| Complaint: | Complaint 20-94 |
|---|---|
| Respondent: | Sarah Carotenuto |
| Premises: | VCA Valley Animal Hospital |
The complainant says his dog was lethargic and not eating so he took the dog to VCA's emergency center in Tucson. He relates that the first veterinarian to examine the dog suggested pyometra but doesn't remember the veterinarian's name; apparently the dog was passed between four different veterinarians during her fatal stay, being tested for diseases including Lyme and Valley Fever to no avail. He states that he was not aware his dog had a rock in her stomach until the third of four veterinarians called him (after three shift changes), also noting that examining the bill it appears the x-ray was not completed for 36 hours after arrival. He says that he was there with his dog every day and held her even while she seized in his arms. He believes if they had done the x-ray earlier and identified the blockage his dog might have had better chances. It appears they did finally do surgery to remove the blockage but there were complications; he states that he spent thousands of dollars to save his dog but euthanasia was recommended by VCA. He wanted answers and VCA wanted double the cost for a necropsy so the dog's body was sent to the University of Arizona; the veterinarian there, Gregory Bradley, allegedly could not identify the cause of death as the dog had no obvious problem. Bradley apparently told him that it would be useful to look at what happened during anesthesia. The complainant requested his dog's records but failed to receive the anesthesia report; he says he had to request it multiple times before they'd send it over. He says a veterinarian friend of his helped to review the records and found dexdomitor (one of the drugs) should not be used in cases of shock or severe debilitation; he also believes that too much IV fluid was used for the dog's body weight, that too much fentanyl was given, and that his dog was not monitored properly. His life and his business are built around dogs but that he's too small to take on a large corporation like VCA by himself; he hopes the Board can help make this right and bring about "a small amount of justice."
Carotenuto's response tells us that she was responsible for the dog's care for only a brief period of time. She also states that she shared the responsibility with Analisa Edell, a licensed veterinarian engaged in VCA's internship program and monitored by Carotenuto. Despite having attended to the dog for a short period she states that she has read the dog's entire history and will respond accordingly. She begins by stating that an abbreviated ultrasound found no fluid in the uterus; they did notice some anomalies on ultrasound interpreted as fluid-filled uterine loops based on the dog's overall presentation, but concedes these could have been fluid-filled intestinal loops rather than confirmation of pyometra. She says the dog was too sick for surgery at the time and that the x-rays only took 16 hours, not 36 as the complainant says; she also questions the complainant's overall timeline and accuses him of conflating the treatment for the blockage with the treatment for the dog's unexplained seizures after surgery. She also states that the complainant was offered a referral to a neurologist regarding the seizures; she's also checked his CareCredit balance and said he had thousands of dollars remaining to have the dog seen at VSCOT but decided not to. As if that weren't enough, she says that he didn't even want to show for the euthanasia. She also states that VCA lacked the necessary skull saws to perform a necropsy, then levies some attacks on Bradley, the UA veterinarian who did do the necropsy elsewhere; she states that if he actually says what the complainant claims, he would not have the information to do so, would have been speaking out of turn, and failed to show professional courtesy by not calling up VCA and letting them know of his alleged concerns first. She also states the concerns regarding medications were the result of Bradley not being able to interpret medical records correctly. She says that if the veterinarians at VCA had been able to be involved in the necropsy perhaps they could have been able to discover why the dog died. She also takes offense at accusations made by the complainant, stating that the veterinarians were hard workers with a good work ethic putting in time over the July 4 holiday weekend.
The Investigative Committee said that the complainant was wrong about the timeline; they also say that the dog was too sick for surgery on intake so it didn't matter if the blockage was initially misdiagnosed as pyometra. They also said some of the complainant's concerns had nothing to do with Carotenuto at all. One interesting note in the Findings of Fact that appears to have gone undiscussed is that the pathologist report on the necropsy found neuronal necrosis consistent with either hypoxia or ischemia and would explain the neurological signs in the dog; it also stated that the age of the lesions "roughly corresponds" to the date of the surgery performed on the dog.
If this sounds like deja vu, it's probably because you read about Carotenuto in her response to 18-93, in which a dog is suspected to have cancer and recommended for euthanasia; the dog goes home and lives after crapping out an apricot pit. Carotenuto's response there tends to have a very similar tone that's worth a read. The Committee found no violations, Tran recused.
We were able to reach the complainant in this case and learned some additional information not present in the public records. According to the interviewees, the dog was suffering from more-or-less uncontrollable seizures and was basically on life support prior to dying. The dog was also said to have survived for only a few minutes once treatment was stopped, appearing to contradict Carotenuto's portrayal of the euthanasia process and disinterest on the part of the complainant.
We were also told that a qualified veterinarian (name provided but kept confidential at their request) had reviewed the dog's records and was allegedly able to identify the point during the surgical procedure when the dog's health was permanently compromised, but was also allegedly unwilling to testify to that effect for fear of career reprisals. Supporting evidence was offered to us but not reviewed in order to respect confidentiality.
If all this is true it leads to at least one inference regarding Carotenuto's attacks on both the University of Arizona pathologist and her concerns about not being included in the necropsy study: VCA may have been aware they effectively killed the dog and wanted to stay on top of it.
| Source: | September 9, 2020 AM Investigative Committee Meeting |
|---|---|
| People: | |
| David Stoll | Respondent Attorney |
| Sarah Carotenuto | Respondent |
| Roll Call: | |
| Carolyn Ratajack | Aye |
| Christina Tran | Recused |
| Jarrod Butler | Aye |
| Robert Kritsberg | Aye |
| Steve Seiler | Aye |
| Result: | Passed |
| Source: | October 10, 2020 Board Meeting |
|---|---|
| People: | |
| David Stoll | Respondent Attorney |
| Proposed By: | Darren Wright |
| Seconded By: | Jessica Creager |
| Roll Call: | |
| Darren Wright | Aye |
| J Greg Byrne | Absent |
| Jane Soloman | Aye |
| Jessica Creager | Aye |
| Jim Loughead | Aye |
| Nikki Frost | Aye |
| Robyn Jaynes | Aye |
| Sarah Heinrich | Absent |
| Result: | Passed |
The primary source for the above summary was obtained as a public record from the Arizona State Veterinary Medical Examining Board. You are welcome to review the original records and board meeting minutes by clicking the relevant links. While we endeavor to provide an accurate summary of the complaint, response, investigative reports and board actions, we encourage you to review the primary sources and come to your own conclusions. In some cases we have also been able to reach out to individuals with knowledge of specific complaints, and where possible that information will be included here.