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.

[HomeBound]

Reckless homicide is a crime in which the perpetrator was aware that their act (or failure to act when there is a legal duty to act) creates significant risk of death or grievous bodily harm in the victim, but ignores the risk and continues to act (or fail to act), and a human death results.

Just a clarification.

Emotions are not involved in the law. I understand that she was overworked, etc. We ALL ARE.

However. That being said. She was trained as a Nurse, along with the rest of us, at a school that is accredited and she was drilled on the 5Rs repeatedly. Like the rest of us.

She was aware, as are the rest of us, at all times, that any of our actions can result in the death of another, which---gives all of us, the constant reminder that we need to be conscious of every single thing we do that involves drugs and patients.

She was aware, that she bypassed more than just 1 safeguard. She bypassed SEVERAL.

Ergo, she was aware that her act created a significant risk of death or grievous harm in the victim, she ignored the risk and continued to act, and a human death results.

As much as people don't like the law when it "seems wrong" or might be applied to their own actions in a case of mistakes---people are jailed every day for "mistakes". I don't think parsing how badly we feel for her applies to what the law states, nor is it helpful to imply that there is "COLLUSION" between golfing buddies.

If this were my grandmother....or my mother....well....I'm not as altruistic as some here, who claim that they'd just forgive and forget.

Sorry. The law is in place for a reason.

[HomeBound]

Again, emotional reaction does not equal "lawful".

If I went out, celebrating my graduation from nursing school, got drunk (willfully), got in my car (willfully), drove home drunk (willfully and in full knowledge that my actions may harm myself or others)---and ran over you or your kids and killed someone?

Reckless homicide? But I'm a nurse. I worked hard at nursing school and I was tired and overworked. I deserved to be able to drink---yes, maybe it was bad judgement that I drink and drive, and yeah, I knew that it's against the law, and yes...I did flout the law that says I am not allowed to do that, because it risks my own life and the lives of others...

but I'm a nurse. I get a pass.

No, I don't.

[EllaBella1, BSN]

Eh. Homebound, I disagree. I don't think anyone is suggesting that she get a pass here just because she's a nurse. The reason I have an issue with this is because although she clearly bypassed several safety checks, there are still components of a system failure here. I read the CMS report which said that pharmacy had verified the versed nearly 10 minutes before she tried to pull it. If that's the case then why wasn't it profiled? Why wasn't there a computer available in radiology for her to scan the medication? Why wasn't the vec in a RSI kit? And since it wasn't, why didn't it require an override?

There have been many sentinel events in the past involving medications- this one is no different. It should be seen as an opportunity to prevent something like this from ever happening again through change. Prosecuting the nurse, especially when the family isn't pursuing legal action, undermines the system improvement process.

I know for sure the nurse did not intentionally cause harm to this patient, and this just opens the door for more nurses being prosecuted in the future.

A hypothetical example- A patient is admitted with sepsis and is on Vancomycin. The nurse misses the order for a scheduled vanc trough and hangs the next dose as ordered. The trough would have been high prior to the dose, and is now critical and is through the roof. The patient's kidneys take a hit and do not recover. They're in acute renal failure, on pressors, end up fluid overloaded, intubated with ARDS and on CRRT. Eventually the family decides the prognosis is so grim that they withdraw and the patient dies. Can this nurse be prosecuted for missing the Vanc trough and administering the dose, kicking off this cascade? Because it's a nursing med error too that ultimately led to a patient's death.

This is a scary precedent to set.

[PhyllisMSN, MSN, RN]

This is absolutely wrong on many levels. Pharmacy and medicine should also share the “blame”.

Why is this nurse able to override a paralytic? The article does not say if the hospital had BCMA- I’m sure most medical centers have. Did the nurse not scan the drug? Did the nurse not have a computer to scan the drug? Was the MRI department in a hurry and insisted that the nurse give the drug?

I think this hospital has hung this nurse out to dry.

[Jory, MSN, APRN, CNM]

I originally answered "no" to whether she should be charged but now I am not so sure after reading more of the articles.

Someone else nailed it, she's being charged with reckless homicide, not murder.

That is the same charge you would get if you were speeding in a car and your negligence to operate in a safe manner caused the death of someone. You did not INTEND for them to die, but your actions were not those of a prudent individual which caused the death of another.

We have all used the override feature, but may I be blunt? How stupid do you have to be to looking for one drug, find one that has a name that isn't even close, call it "good enough" without so much as checking with the pharmacy???? I don't think many new graduate RNs would have made a mistake that dumb.

To any newer nurses reading this: If you are going to use the override feature, your eyes are taking place of electronic safeguards. You had better go through every single of the five rights and make sure that medication is 100% correct before you give it. If any of it is "off" DON'T give the medication.

[Wuzzie]

On 2/6/2019 at 2:18 AM, hyllisR said:

This is absolutely wrong on many levels. Pharmacy and medicine should also share the “blame”.

I'm curious to know why you think this. What exactly did the pharmacy or the physician do wrong?

[PhyllisMSN, MSN, RN]

On 2/6/2019 at 6:41 AM, Wuzzie said:

I'm curious to know why you think this.

On 2/6/2019 at 6:41 AM, Wuzzie said:

I'm curious to know why you think this.

I’m sure Vanderbilt has an Omnicell or Pyxis. Why is the nurse allowed to override a paralytic? I would be willing to bet if someone did a root cause analysis of this unfortunate incident, there would be a breakdown on many levels. When Incidents like this happen, very rarely is there one person/ department to blame.

[Wuzzie]

8 hours ago, KatieMI said:

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.

Which is why she isn't being charged with murder.

[Wuzzie]

1 minute ago, hyllisR said:

I’m sure Vanderbilt has an Omnicell or Pyxis. Why is the nurse allowed to override a paralytic? I would be willing to bet if someone did a root cause analysis of this unfortunate incident, there would be a breakdown on many levels. When Incidents like this happen, very rarely is there one person/ department to blame.

The ability to override is a common and necessary evil for emergency situations. I have had to pull Vec in an emergency on more than one occasion. The blame for this tragedy lies solidly on the shoulders of the nurse involved. I'm not always so black and white (see my comments on another recent medication error thread) but this situation is so beyond the pale that I find myself absolutely incapable of cutting her any slack whatsoever. That being said I certainly am not rejoicing in the ruination of her life. I would never wish what she's going through on any human being, not even my worst enemy.

[adventure_rn, MSN, NP]

24 minutes ago, Wuzzie said:

I would never wish what she's going through on any human being, not even my worst enemy.

I so agree.

This whole story reminds me so much of the nurse at Seattle Children's who committed suicide after a med error killed a baby (she accidentally gave 10 times the dose of calcium chloride). Instead of completing a root cause analysis, the hospital quickly fired her. This was an amazing critical care nurse with decades of experience on the unit.

Even if this person made a huge med error, I'm sure the guilt is already destroying her life. I don't see how a homicide charge would benefit anyone in this scenario.

[PeakRN]

From my understanding this nurse made several deviations from the standard of care that placed the patient at risk and the patient resulting died.

While I sympathize with her, it doesn't change the level of neglect that occurred and that her actions killed the patient.

I also think that we should remember that she has not yet been convicted, and is legally innocent until proven guilty in criminal court. She hasn't just been thrown in the prison, she will have her day in court to defend herself and a jury will make a decision based on her and the prosecutors evidence. I don't think that given the apparent circumstances that their be a criminal investigation or a trial.

[Iheartwoundcare, MSN, APRN, NP]

What is the legal precedent to charge a med error as reckless homicide? Do we all need to now prepare ourselves for the same fate if we make a mistake in the future? Frightening.

Revoke her license. Community service. She’s already going to live in some sort of hell the rest of her life.