By Rebecca Mahoney
Orlando Sentinel (Florida)
Copyright 2007 Sentinel Communications Co.
SOUTH DAYTONA, Fla. — A violent stomachache prompted 84-year-old Marie Caschetta to call 911 in January 2006.
She expected to end up in a doctor’s care. Instead, according to a lawsuit, she wound up losing most of her right arm.
Caschetta says a paramedic with Volusia County’s ambulance service, EVAC, wrongly gave her a drug that can cause gangrene when improperly injected.
The South Daytona woman has since undergone three amputations, each time losing a different portion of her right arm, and she may face a fourth amputation that would take her elbow.
“I lost my whole life that day,” said Caschetta, who is suing for an undisclosed amount of money. “I went in for a tummy-ache and came out without a hand. I’m an invalid.”
The lawyer representing EVAC, Barbara Flanagan, declined to comment on the case. According to court records, however, Flanagan has argued that Volusia County, not EVAC, is legally responsible because its medical director sets the protocol for ambulance responses. County attorney Dan Eckert did not immediately return a call seeking comment Monday.
At issue is the paramedic’s use of a medication called Phenergan or promethazine, used to quell nausea. If it is accidentally injected into an artery instead of a vein or a muscle, it can make arteries shut down and cause gangrene.
That’s what Caschetta says happened to her.
According to her lawsuit filed in Volusia County Circuit Court, Caschetta called 911 on Jan. 28, 2006.
She said she protested when the paramedic, Louana Mangan, told her she was going to give her a shot of the drug. Mangan could not be reached for comment Monday.
“I told her, `Don’t, honey, my veins roll,’ ” said Caschetta, meaning that her veins sometimes move or collapse unexpectedly. “She just said, `Don’t be so dramatic,’ and gave me the shot.”
Mangan, however, says Caschetta told her she had had the drug before and had never had any problems with it.
“I asked her if she wanted the treatment. She said yes,” Mangan testified during a deposition, according to court records.
Caschetta said she left Halifax Hospital’s intensive care unit 35 days after the ambulance ride, minus two fingers. She later had her hand and forearm amputated in separate surgeries.
Similar lawsuits involving Phenergan have been filed around the country by patients who say they lost fingers and limbs after the drug was accidentally injected into an artery. In 2000, a Vermont woman successfully sued drug manufacturer Wyeth for $7.4 million for failing to adequately warn of the potential danger of intravenous use.
Now, after a lifetime of gardening, cooking, crocheting and golf, Caschetta is learning to live life with only one hand.
“I don’t like having to ask for help. I have to ask for help putting on my earrings, taking a shower, opening cans,” Caschetta said Monday.
In some ways, she has adjusted. She opens milk bottles by wedging the container between her feet and twisting the cap with one hand.
To crochet, she wraps her stump in an ace bandage, then wedges a crochet hook between the folds of the fabric.
In other ways, she says she is a changed person — dependent and weepy, noticed for her stump and singled out for pity.
Recently, she stopped to use a restroom at Wal-Mart and asked a young woman for help buttoning her pants. Caschetta recalls weeping in humiliation as the woman recoiled and shouted, “What’s the matter with you, are you gay?”
“It’s been hard on all of us,” said her husband, Arthur, 87, who says the couple worries about how they’ll pay their $100,000 in medical bills. “But we survive it. She’s my baby.”
Caschetta said she wants EVAC to change its policy, so that nobody is given medication unless it’s a life-or-death situation.
“This never should have happened to me, but now all I want is to make sure this never happens to anyone else,” said Caschetta. “Nobody should have to go through what I have.”