Nurse Charged With Homicide

[Nurse Beth]

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.

[Emergent, RN]

On 2/5/2019 at 9:46 PM, Nurse Beth said:

Red or white? ?

[Horseshoe, BSN, RN]

Criminal charges for incompetence????

Now THAT is scary.

[Sour Lemon]

1 hour ago, Emergent said:

I disagree with these changes. This was a tragedy, a horrible mistake. Take away her nursing license but don't destroy her life.

The family has said that the woman would have forgiven her.

That is very gracious of the family.

So far there’s one vote in favor of the charges. I would love to know more about the individual who feels that way. Are they a nurse? Something else?

[Jory, MSN, APRN, CNM]

I pulled up an article, apparently the reason they are charging her is because she bypassed several safety policies which ultimately caused the patient's death.

[KatieMI, BSN, MSN, RN]

It looks just like trying to convict someone of homicide after accidentally hitting and killing a man while speeding 25 miles over speed limit.

Yes, it is a tragedy. Yes, someone had died. Yes, there was spectacular level of stupidity demonstrated by more than one person. But, no, it was not a cold-bloody murder. It was, that is to say, a reckless driving. Stupid and tragic, but just... stupid, after all.

And, BTW, things look like the doc who ordered a definitely gray-zone drug (as it was discussed on this very forum already, Versed is neither common, nor, actually, directly indicated for symptomatic treatment of claustrophobia alone as opposed to monitored intra-procedural sedation) got dry out of deep and hot water.

[canoehead, BSN, RN]

It's not murder, but its reckless endangerment.

V..E... ah, close enough...that's unforgiveable.

[Corey Narry, MSN, RN, NP]

40 minutes ago, KatieMI said:

And, BTW, things look like the doc who ordered a definitely gray-zone drug (as it was discussed on this very forum already, Versed is neither common, nor, actually, directly indicated for symptomatic treatment of claustrophobia alone as opposed to monitored intra-procedural sedation) got dry out of deep and hot water.

It's not that unusual to order a benzodiazepine drug (Versed or Ativan) to patients undergoing an MRI who are claustrophobic. Hospital procedures and national standards require monitoring of these patients by the nurse who gives the dose. I don't think there is responsibility on the side of the physician. If anything, VUMC should be held liable for not maintaining a system that makes sure patients given a dose of an IV benzodiazepine are monitored by a nurse.

I know a colleague who is familiar with the case and tells me the nurse involved bypassed multiple safeguards to prevent this tragedy from happening. VUMC uses vecuronium packaging with a clear warning stating that the drug is a paralytic. She reconstituted vecuronium prior to administration as is usual for that drug yet the fact is Versed never requires reconstitution.

Is the treatment she is facing now justified? she is being charged with reckless homicide not cold blooded murder. It's hard to answer that since I don't know her state of mind, what her patient load was, or what her training has been. This is in the hands of lawyers and the courts now. I was told this was an ICU patient (abeit ready for transfer out of the unit) and this was a nurse who has trained in the ICU.

It is rare for acts of negligence by healthcare professionals to be treated as a criminal case. The physician that gave Michael Jackson propofol faced criminal charges so there has been precedence. My own take home lesson from this is never is the time more right to demand safe nurse staffing, adequate mentorship/training, and Pharmacy checks prior to administration of medications using the override function only in true emergencies.

BTW, I answered that she should not have been charged if anyone was wondering.

[CaperRNBigGuy]

This is a tremendous overreach by the Police/DA, this is purely an unfortunate medication error which sadly in these trying times of short staff, compelled overtime, too much assigned responsibility & care, any Nurse could make this type of error and this type of response to the error will adversely affect Nurse retention particularly @ that Facility but at many others as well as this story gains traction in the Media, it will adversely affect recruitment into Nursing Schools (why set yourself up for a potential murder rap when you can take a MSW or a MOTt or enter Phc. Program & have no worries plus better working conditions & pay! The point was raised what would happen if an MD had made the error? The answer is simple, there’d be none of this discussion as no one would ever had been notified. It is our transparency & our compulsion to report that we open ourselves to censure, we don’t know when to stop! The idea of reporting errors was to allow an internal review to assure any required changes in practice could be implemented by the individual Nursing Staff or Department wide where necessary. This process is both integral & necessary to the proper function of any Nursing Department & Hospital. It serves as a feedback loop. A component of the Quality Management Circle, no Nsg Service is ever that good, that highly polished that they never make any medication errors. If Staff feel they are going to possibly be charged by the Police, possibly lose their Nsg licenses, lose their jobs & ability to support their families, they are simply going to cover up their mistakes, falsify theMedication Record & fail to report the errors, they’re going to play the long shot odds after all they have nothing worse to lose-their job is on the line already, and the overall risk to patients shoots through the roof! This is an extremely shortsighted approach to patient management & overall greatly increases risks to patients, immediately through the increased unreported & therefore untreated medication errors and the overall adverse staffing affects that will transpire, decreased recruitment, decreased retention, & decreased willingness to do medication assignment.

[HiddencatBSN, BSN]

I just read about this and headed right on over here to talk about it.

It sounds like the hospital, faced with losing money, threw her under the bus. How many patients did she have? How many shifts in a row had she worked? Was she on her regular unit? Was she properly trained? How was the vecuronium labeled? What distractions did she face while getting the medication, and do they profile meds to patients there (so you’re selecting from a med-list and not all available meds)? If the hospital was in danger of losing Medicaid money over this why is the nurse taking all the blame legally? Did she have a pattern of risky practice or negligence?

[JKL33]

For the sake of every other patient in a hospital in this country, I hope CMS and the general public understand that she has not done any one single wrong here that hasn't been done innumerable times. I bet every one of them has happened at V in the past 8 hours.

- Failure to conscientiously read a label

- Fail to ensure 5Rs

- Use override function on pyxis

- Failure to monitor according to SoC

****

• Many, many people have done #1 and/or #2. Usually when they do, we all say, "Don't be so hard on yourself!" Either that or no one ever even knows about it because it didn't lead to an actual mistake or if it did, there was no obvious patient harm
• If you've been a nurse since before auto-profiling, especially in certain departments, there's a good chance that #3, using "override," is (or fairly recently has been) SoP in your work area.
  • That aspect of this makes me particularly sick because the entity in question is using the override thing to make this look particularly evil. And actually the override wasn't the major problem here.
  • But if you don't claim it was the (utterly reckless) major problem, then eventually you might come around to some of the other factors, like the idea of a newer nurse who clearly was not prepared enough for this role to be familiar with either of these two medications or the required monitoring, being in a role of roving help-all while orienting someone even newer while being sent all over the damn hospital (or to at least two different outpatient departments, in one of which there were no other clinical/nursing staff present and no tools for nursing care), to do these various things, neither of which were urgent or even necessary, so that she could medicate the patient of a nurse who couldn't medicate her own patient because she was busy watching two full assignments' worth of patients in the ICU.
• You might not think so, but you've probably done #4, too. If you've missed a set of important vitals, if you haven't reassessed as quickly as you should after giving pain medication, if someone took your patient off the monitor and didn't put them back on, if you delegated a monitoring-related task that was then not completed in a timely manner (vitals, blood sugars, etc., etc., etc.)

The most unfortunate and egregious thing was not reading the label, and that's the bottom line.

But what she did NOT do was "bypass a hospital safety measure *in order to* gain access to the lethal drug used to to execute inmates on death row."

**

Oh, and she is also charged with impaired adult abuse. Which I'm guessing, to avoid "inadvertently" sounding like something isn't, would have been better written, "impaired-adult abuse" (IOW, the patient was impaired secondary to the medication).

[HiddencatBSN, BSN]

I work in the ED and we override ALL the time because we need the med before pharmacy can profile it. Usually by the time I get to a room it’s been profiled and I can scan it but especially for stuff that’s very urgent it might not be. Overrides are blocked on non-emergency meds but not on emergency meds so there’s a built in allowance for the overrides to happen given the way patient care works in the ED.

[monurse83, MSN, RN, APRN]

The nurse should most definitely lose her license to practice but not be locked away to lose her life in a prison system. It's bad enough that she has to deal with the consequences of her mistake for the rest of her life, knowing that she killed someone based on her negligence as a health care provider.