A former EMT pleaded guilty after prosecutors say she tampered with liquid fentanyl vials inside an ambulance service’s narcotics kit and replaced the drug with another substance while on the job in Massachusetts. By swapping the fentanyl citrate — meant for treating extreme pain — inside three vials for saline, ambulance patients were put at risk, court documents state.

The saline solution could have been wrongfully given to patients during an emergency. Candice Mangan, 43, of Medford, faces up to 10 years in prison after pleading guilty to tampering with a consumer product in a federal court in Boston on Aug. 31, according to a Sept. 6 news release from the U.S. Attorney’s Office for the District of Massachusetts. “The grave consequences of the opioid crisis extend far beyond street level dealing of heroin and fentanyl, which continues at an alarming pace,” U.S. Attorney Rachael Rollins said in a statement.

Fentanyl is a powerful and addictive opioid much more potent than morphine. It was created pharmaceutically to manage pain, according to the Drug Enforcement Administration.

An attorney for Mangan, Brian Murphy, told McClatchy News in a statement that his client is “deeply regretful of her actions and of letting down those who depended on her” and that she “suffers from drug addiction.” “She is apologetic to those whose trust she betrayed and remorseful for failing to address her own addiction earlier and more successfully.” In March 2020 until October of that year, Mangan worked part-time for Cataldo Ambulance Service while a licensed EMT paramedic in Massachusetts, prosecutors say.

On Sept. 30, 2020, while working a shift in Needham, she opened a narcotics box containing four vials of fentanyl citrate and removed the substance with a syringe from three vials, court documents state. The three vials were replaced with saline. “The liquid remaining in the three vials contained only approximately 4.4%, 6.8%, and 24.2% of the declared concentration of fentanyl citrate,” the release says. Mangan took the fourth vial of fentanyl and put the “tampered-with” syringes back inside the narcotics box before resealing it to give the appearance it was never opened, according to a statement of facts.

While working for the ambulance service, it is believed that Mangan tampered with more vials of fentanyl at other locations in Massachusetts, court documents state. “Those who knowingly tamper with medicines put patients’ health at risk,” Fernando P. McMillan, the special agent in charge of the U.S. Food and Drug Administration’s Office of Criminal Investigations in New York, said in the statement. Murphy, Mangan’s attorney, said his client’s drug addiction “began as a result of physical pain from ailments she had acquired during a lifetime working as a firefighter and paramedic.”

Then her addiction “was later exacerbated by the trauma of working on an ambulance throughout the COVID pandemic,” Murphy added. “Candice is committed to repaying her community through rebuilding her life in sobriety with a focus on helping other first responders who are suffering from addiction overcome the challenges they are facing and addressing their unique stressors so they can avoid the mistakes she has made.” Mangan also faces a fine of up to $250,000 in connection with her guilty plea, the release says.

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