Family of Iowa Man Sues Over Injection Error

The family of a man who died after being injected with a lethal dose of a paralytic agent by a Sioux City Fire Rescue paramedic has filed suit against the city, nine emergency responders, and a physician. James Foster Jr., 26, died on August 18, 2023 after former paramedic Deanna LaMere mistakenly injected him with rocuronium

LaMere, 46, reportedly thought she was administering ketamine. There is a factual question about when she discovered her error, and whether she did all she could to manage Foster’s condition. She is currently facing a criminal charge of involuntary manslaughter. Here is earlier coverage of the filing of the manslaughter charge.

The family’s suit was filed in US District Court for the Northern District of Iowa, alleging civil rights violations under 42 U.S.C. § 1983 for deliberate indifference; Monell Liability for (1) failure to supervise, (2) failure to train, and (3) failure to screen, investigate and discipline; medical malpractice; wrongful death; and negligent hiring, retention, and supervision.

The factual allegations are disturbing, and quoted here at length:

Defendant Officer Ochoa was dispatched in the early morning hours of August 18, 2023 to a report of an individual sitting or lying in the street.
At 3:53 a.m., Defendant Officer Ochoa encountered Mr. Foster on 3rd Street in Sioux City.
Mr. Foster reported that he did not need assistance and that it was humiliating for her to encounter him like that.
Mr. Foster reported that he had hurt his arm.
Officer Ochoa radioed for medical assistance, Code 1 (non-emergency, no lights or sirens).
Mr. Foster had his hands up and appeared confused and disoriented while speaking to Officer Ochoa.
At 3:57 a.m., Officer Ochoa attempted to assist Mr. Foster to move from his position and he reacted in fright, moving away from her.
Defendant Paramedic LaMere arrived on scene at 3:57 a.m. in response to Officer Ochoa’s call for Code 1 medical assistance.
Arriving with her were Defendants EMT Drake Carnahan, AEMT Dustin L. Johnson, EMT Brandon R. DeRocher, and Jordan Reinders.
These Defendants all arrived on scene without lights or sirens.
Paramedic LaMere asked Mr. Foster “What kind of drugs do you got on board?” at 3:58 a.m. She did so from several feet away and failed to do any assessment, nor did she attempt to do any sort of assessment of Mr. Foster. She then asked “What did you take tonight?”
Mr. Foster responded that he had information in his car. Paramedic LaMere asked “Are you schizophrenic? Are you supposed to be taking some meds?”
No Defendant EMT conducted any assessment of Mr. Foster, nor attempted to conduct any assessment of him at this or any other time during this incident.
Deanna LaMere falsely recorded in the incident report/run sheet that she conducted an ALS (advanced life support) assessment of Mr. Foster when she arrived on scene, although body cam footage clearly shows that this was not done by her or any other responder.
At 3:59 a.m., Officer Ochoa asked Mr. Foster if there was anything medical could do for him and he responded “no.”
Also at 3:59 a.m., Sergeant Schmeckpeper and Defendant EMT Drake Carnahan, AEMT Dustin L. Johnson, EMT Brandon R. DeRocher, or Jordan Reinders discussed Mr. Foster’s condition and Sergeant Schmeckpeper stated that he did not know if Mr. Foster even had any injuries.
Mr. Foster then reported that his arm was causing him pain.
Mr. Foster was unarmed, surrounded by eight responding individuals, including multiple armed police officers, and never made any move toward any responding individual or posed a threat to them in any way.
Officer Ochoa again tried to assist Mr. Foster to stand at 4:00 a.m. and he reported that he was experiencing pain and then agreed to medical assistance.
At 4:01 a.m., Paramedic LaMere said to Mr. Foster “Let’s get up and go to the ambulance.”
Mr. Foster responded “I can’t.” Paramedic LaMere responded “yes you can,” and Officer Ochoa stated “we’ll help you.”
Defendants then attempted to assist Mr. Foster to stand up and walk to the ambulance but he became frightened and started to cry.
Paramedic LaMere described Mr. Foster’s actions at this time as follows: “he scoots away on hands and knees like is an animal.” [sic]
Defendants then rolled a gurney next to Mr. Foster and he again moved away in fear as he remained disoriented.
At this time, Mr. Foster attempted to stand on his own and walk before falling down. Between approximately 4:04 a.m. and 4:08 a.m., multiple Defendants stated that Mr. Foster was calm on the ground and that it was fine if they waited for him to be ready for assistance. He remained peacefully lying on the ground at this time.
At 4:08 a.m., Mr. Foster unsuccessfully attempted to stand.
At 4:08 a.m., Paramedic LaMere returned from her emergency response vehicle and approached Mr. Foster with a syringe accompanied by Defendant EMT Drake Carnahan, AEMT Dustin L. Johnson, EMT Brandon R. DeRocher, or Jordan Reinders.
Multiple Defendants, including Paramedic LaMere, Officer Ochoa and Sergeant Schmeckpeper forcibly held Mr. Foster down against his will so that Paramedic LaMere could inject him with medication he had not been told about and that he did not consent to have.
There was no medical indication for an injection and Mr. Foster had still not been assessed in any way at this time.
Paramedic LaMere did not verify the medication that she drew up for Mr. Foster. She asked her partner (one of the Defendants) to “verify” the medication was correct even though he did not actually witness her drawing up the medication.
Paramedic LaMere falsely recorded that she and her EMT partner verified the correct dose again falsifying the incident report/run sheet.
Paramedic LaMere informed the on-scene Defendants that she was injecting Ketamine to chemically restrain Mr. Foster. However, she injected him with a powerful and dangerous paralytic agent used in intubation procedures, Rocuronium.
While receiving the injection, Mr. Foster screamed and asked if the injection would kill him. He reported that the injection was causing him pain and he was told by one of the on-scene Defendants that it would help him relax.
Paramedic LaMere stated “you’re fine” in response to Mr. Foster’s distress and thanked the on-scene Defendants for holding Mr. Foster down, audibly chuckling at Mr. Foster.
At 4:09 a.m. Paramedic LaMere told the on-scene Defendants “all right that’s Ketamine it should be kicking in like now.”
The on-scene Defendants then moved Mr. Foster to a gurney. He repeatedly stated that he was afraid they were trying to kill him.
There were numerous other options other than chemical restraint for Mr. Foster. Not only were they not implemented, they were never even considered by any one of the eight responding individuals.
Mr. Foster was handcuffed at 4:10 a.m. Immediately afterword he began to struggle to breathe, audibly gasping for air and asking “Am I gonna die?”
Mr. Foster then began to repeatedly cry “I can’t breathe.”
Mr. Foster’s breathing deteriorated almost immediately and becoming labored as he audibly and visibly gasped and wheezed as displayed clearly on Sergeant Schmeckpeper’s body cam footage.
Not a single on-scene Defendant checked to see if Mr. Foster was in medical distress or if he needed medical attention. It would be apparent to any lay person at this point that Mr. Foster could not breathe and needed further medical attention.
At some time between when she injected Mr. Foster and 4:11 a.m. Paramedic LaMere discovered that she had injected Mr. Foster with a lethal dose of Rocuronium and knew that he needed immediate attention to survive. However, she informed no one of this medication error and took no action to prevent Mr. Foster from going into cardiac arrest.
Even with Paramedic LaMere’s failure to inform the on-scene Defendants about what she had done, it was apparent that he needed medical attention. They had a duty to act and they did nothing.
At 4:11 a.m. Mr. Foster stated that he was dying. Sergeant Schmeckpeper responded: “You’re not gonna die, you’re fine.”
Paramedic LaMere and Officer Schmeckpeper falsely stated in their reports that Mr. Foster began “kicking and swinging” at personnel or “pulled on one of the firefighter’s legs with his arms” after he was injected.
Body cam footage clearly shows that this did not occur. Additionally, even if this had occurred, it would not have been cause for the chemical restraint as it did not occur until Mr. Foster had already been injected with a lethal dose of Rocuronium and was unable to breathe.
As Mr. Foster gasped for air and pleaded that he did not want to die, the on-scene Defendants restrained him, held him down and then further restrained him on the gurney by handcuffing him.
At 4:13 a.m., as Mr. Foster stopped all movement due to the Rocuronium, and one of the on-scene Defendants then told him “night night.” Mr. Foster’s eyes remained open while he lay motionless on the stretcher.
No on-scene Defendant assessed Mr. Foster’s breathing or vital signs even though it is known that Ketamine (the intended medication) is a respiratory depressant.
Knowing that Mr. Foster had been injected with a lethal dose of Rocuronium, Deanna LaMere told the police officers to remove Mr. Foster’s handcuffs, stating “I don’t see any problems. I think he’ll be sleeping now.”
After the ambulance left the scene, Sergeant Schmeckpeper exclaimed, “teamwork!” indicating a successful response to a scene.
Once in the ambulance, Mr. Foster’s breathing worsened, and Paramedic LaMere and the other Sioux City Fire Rescue Defendants applied oxygen and an oropharyngeal airway, but did not attempt to intubate him or call for help.
At 4:14 a.m. Mr. Foster was ventilated by bag valve mask.
Mr. Foster’s heart stopped at 4:18 a.m. and EMT Reinders started CPR.
Mr. Foster was given epinephrine at 4:21 a.m. and was intubated at 4:25 a.m.
Deanna LaMere called ahead to the acute care hospital and reported Mr. Foster’s condition and falsely reported that he had received Ketamine. She did not advise medical personnel about the fact that she had injected Mr. Foster with a lethal dose of Rocuronium.
Mr. Foster received another dose of epinephrine at 4:28 a.m.
When Mr. Foster arrived at Mercy Medical Center, Deanna LaMere finally informed medical personnel that she had injected him with Rocuronium. She then continued her clumsy cover-up when she improperly disposed of the vials of Rocuronium and Ketamine in a sharps container in contravention of Sioux City Fire Rescue’s policies and procedures and/or protocols.
Mr. Foster died two days later at Mercy Medical Center – Sioux City as a result of the cardiac arrest and the brain death he experienced due to the Rocuronium.