procedure, and when King's pain was obvious, Inampudi repeatedly ordered Casareto, who struggled to stay awake and was rocking back and forth, to "get back to her patient and figure out why the pain medication was not working."