Nurse Charged With Homicide

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  1. Should Radonda Vaught, the nurse who gave a lethal dose of Vecuronium to patient at Vanderbilt University Medical Center, be charged with reckless homicide?

    • 395
      She should not have been charged
    • 128
      She deserved to be charged

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Radonda Vaught, a 35 year old nurse who worked at the University of Vanderbilt University Medical Center, has been indicted on charges of reckless homicide. Read Nurse Gives Lethal Dose of Vecuronium

Radonda is the nurse who mistakenly gave Vecuronium (a paralytic) to a patient instead of Versed. The patient died.

Specializes in Pediatrics, Pediatric Float, PICU, NICU.
12 minutes ago, Wuzzie said:

It also should be noted that when you override on an Accudose a window pops up stating that only STAT meds should be overridden and that at this institution there is a bright orange sticker on the cubie that states in effect "Warning Paralyzing agent".

And also this!684863169_veclid.jpg.8d97aea6c9bf0385ce51eaa8d5c84135.jpgvec lid.jpg

Exactly! How can ignoring this be excused? No matter how busy, how short staffed, how whatever - how can we excuse blatantly ignoring a warning like this? Not to mention the other safety measures that were ignored. And how is a nurse ignoring/not paying attention to this when they are drawing up a medication much different than someone taking their eyes off the road while they are driving to look at a text.

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9 minutes ago, juan de la cruz said:

It may have also been more prudent for the provider to not order the 2 mg Versed all at one but maybe in divided doses with the nurse monitoring and determining if more doses are needed. But then again, the patient never got the right drug in the first place so we would never know if Versed was the appropriate choice or not.

If you read the CMS report it actually was. She was supposed to receive 1mg and then the additional 1mg if she had continuing issues. Which leads me to believe the intensivist thought the nurse would be remaining with the patient.

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Specializes in ACNP-BC, Adult Critical Care, Cardiology.
25 minutes ago, JadedCPN said:

This was a really interesting read even though it is super long and sheds some light on the gross negligence of this nurse.

This is what happened by her own recollection...

The RN stated he/she then chose the override setting on the ADC and searched for the Versed. RN #1 stated she was talking to the Orientee while he/she was searching the ADC for the Versed and had typed in the first 2 letters of Versed which are VE and chose the 1st medication on the list. RN #1 stated he/she took out the medication vial out of the ADC, and looked at the back of the vial at the directions for how much to reconstitute it with. RN #1 verified he/she did not re-check the name on the vial. RN #1 stated he/she grabbed a sticker from the patient's file, a handful of flushes, alcohol swabs, a blunt tip needle. RN #1 stated he/she put the medication vial in a baggie and wrote on the baggie, "PET scan, Versed 1-2 mg" and went to Radiology to administer the medication to Patient #1.

In her own words -

"I was in a patient care role, I was the help-all nurse. A help-all nurse is a resource nurse and I had an Orientee. I went and searched for the med under [the patient's] profile [in the ADC] and it was not there. I chose the override setting and I searched for it. I was talking to the Orientee about why we do swallow studies in the ER...I typed in the first 2 letters [VE] and that's how I hit it, I chose the 1st one on the list. I took out the vial and I looked at the back at the directions for how much to reconstitute it with, I did not re-check the name on the vial."

Edited to add for those not familiar with a vial of vec, per the report it says: The vial had a red top that documented, "WARNING: PARALYZING AGENT."

I don't know if any of our nurses here think of generic vs brand names when pulling meds out of the Pyxis. I can imagine in a hurry, medication names get blurry in our heads but Versed is a brand name for Midazolam and Vecuronium is a generic name for Norcuron.

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Specializes in ACNP-BC, Adult Critical Care, Cardiology.
1 minute ago, Wuzzie said:

If you read the CMS report it actually was. She was supposed to receive 1mg and then the additional 1mg if she had continuing issues. Which leads me to believe the intensivist thought the nurse would be remaining with the patient.

Gotcha, thanks for pointing that out. Yeah, intensivists are pretty savvy about meds used in conscious sedation but then again, maybe didn't communicate that plan to the nursing staff? But gosh, that totally adds another layer to the gross negligence on the part of this poor nurse.

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Specializes in Pediatrics, Pediatric Float, PICU, NICU.
2 minutes ago, juan de la cruz said:

I don't know if any of our nurses here think of generic vs brand names when pulling meds out of the Pyxis. I can imagine in a hurry, medication names get blurry in our heads but Versed is a brand name for Midazolam and Vecuronium is a generic name for Norcuron.

That is no excuse. And my point is that regardless, she admitted she didn't even look at the vial after she pulled it out of the dispenser. Even for a "basic" medication like PO tylenol, a prudent nurse should be looking at what medication they pull out of the machine to make sure that the right medication is being dispensed.

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Specializes in ACNP-BC, Adult Critical Care, Cardiology.
1 minute ago, JadedCPN said:

That is no excuse. And my point is that regardless, she admitted she didn't even look at the vial after she pulled it out of the dispenser. Even for a "basic" medication like PO tylenol, a prudent nurse should be looking at what medication they pull out of the machine to make sure that the right medication is being dispensed.

That's actually also my point. I am not trying to sound smart but if I were to pull meds from the Pyxis (which I haven't done for many years admittedly), I would search under Midazolam and not Versed, hence, I likely would not have pulled Vecuronium out in a hurry...and I would check the label for sure.

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Specializes in Pediatrics, Pediatric Float, PICU, NICU.
1 minute ago, juan de la cruz said:

That's actually also my point. I am not trying to sound smart but if I were to pull meds from the Pyxis (which I haven't done for many years admittedly), I would search under Midazolam and not Versed, hence, I likely would not have pulled Vecuronium out in a hurry...and I would check the label for sure.

My apologies for misunderstanding.

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Specializes in ACNP-BC, Adult Critical Care, Cardiology.
Just now, JadedCPN said:

My apologies for misunderstanding.

No worries

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2 minutes ago, juan de la cruz said:

That's actually also my point. I am not trying to sound smart but if I were to pull meds from the Pyxis (which I haven't done for many years admittedly), I would search under Midazolam and not Versed, hence, I likely would not have pulled Vecuronium out in a hurry...and I would check the label for sure.

Makes me wonder if the medication actually was available in the patient's profile (contrary to what she said) but was listed as Midazolam and she didn't know that was Versed hence the override. ?

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4 minutes ago, Wuzzie said:

Makes me wonder if the medication actually was available in the patient's profile (contrary to what she said) but was listed as Midazolam and she didn't know that was Versed hence the override. ?

That's what I assumed all along....

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Just now, JKL33 said:

That's what I assumed all along....

Our Pyxis looks for generic or brand names.

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26 minutes ago, JadedCPN said:

Exactly! How can ignoring this be excused? No matter how busy, how short staffed, how whatever - how can we excuse blatantly ignoring a warning like this? Not to mention the other safety measures that were ignored. And how is a nurse ignoring/not paying attention to this when they are drawing up a medication much different than someone taking their eyes off the road while they are driving to look at a text.

Saying she "ignored the warning" implies she read it and discounted it. I don't even think she read it or noticed it because she had allowed herself to be distracted by talking about an entirely unrelated issue in the ER to her orientee. So, again there is no bad intent, but it illustrates how completely removed she was from the situation actually at hand. It is pretty amazing how those warning labels just did not penetrate her conscious mind.

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