NPR's take on RV

Published

https://www.npr.org/sections/health-shots/2019/04/10/709971677/when-a-nurse-is-prosecuted-for-a-fatal-medical-mistake-does-it-make-medicine-saf

I am usually a big proponent of NPR's balanced reporting. But there are so many of us who have feelings about this it seems...awkward and perhaps a touch lazy to let the ANA and one nurse who does safety research speak for all of us.

At any rate, we may learn more tomorrow.

Specializes in Home Health (PDN), Camp Nursing.

Here’s a bit of an article on the hospitals response. It was less than stellar but mostly not criminal. If I was the doctor who signed the natural causes death certificate though I might be giving my a heads up.

(although I remember reading it somewhere I cannot confirm that the death certificate was botched. I apologize if I’m wrong on that)

https://www.google.com/url?sa=i&source=web&cd=&ved=0ahUKEwi8ia6fzczhAhWKZd8KHdm1C38QzPwBCAI&url=https%3A%2F%2Fwww.tennessean.com%2Fstory%2Fmoney%2F2018%2F11%2F30%2Fvanderbilt-patient-death-medication-error-medical-examiner%2F2155152002%2F&psig=AOvVaw0aWn-EREyHK9GK2Wp5Yntg&ust=1555228894064999

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On 4/10/2019 at 10:35 AM, ruby_jane said:

https://www.npr.org/sections/health-shots/2019/04/10/709971677/when-a-nurse-is-prosecuted-for-a-fatal-medical-mistake-does-it-make-medicine-saf

I am usually a big proponent of NPR's balanced reporting. But there are so many of us who have feelings about this it seems...awkward and perhaps a touch lazy to let the ANA and one nurse who does safety research speak for all of us.

At any rate, we may learn more tomorrow.

Was that one nurse "speaking for all of us," or was she just asked by a reporter to give her opinion about the incident?

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Just popping in to continue registering my objection to the idea that V's actions amount to suffering a series of unfortunately sloppy oversights.

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Specializes in NICU/Neonatal transport.
5 hours ago, Alex Egan said:

Here’s a bit of an article on the hospitals response. It was less than stellar but mostly not criminal. If I was the doctor who signed the natural causes death certificate though I might be giving my malpractice insurance a heads up.

(although I remember reading it somewhere I cannot confirm that the death certificate was botched. I apologize if I’m wrong on that)

https://www.google.com/url?sa=i&source=web&cd=&ved=0ahUKEwi8ia6fzczhAhWKZd8KHdm1C38QzPwBCAI&url=https%3A%2F%2Fwww.tennessean.com%2Fstory%2Fmoney%2F2018%2F11%2F30%2Fvanderbilt-patient-death-medication-error-medical-examiner%2F2155152002%2F&psig=AOvVaw0aWn-EREyHK9GK2Wp5Yntg&ust=1555228894064999

From the above article:

Quote

Instead, the reporting doctor attributed the death to bleeding in the patient’s brain and vecuronium was never mentioned, the official told federal officials.

“We released jurisdiction because there was an MRI that confirmed the bleed,” said the medical examiner's official, who is quoted in the federal report but not named. “(A Vanderbilt doctor) stated maybe there was a medication error, but that was hearsay, nothing has been documented. Since there was no documentation and he/she said it was just hearsay, we didn't see any red flags..."

So this is definitely a red flag to me. A doc says, when giving handoff about a deceased patient, that there may have been a med error that contributed, but that it was "hearsay", that should be a red flag - Either to automatically do the autopsy or ask the doctor to find out more definitively about the med error. On my current unit, fellows, including first year fellows (who are barely not residents) are making that call for deceased patients. They may be unsure if they are going to get in trouble for "tattling". Just like some docs won't apologize because they've been taught/heard that if you apologize, that can be used as an admission of guilt. I sincerely doubt the doc who called it in intended to thwart an autopsy to prevent medicare from finding out what happened.

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7 minutes ago, LilPeanut said:

From the above article:

Just like some docs won't apologize because they've been taught/heard that if you apologize, that can be used as an admission of guilt.

That's interesting, because IIRC, the research has shown that doctors who admit fault and sincerely apologize are actually less likely to be sued.

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Despite the hyperbole I see here often I have only worked with a handful of physicians that were class A jerks. Most of them were really nice people who truly respected us. That being said I wonder if the immediate response upon discovery of the error was a means to protect RV. Calling it “hearsay” and such. When I made my med error the physician said to me “don’t worry I’ll just write an order to cover it”. He’s a good doctor and a good human who was looking out for me. Of course I refused and took my lumps. Ouch! I also have to think this might have been the first time, at least in a long time, a nurse actually killed a patient and they really didn’t know what to do in the immediate aftermath. Later on is when the machinations began outside of the clinical staff.

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Specializes in NICU/Neonatal transport.
14 minutes ago, Horseshoe said:

That's interesting, because IIRC, the research has shown that doctors who admit fault and sincerely apologize are actually less likely to be sued.

That's true, but that fear of admitting guilt (even on someone else's behalf) might have come to the forefront when put on the spot.

8 minutes ago, Wuzzie said:

Despite the hyperbole I see here often I have only worked with a handful of physicians that were class A jerks. Most of them were really nice people who truly respected us. That being said I wonder if the immediate response upon discovery of the error was a means to protect RV. Calling it “hearsay” and such. When I made my med error the physician said to me “don’t worry I’ll just write an order to cover it”. He’s a good doctor and a good human who was looking out for me. Of course I refused and took my lumps. Ouch! I also have to think this might have been the first time, at least in a long time, a nurse actually killed a patient and they really didn’t know what to do in the immediate aftermath. Later on is when the machinations began outside of the clinical staff.

I agree with this a lot. It's the fact they brought it up and called it hearsay, meaning the doc felt like they should mention it, but also didn't want to screw over a colleague, so kind of round about mentioned it, figuring if someone was concerned, they'll ask more questions etc.

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Specializes in Home Health (PDN), Camp Nursing.

I understand some of the mitigating factors BUT the patent was on life support until the next day. This wasn’t a doctor calling the code and then picking up the phone. The error had to be known at that point.

Intent is hard. I agree that the doctor most likely didn’t INTEND to mislead an investigation. However...they did just that. The intent only shades the level of the charge the crime itself persists.

If an inexperienced doctor was making that call and unsure they needed to find someone with more background to do it. If the doctor who had care of the patent had not been briefed on the circumstances of the incident, but the hospital lawyer had, that’s conspiracy.

RV is IMHO guilty of negligent practice resulting in death. If that makes her a criminal or not I don’t know. However something stinks at that hospital and I bet we start smelling it as the discovery process starts for this trial.

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On 4/12/2019 at 4:03 PM, FSZ Student Nurse said:

I agree that defending her might not be in the nursing profession's best interests, but it's true that there are nurses who are visibly supporting her. Some nurses even came to her hearing to show support.

Nurses who are reserving judgement or don't support her at this point seem to be confined to an anonymous, online chat room. As far as the public is concerned, nurses support her.

What is wrong with reserving judgment?

Clearly, none of us knows all the facts surrounding this unfortunate incident.

I believe RV deserves support, and posted that I hope she is receiving mental health counseling.

But I am reserving judgment.

That means I will not vilify her, nor will I shout her innocence.

But I do support her.

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Specializes in Home Health (PDN), Camp Nursing.
37 minutes ago, Lil Nel said:

What is wrong with reserving judgment?

Clearly, none of us knows all the facts surrounding this unfortunate incident.

I believe RV deserves support, and posted that I hope she is receiving mental health counseling.

But I am reserving judgment.

That means I will not vilify her, nor will I shout her innocence.

But I do support her.

I agree here are the facts of the case which I have considered carefully. Please read it and reflect. This is the TBI investigation and interview. This is the evidence submitted to swear out a warrant for her arrest. It’s mostly a summary of HER INTERVIEW. This is not a reporters interpretation it is source data

https://ewscripps.brightspotcdn.com/3d/46/feb995d34e9782f9ae33e37391c0/0716-001.pdf

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6 hours ago, Lil Nel said:

What is wrong with reserving judgment?

Clearly, none of us knows all the facts surrounding this unfortunate incident.

I believe RV deserves support, and posted that I hope she is receiving mental health counseling.

But I am reserving judgment.

That means I will not vilify her, nor will I shout her innocence.

But I do support her.

Nothing wrong with reserving judgment. That's often a wise response. Also, by "supporting" her, I was referring to those who are defending her practice and seem to object to the current legal proceedings.

My post was in response to the complaint that it is inaccurate reporting to claim nurses are defending her. My point was that there are nurses who do publicly defend her, and nurses who take issue with her actions are doing so in a private forum. If nurses don't say something publicly, how are the journalists supposed to know what they are thinking?

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Specializes in NICU/Neonatal transport.

https://assets.documentcloud.org/documents/5346023/CMS-Report.pdf

This is the CMS report if you haven't read it.

It has much of the same information, but additional input from the hospital administrators about their actions.

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