Criminal charges against WI Nurse

[Dorito, ASN, RN]

What are your thoughts on the criminal charges brought against the nurse who made a med error at St. Mary's hospital ? I feel this is inappropriate action and sends the wrong message to many nurses. Mistakes happen. I feel very sorry for the family and my prayers go out to the nurse. Here is the article:

Former St. Mary's nurse charged in death of patient

DAVID WAHLBERG and ED TRELEVEN

Contact David Wahlberg at [email protected] or 608-252-6125 and Ed Treleven at [email protected] or 608-252-6134.

Nursing and hospital officials were outraged Thursday after the state filed a felony charge against the nurse whose medication error caused the death of a teenager at St. Mary's Hospital in July.

It's the first time a health- care worker has been criminally charged for an unintentional error in Wisconsin, the officials said. They said the filing could make it more difficult to recruit and retain nurses, already in short supply.

An official with the state Department of Justice, which charged Julie Thao with neglect of a patient causing great bodily harm, defended the move.

"The circumstances of the case go well beyond a simple mistake," said department spokesman Mike Bauer. He said Thao violated several hospital and nursing rules.

Thao, 41, of Belleville, is scheduled to appear Thursday in Dane County Circuit Court. If convicted, she faces a $25,000 fine and up to three years in prison and three years of extended supervision.

Thao, who no longer works at St. Mary's, was caring for 16- year-old Jasmine Gant of Fitchburg on July 5 as Gant was about to deliver a baby.

She mistakenly gave Gant an epidural anesthetic intravenously, a state investigation previously revealed. Gant was supposed to receive penicillin through the IV for a strep infection. An epidural is supposed to be injected near the spine to numb the pelvic area during birth.

Gant died shortly after the error. Her baby boy, delivered by emergency Caesarean section, survived.

According to the criminal complaint, Thao:

Improperly removed the epidural bag from a locked storage system. Gant's physician, Dr. Joseph Fok, never ordered the epidural.

Didn't scan the bar code on the epidural bag, which would have told her it was the wrong drug.

Ignored a bright pink label on the bag that said in bold letters, "FOR EPIDURAL ADMINISTRATION ONLY."

Disregarded hospital and nursing rules in failing to confirm a patient's "five rights" when receiving drugs: right patient, right route, right dose, right time and right medication.

"The actions, omissions and unapproved shortcuts of the defendant constituted a gross breach of medical protocol, resulting in the death" of Gant, wrote Gregory Schuler, an investigator with the justice department's Medicaid Fraud Control Unit.

According to a written statement and an interview with a state investigator, Thao said she got the epidural bag to show Gant what it looked like. She acknowledged she "had no business getting it out" of the storage locker.

Thao said Gant started crying and panicking; others in the room that day disagree. Gant's emotional state caused Thao to "scoop up" the wrong medication bag, she said.

"I allow priority for compassion to override the need for detail," Thao said.

An investigation continues into whether action should be taken against Thao's nursing license, said Steve Gloe, general counsel for the Wisconsin Department of Regulation and Licensing.

Thao and her attorney, Steve Hurley of Madison, couldn't be reached for comment Thursday.

Shortly after Gant's death, regulators threatened to revoke St. Mary's license and Medicare contract. They cited the hospital with three violations of federal regulations and three violations of state regulations.

After the hospital said it was re-educating nurses and updating policies, the regulators cleared the hospital from penalties.

In a prepared statement Thursday, St. Mary's spokeswoman Sarah Carlson said, "We are very saddened by this development and are sorry to see criminal charges filed against the nurse."

Dana Richardson, vice president for quality at the Wisconsin Hospital Association, said in a prepared statement that "it is cruel to allege that this mistake constituted criminal conduct."

The charge "accomplishes nothing other than to compound the anguish of this situation," she said.

In an interview, Richardson said the charge could have a chilling effect, causing people to be less likely to go into nursing or other health-care fields. "This sends the message that you are at risk for criminal charges if you make an unintentional error," she said.

The Wisconsin Medical Society, the state's doctor group, also opposed the charge, saying it could result in decreased access to health care, especially in underserved areas.

Gina Dennik-Champion, executive director of the Wisconsin Nurses Association, said she was "very concerned" about the charge.

Many nurses are already stressed dealing with today's sicker patients, new technology, increased paperwork, staff shortages and requests for overtime, she said.

"This is one more blow," she said. "It certainly isn't going to help morale."

The charge could also cause a setback in the trend within the health-care system toward more transparency about mishaps, Dennik-Champion said.

Rita Vosters, a clinical associate professor of nursing at UW-Madison, said she has talked about the Gant incident in her classes this year.

"Hopefully it will make nurses more careful with medications," she said.

The criminal charge "will be difficult on nurses," Vosters said. "Most nurses do the best job they can . . . But sometimes mistakes happen."

[UM Review RN, ASN, RN]

"This sends the message that you are at risk for criminal charges if you make an unintentional error," she said.

Exactly.

[Fretschy]

I am sad for the loss the Grant family has suffered, also my heart goes out for Julie Thao, this is something she will live with for the rest of her life.

I do not understand the criminal charge because where is the intent to harm?

[CHATSDALE]

this is a gross mistake...i don't know how i would rule if i wwere a da in this case..what level were the charges?

[traumaRUs, MSN, APRN]

This is truly scary for nursing as a profession - are we all going to be held criminallly liable if we make a mistake?

[Sheri257]

I do not understand the criminal charge because where is the intent to harm?

We just went through the legal module in our nursing program, and we were told we could be charged with criminal negligence in situations like this.

In fact, we just had a test question this week with a similar scenario. They taught us that if it's a gross deviation from the standard of practice then, you could be looking at criminal charges also because you're expected to meet minimum standards as a safe practioner.

I assume that if this is what they're teaching in nursing programs presumably, it's fair game for prosecutors.

:typing

[traumaRUs, MSN, APRN]

Gee whiz!

[Sheri257]

This is truly scary for nursing as a profession - are we all going to be held criminallly liable if we make a mistake?

No ... I don't think that's the point here. Seems to me this case is different. As the article points out the nurse:

Ignored a bright pink label on the bag that said in bold letters, "FOR EPIDURAL ADMINISTRATION ONLY."

This doesn't seem to be a case of similar names or labeling that should be corrected by the hospital and/or manufacturer because it causes confusion.

And, the nurse acknowledged that she "had no business getting it out" of the storage locker.

If the label had bright pink warnings on them, the nurse is expected to pay attention to that. This was gross negligence that caused a death.

:typing

[tvccrn, ASN, RN]

If gross negligence is the charge, then yes, I feel it's appropriate.

Yes, she made a mistake. In fact, she made SEVERAL mistakes. That's where the problem lies. If it had been one single mistake, I would think this was overkill, but with all the mistakes she made, she needs to be held accountable.

tvccrn

[traumaRUs, MSN, APRN]

I still feel that she is not criminally responsible. Yes, she made a mistake (a truly terrible one) but she did not do it maliciously or on purpose. I would want some action taken on nursing license but is she a danger to society? Probably not...so she shouldn't be held criminally liable.

[bubblymom373]

I agree with tvccrn. Too many mistakes. I wonder how long she has been working as a nurse before this happened.

[Sheri257]

I still feel that she is not criminally responsible. Yes, she made a mistake (a truly terrible one) but she did not do it maliciously or on purpose. I would want some action taken on nursing license but is she a danger to society? Probably not...so she shouldn't be held criminally liable.

If you run a bunch of traffic lights and kill somebody in a car accident ... you're still guilty of negligent homicide, even if you didn't maliciously mean to kill anybody.

That's what the negligent homicide statute is for. At some point, people have to be responsible for their actions.

:typing