Nurse Charged With Homicide

31 minutes ago, mtnNurse. said:

I think it's pretty unlikely she was aware that her behavior might kill that patient, because if she had been then she would not have behaved in the way she did. She was being mindless and made the horrible assumption that she grabbed the right medicine. When committing the fatal act of injecting it into the patient I bet she had no doubt in her mind that she was giving the right medicine and the patient would not be harmed. So I don't think "reckless homicide" applies to her situation. You argued that she should have been aware, and that's true, but that doesn't mean she was.

Ok, let's follow that logic.

You are trying to have me believe that she was unaware that ANY DRUG, (which was my point) could kill a patient?

I wasn't speaking of the vec in particular, if you read my comment correctly.

I said, "Being a nurse, she has to be aware that ANY DRUG that she gives can be the lethal one" for that particular patient.

You are saying that she or any nurse gives drugs completely ignorant of the fact that innocuous drugs such as aspirin, normal saline or senna could kill a patient that is allergic to it?

That is my point. Did she look to see if the patient was allergic to versed? No. She overrode the pyxis, didn't read, didn't comprehend, didn't care to--and didn't even check to see---that IF she actually had the drug she "assumed" (you know what assuming does and there is ZERO PLACE FOR IT in medicine) was the right one---was this patient allergic to it?

 

Question, who brought these charges against her?

 

Here is a non nursing case that is going to trial regarding a train engineer who went too fast into a curve, causing the train to derail killing 8.

 https://www.foxnews.com/us/charges-reinstated-against-amtrak-engineer-in-philadelphia-crash

Amtrak did take responsibility and made changes, adding detection technology to avoid this type of accident. 

He was not impaired in any way, it sounds like human error. It certainly has parallels to this case. 

 

Perhaps there should be more stringent controls for the Vecuronium? Ie; 2 nurses to verify? I'm sure a  physician would not have been charged- a nurse should not be charged unless she had intent to harm.  

3 minutes ago, Crow31 said:

Question, who brought these charges against her?

 

District attorney over her county.

3 minutes ago, Ron Wallace said:

District attorney over her county.

How was the District Attorney notified?

3 minutes ago, Crow31 said:

Question, who brought these charges against her?

 

Grand juries and prosecutors usually are the ones who do this. However, it had to originate someplace. I do believe Emergent when she said that there is some political motivation, but I don't believe it was directed at this nurse--she was able to gain employment elsewhere in another facility very quickly. Vandy would have blackballed her--

Which speaks to turfing. They didn't report the error, the MD "can't recall" if there was vec given, the documentation shows nothing of the actual drug given, the ME wasn't informed correctly---the list goes on for how Vandy covered this up...

and then they give her a recommendation to another facility---and nothing is sent to the TBON.  My pal was accused of diverting and within days of the manager informing him, a letter was zipped off to the BON, and he was immediately pegged on nursys with big red letters that he is under investigation.

I call BS on the whole thing. Vandy enabled and encouraged this situation and this RN didn't have the sense God gave a goose to know that she simply didn't have the chops to do this particular job. She may be a wonderful MedSurg or OR or whatever RN....but in this role, she failed miserably.

Vandy fired her for cause (killing a patient from a serious med error) and then turfed her. Chances are good that they wished on a sparkling star that she goes away, nobody says nothing, and everybody moves on unscathed. Until someone squawked.

The schools are as much to blame. I see "BSN trained" nurses coming out of school so impaired clinically that I cannot believe they ever touched a patient. But that isn't what nursing school is for. It's to train you to pass the NCLEX. Did you know that the only round that counts is your first try? If you fail and then pass---the school still gets dinged over that. So the main focus is getting you through that one test, first time.  I never touched an IV while in school. Not once. I landed a trauma RN position because I was prehospital and I had years of venipuncture in my prior job. Nursing school taught me to CYA and write well.

Lemur00.....you are quite possibly, the most eloquent writer I have ever seen. Very articulate and you almost have me coming over to your side with your persuasive argument. There is enough blame to go around, I agree. But we are not talking about anyone else. We are talking about the behavior of this particular nurse.

14 minutes ago, Crow31 said:

Question, who brought these charges against her?

 

The Tennessee Bureau of Investigation was involved in her case. I’m suspecting it’s State of Tennessee vs aforementioned RN.

7 minutes ago, Ron Wallace said:

District attorney over her county.

Whenever the pathology report came back and said the patient had been overdosed on the incorrect drug the pathologist reviewed the amount of the medication in the PT’s blood at the time and from there the facility probably did an investigation, then turned over their results to the authorities. Then the information was sent to a District Attorney and he/she is now prosecuting the charges.

42 minutes ago, juan de la cruz said:

Just as a hypothetical question...I learned of this case from an acquaintance at VUMC even prior to this case blowing up in the media. This happened over a year ago and I’m told that the nurse was fired following the sentinel event at VUMC but sought employment and did get a job at another ICU in the Nashville area fairly soon after the case. There was either no complaint made to the BON or the process for investigating BON complaints go at a snail’s pace, I’m not sure. If this is true, would that affect perceptions of the jury on how she dealt with the tragedy? I think it might get brought up as a point against her. I have no idea what her state of mind is before, during, and after it happened so I won’t pass judgement.

I can imagine a good lawyer spinning it in her favor ...if she did well in the new position, had no disciplinary actions, etc.

Physicians aren't charged criminally if they cause a patients death. In fact, I know several doctors that have made mistakes causing the deaths of several patients. That's what malpractice insurance is for. Civil cases are brought against them. They aren't charged with homicide. Nurses give the wrong meds all the time. Something like this could happen to any one of us. We can't let this happen to one of our own. If we can be charged for trying to help others, then no one will want to become a doctor or a nurse!

12 minutes ago, HomeBound said:

You are trying to have me believe that she was unaware that ANY DRUG, (which was my point) could kill a patient?

I don't believe in the moments she killed the patient that she was aware she might be killing the patient. Every single time you drive a car, are you aware that you might hit and kill someone by accident? I think she was being mindless in those fatal moments. If she were aware in those moments she would have remembered the safety measures.

19 minutes ago, HomeBound said:

Did she look to see if the patient was allergic to versed? No. She overrode the pyxis, didn't read, didn't comprehend, didn't care to--and didn't even check to see---that IF she actually had the drug she "assumed" (you know what assuming does and there is ZERO PLACE FOR IT in medicine) was the right one---was this patient allergic to it?

It sounds like in her "helper nurse" role, she was used to running around and performing single tasks for different nurses. Maybe she was not taking report on the patients she was performing tasks for. So she probably assumed that the nurse who delegated the task to her made sure the patient wasn't allergic to the drug. You're right, assumptions are dangerous. But we have to make them all the time at our jobs. We assume syringes and vials are filled with the medication on the labels. If we could not assume and had to double-check everything fellow doctors, nurses, respiratory therapists, etc. said and did, we not only would need a doctor's degree in addition to our nurses's degree but we would not have time to do our jobs. But you're right that certain assumptions should never be made. (It'd be helpful in a different thread to give less experienced nurses a list of what assumptions should never be made, if any of us ever feels up to that.)

None of what she did (that we know of from what's been discussed) makes her guilty of reckless homicide.