By Mandy Miles, Jim McCarthy and Alex Rickert
Last updated: Friday, Aug. 16, 2 p.m.
A grand jury this week 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, Dilaudid 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,” states an Aug. 16 report from the Monroe County State Attorney’s Office. “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.
Monroe County Mayor Holly Raschein told Keys Weekly on Friday morning that she found out as she was traveling to Key Largo for the groundbreaking of the Twin Lakes flood mitigation project.
“We’re going to regroup and continue to run county government operations,” she said. “We need to be proactive and work to restore accountability, transparency and the people’s faith in our county.”
In a press release, county spokeswoman Kristen Livengood said that Gastesi’s position as a voluntary adviser, held since his retirement in February, had been terminated as of the morning of Aug. 16.
“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.”
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.”
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.
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 last week. Rusinowski’s indictment was quickly followed this week by those of former MCFR and Trauma Star medical director Dr. Sandra L. Schwemmer and Trauma Star division chief Andrea Thompson.
Both Schwemmer and Thompson were charged with multiple counts, including official misconduct, providing false information to law enforcement, tampering with physical evidence, and 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 Monroe County Sheriff’s Office initially reported Rusinowski’s arrest in connection with 16 missing pre-filled 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.
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 allegedly drove Rusinowski to a South Florida rehab facility before she could be arrested.
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.”
“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 Friday. “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.”
The Keys Weekly will update this developing story as more information becomes available. 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.
