MINNEAPOLIS -- Hospital officials said Thursday that they regret the suffering of a patient last fall, when a nurse at Abbott Northwestern Hospital in Minneapolis allegedly stole his pain medicine before a routine kidney procedure.
But they refused to draw any conclusions about what might have gone wrong, or why the procedure wouldn't have been halted if the patient was in pain.
"We would never ever dispute a patient's perception of their pain," said Dr. Penny Wheeler, chief medical officer at Allina Hospitals & Clinics, which owns Abbott. "We're very sorry that that occurred to anybody under our care."
The nurse, Sarah May Casareto, was charged Wednesday in Hennepin County District Court with stealing the painkiller, fentanyl, instead of giving it to the patient.
Larry V. King, 56, a Carver County sheriff's deputy, confirmed Thursday that he's the patient identified as "L.V.K." in the criminal complaint. According to the complaint, Casareto gave him only about a third of the prescribed dose of the painkiller before the Nov. 8 procedure, when a tube was inserted through his back into a kidney. She allegedly told him to "man up here and take some of the pain," the complaint said. Neither Casareto, 33, of Forest Lake, Minn., nor her attorney has responded to requests for comment.
"I'm feeling fine and back at work," said King, who lives in Bloomington, Minn. But he declined to speak specifically about what happened to him. "It was a very unfortunate thing. That's all I can say."
According to the complaint, King was supposed to receive 500 micrograms of fentanyl, a powerful painkiller, but Casareto only gave him 150 micrograms and never accounted for the rest. King told police that the pain was "enough just about to bring (him) off the table," and that someone leaned on his back to hold him down. He also said an assistant asked the doctor if they should strap his legs to restrain him.
Officials say they're prohibited by law from discussing a patient's case, or confirming or denying what happened.
But Wheeler said that patients are constantly monitored and that the staff is always prepared to change course if a patient appears too uncomfortable. In procedures like the one in question, patients receive what is known as conscious sedation, which leaves them awake but relieves pain.
"We stop; we take stock; we adjust things," she said, adding, "I've never witnessed any kind of procedure where any patient was held down."
In this case, the procedure was done by a radiologist who was not identified by name. He told police that he had done hundreds if not thousands of similar procedures, and that this patient's discomfort was "unusual."
Dr. Robert Vogelzang, a radiologist at Northwestern University in Chicago, said the doctor was probably caught between "a rock and a hard place, and I sympathize."
He said doctors operate "under the assumption that the patients are getting the stated doses of drugs," and in this case, they may not have realized the truth until it was too late.
"They were faced with an extremely unusual situation," said Vogelzang, former president of the Society for Interventional Radiology. "I suspect they were suddenly confronted with a patient who had been reasonably calm, and suddenly boom, you get to the painful part of the procedure," he said. At that point, he said, they may have decided the safest option was to finish quickly.
Wheeler also noted that there is a delicate line between giving too little pain medicine and giving too much when someone goes under the knife.
"If you give too much, you can suppress (breathing)," she said. "It's always a balance."
Wheeler said that doctors would have had no way of knowing during the procedure what police later said they learned: that the nurse allegedly took most of the drug herself, leaving the patient "writhing in pain."
David Kanihan, an Allina spokesman, said hospital officials were continuing to investigate. Officials from the federal Centers for Medicare and Medicaid Services also said they're looking into the incident, which they learned about Thursday from news reports.
Casareto was charged with theft of a controlled substance, a felony. She quit the hospital shortly after the incident, when she was confronted by colleagues for acting intoxicated and falling asleep during the procedure. When hospital officials demanded that she take a drug test, she resigned instead.
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Hospital officials would not say whether they reported the incident to police. King filed the police complaint in December and has hired Tony Nemo, a lawyer with Minneapolis law firm Meshbesher and Spence, to represent him.
Nemo said his client wants to know why the hospital didn't recognize the nurse's problems beforehand and that, barring "something dramatic," he expects to file suit against the hospital.
"He's physically fine," Nemo said Thursday of King. "But ... it's something you probably never forget."
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