By Mandy Miles, Jim McCarthy and Alex Rickert
A grand jury has indicted retired county administrator Roman Gastesi, who was slated to return to the top county job next month, for official misconduct in connection with the ongoing investigation into the theft, loss and attempted cover-up of more than 600 missing vials of fentanyl, morphine and other narcotics from the county’s Trauma Star medical helicopter service.
The misconduct charge “stems from alleged actions that took place between Aug. 11 and Nov. 17, 2022, during which Mr. Gastesi is accused of knowingly and intentionally obstructing, delaying, or preventing the communication of information relating to the commission of a felony that directly affected the government entity he served,” stated an Aug. 16 report from the Monroe County State Attorney’s Office (SAO). “This charge is classified as a third-degree felony under Florida Statute 838.022(1)(c). If convicted, Mr. Gastesi could face up to five years in prison, five years of probation, and a fine of up to $5,000.”
“Mr. Gastesi’s alleged actions reflect a pattern of misconduct that affects our community’s trust in government, and we are fully committed to ensuring justice is served,” State Attorney Dennis Ward said.
Judge Mark Wilson has signed a document for Mr. Gastesi’s arrest and set bond at $25,000, the state attorney’s office said in its press release.
“We literally just found out as we were on our way up here to Key Largo (for the groundbreaking of the Twin Lakes flood mitigation project),” Monroe County Mayor Holly Raschein told the Keys Weekly the morning of Aug. 16. “We need to be proactive and work to restore accountability and transparency and the people’s faith in our county.”
In a press release that same day, county spokeswoman Kristen Livengood said that Gastesi’s position as a voluntary adviser, held since his retirement in February, had been terminated.
“County operations will continue as they have for the past six months. These are serious criminal charges, and we are taking these allegations very seriously,” said acting county administrator Kevin Wilson, who will continue to serve in the post. “We will follow due process while we await formal court proceedings. Our first priority is to ensure that the county’s services continue for our residents and visitors without interruptions.”
“It’s important to remember that the theft of the drugs occurred two years ago, but the ongoing efforts by Monroe County Fire Rescue from medics to managers, all the way up to the top levels of county government, to conceal and cover up the large-scale theft of pharmaceutical narcotics is deeply troubling,” Sheriff Rick Ramsay told the Keys Weekly on Aug. 16. “Trauma Star continues to operate safely and efficiently today. Residents can have confidence in the sheriff, the sheriff’s office and Trauma Star. What’s at issue is people’s trust in county government and Monroe County Fire Rescue.”
Clerk’s Trauma Star audit fueled indictments
Gastesi’s is the fourth indictment connected to the investigation into Monroe County Fire Rescue, which oversees the daily operations of Trauma Star, and its controlled substance protocols, or lack thereof.
All investigations stemmed from a 2023 audit by the county clerk’s office of Monroe County Fire Rescue’s controlled substances protocols. The audit report noted no wrongdoing on the part of the Monroe County Sheriff’s Office, but offered a scathing review of MCFR’s controlled substances protocols and was highly critical of senior county administration.
The nearly 80-page audit report details massive discrepancies in controlled substance inventory records due to theft, stating that “controlled substances were being diverted by MCFR staff along with a widespread lack of management oversight.”
The audit details a total of 623 vials of controlled substances missing from inventory logs during the audit period — June 2021 through July 2022 — including 242 vials of Dilaudid and 219 of fentanyl. Though it acknowledges that some discrepancies could be due to sloppiness in record-keeping, which are extensively criticized throughout the report, it estimates that 246 missing vials – including 91 of fentanyl and 84 of Dilaudid – were likely stolen via the intentional falsification of records.
Former chief flight nurse Lynda Rusinowski, who admitted last year to the theft of narcotics due to an addiction, was the first to be indicted. Rusinowski’s indictment was quickly followed by those of former MCFR and Trauma Star medical director Dr. Sandra L. Schwemmer and Trauma Star division chief Andrea Thompson.
As announced in multiple SAO press releases, Thompson stands to face 11 total charges – a combination of official misconduct, falsifying patient records and providing false information to law enforcement. Schwemmer faces a total of three charges – one count of official misconduct, one of providing false information to law enforcement and one of altering patient records.
In an Aug. 9 press release, the county announced that it would terminate its contract with Schwemmer’s company for medical director services immediately, and suspended Thompson without pay.
The sheriff’s office initially reported Rusinowski’s arrest in connection with 16 missing prefilled morphine syringes, adding that officials with MCFR received an anonymous tip in late July 2022 about Rusinowski altering controlled substance inventory logs in an effort to pilfer the drugs. As chief flight nurse, she was an employee of Monroe County Fire Rescue, not the sheriff’s office.
The 2023 audit cites a lack of attention by Schwemmer as a “primary reason that the chief flight nurse’s alleged drug diversion activities went undetected for so long.” Schwemmer was counseled three times by then-Chief Steve Hudson about proper procedures and oversight, according to the audit report.
Schwemmer was let go by the county as medical director. On Aug. 14, Monroe County hired Antonio Gandia as its medical director for ground and air ambulance services. It followed a meeting among Gandia, Monroe County Fire Chief Jim Callahan and other officials.
Thompson was investigated for allegedly removing syringes, tourniquets and other medical equipment from Rusinowski’s vehicle that could have been used as evidence in the criminal case. Thompson also allegedly drove Rusinowski to a South Florida rehab facility before she could be arrested.
County commission reacts, weighs second investigation
Upon learning of Gastesi’s indictment, county commissioner Craig Cates told the Keys Weekly he was very concerned for the county.
“He’s still innocent until proven guilty, but for public trust we have to show citizens we are taking this very seriously and will do what’s necessary to move forward,” he said. “I have faith in our current acting administrator Kevin Wilson to continue doing a great job now as we work through these issues. We can all promise we’ll come out of this better, with better policies so this never happens again.”
Cates told the Weekly he would propose hiring an independent third-party firm to follow up on the 2023 clerk’s audit during the BOCC’s Aug. 21 meeting in Key West. The meeting was in progress at presstime. Cates’ proposed agenda item reads, “Discussion regarding the Monroe County Grand Jury’s ongoing investigation into Monroe County Fire Rescue and the Trauma Star program and direction on whether the Board should retain an outside firm to conduct an independent investigation of this matter.”
“I’m not blaming anyone at all, but I hope my fellow commissioners will agree we need to look closer at this,” he said. “This is life and death we’re dealing with and I think there are some aspects that weren’t thoroughly investigated or followed up on.”
County commissioner Michelle Lincoln told Keys Weekly that she welcomes an audit and investigation to “make sure we’re doing everything in the way we’re supposed to be doing to keep our county running the way it should run.”
“We’ll be in standby mode to see what this investigation and indictment leads to,” Lincoln said.
Grand jury reports expected
Additional details are expected when the county clerk releases the grand jury report with potentially damning details that prompted the recent MCFR and Monroe County indictments. At presstime, the reports were pending redaction by officials for individuals named in the investigation, but not yet indicted or charged with crimes.
“I don’t expect the report to include any wrongdoing at all by the sheriff’s office, but I do expect it to be highly critical of the management and administration of MCFR and the county,” Ramsay told the Weekly on Aug. 22. “And if it also includes recommendations for improvements and solutions, I’ll be glad to assist in any way I can.”
Schwemmer, Gastesi respond
In an Aug. 16 email to media members, Schwemmer’s attorney Kader Schull listed her career accomplishments, calling the allegations against the former medical director “totally inconsistent with someone who has dedicated most of her career to improving life-saving medical services in Monroe County and throughout South Florida.”
“She has fully cooperated with investigating missing medications from the air rescue hangar and will continue to do so,” he said. “She steadfastly maintains that she has not done any wrongdoing in this matter and looks forward to clearing her name in court.”
Gastesi declined to comment on the ongoing case on Aug. 20.
In Trauma Star operations, Monroe County Fire Rescue is in charge of the flight nurses, Trauma Star’s medical supplies, patient records and oversight of all three. The Monroe County Sheriff’s Office is in charge of the pilots and the Trauma Star helicopters that annually transport 1,200 to 1,300 patients, often with life-threatening conditions, to mainland hospitals.
