Nurse Charged With Homicide

Nurses General Nursing

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You are reading page 34 of Nurse Charged With Homicide

  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

523 members have participated

mtmkjr, BSN

453 Posts

44 minutes ago, johsonmichelle said:

You did not answer my question, I'm not trying to deter from the original case, because the nurse in question is an ICU nurse. I'm not an ICU nurse, therefore I would not administer ICU medications under normal circumstances especially in this case. It's also part of the unit policy not administer those type on my floor unless it was an emergent situation.

I thought the question was answered, so I don't think I understand what you are asking. There are so many posts...can you clarify?

mtnNurse., BSN

1 Article; 147 Posts

Homebound, regarding what you said about my posts, I thought part of the discussion could be about whether her behavior fits the definition of "reckless homicide" because OP's question is whether she should be charged with reckless homicide. I'm sorry if I sometimes repeat my points as everyone else has been doing -- I think it would be helpful for everyone to read every single post in the thread before replying so we don't keep repeating ourselves (and no, I'm not saying you didn't do so). Maybe part of your reaction to what I wrote is that I used the words quoted below "to be charged with" when what I was meaning was "to be charged with and found guilty of". Regarding you writing that I take on the "because I said so" attitude, and for the sake of our conversation, let's all assume that when someone writes something like "her behavior didn't fit the definition of reckless homicide" that it is preceded by "in my very humble opinion, despite not being as smart as I really wish I was, I think that...".

Quote

To be charged with "reckless homicide", she had to consciously in those moments be aware of the fact that she was taking a chance on killing that patient. To be charged with "criminal negligence", she did not have to be aware of the fact she might be killing the patient, but only be aware of the fact she held a weapon in her hand, so to speak. Interpreting the law is a subjective thing, so of course we can disagree on which definition, if any, her behavior fits.

I believe she doesn't fit "reckless homicide" because it seems obvious to me that had she known she was possibly about to kill the patient she would have been aware enough to double-check the medicine. I believe she doesn't fit "criminal negligence" because I think she was being mindless and taking it for granted that she had the right medicine. I don't think she should be criminally charged; lose her license or other solutions maybe, but not criminally charged. But I can definitely see "criminal negligence" at least making more sense as a charge than "reckless homicide", which is the charge. And the abuse charge? That doesn't make sense unless she did it on purpose.

mtnNurse., BSN

1 Article; 147 Posts

17 hours ago, Molemedic said:

Her actions although a mistake fit the very definition of reckless homicide according to Tennessee state law. Inadvertently administering the wrong medication would have been cause for discipline and possible discharge but the act of intentionally and RECKLESSLY overriding a safety feature designed to prevent this sort of error is what makes this a crime. There were multiple points which could have led to the recognition of the error had the nurse followed hospital policy and nursing guidelines but instead, she disregarded everything she had ever been taught or told and acted RECKLESSLY. I understand that the Patient's family remains forgiving but the fact of the matter is that her actions and recklessness caused the loss of life and this action has consequences. I think many nurses defend or feel sympathy for her out of fear of one day being in the same situation

Molemedic, critical care nurses have given good reasons for the essential override function multiple times so I hope you read them. Yes, we all think she should not have bypassed the patient rights of medication administration, she should have monitored the patient, she should have done many things differently, or she perhaps should never have become a nurse (or she was actually a prudent nurse and unimaginable things happened that day to cause her to be so mindless). Most comments are displaying shock of all that she should have done yet did not do. BUT...and I would love for a nurse-lawyer to weigh in on this -- doesn't "reckless homicide" imply that in the moments of pushing that med and walking away, she was consciously thinking her patient has a good chance of dying from what she just did? In contrast, wouldn't "criminal negligence" imply that she did not stop to think in those moments that she was gambling with that patient's life? I know my questions will bring more of the same "she SHOULD have known, there is NO excuse for not being AWARE every single second of every single day as a nurse!" -- and yes, we all agree she is to blame for that and it's tragic and she should, should, should have to infinity and beyond. But that does not answer these questions I have about the criminal charges being put on her.

I don't think anyone here thinks she did it on purpose, and we all know there does not have to be intent to kill to be guilty of reckless homicide (if it were intended, there would be a harsher murder charge). But though not intended, several do not like it being called a mistake or error. So is "failure" an ok word to use for you? I think-that-we-all-think-that her failure should have consequences. My question is, if you were to assume the very best of this nurse, meaning she was incompetent but well-meaning: does her failure warrant 12 years in prison, alongside those who killed on purpose, followed by a life-time of trying to get by in this country as a felon?

And yes, Molemedic, you are right that some of us fear criminal consequences for future unintended failures we have. I wholeheartedly agree with those who have said tragedies such as this are a good wake-up call to always, always, always be 100% aware of what you are doing and why when you are working as a nurse. Yet I also know despite all our best efforts, we as humans might fail when we least expect it. No, you will never ever fail in the way this nurse failed, those of you who have have claimed that many times. But you might fail in another way that you can't imagine right now. And most of us agree this nurse badly failed and is to blame. What surprises me are the nurses who don't think ANY changes to the unsafe work environments could make ANY difference in preventing future failures like this, despite several people pointing out some very good ideas that could help in prevention.

23 hours ago, Wuzzie said:

That awareness brings an abundance of caution into my practice which makes me take the time to do things the right way...every. single. time.

Let's all strive to be as aware as Wuzzie always is in her practice, and also while we're at it, let's be aware of how the environment can affect our awareness and how to improve that environment along with ourselves.

She most likely was exhausted due to not enough staff to cover the floor or unit . I have worked with nurse’s from critical care that went to Home Health due to not being properly staffed and she did not want to be responsible if she could not adequately take care of the patients !!!! Most likely the nurse was fatigued and over worked in which the facility allowed !! Need to staff more nurse’s to take care of patients !!

AceOfHearts<3

916 Posts

Specializes in Critical care.
2 hours ago, Pippynurseuk said:

I'm from the UK and I work in patients homes not in a hospital so completely different culture. I am curious how technology; automated medication machines, scanning etc has affected nurses thinking and behaviour. What are people's honest opinions, has this created a culture where it's the norm to not read labels on vials? Not judging, just curious.

I always check the name and dosage on any med. I work in an ICU in the USA and I once pulled an IV antibiotic out of the med room that was labeled for my patient, the correct time was on it, the correct med name was on it etc. but it was NOT the correct med. Pharmacy had put the label on an entirely different antibiotic. I wasn’t impressed with their laissez faire attitude about it. I reported it to my manger with the evidence (the clearly mislabeled med) and filed an event report about it.

I check my meds at a computer outside of the patient’s room first, then I take them in and look over them again while scanning (I also say what the med is and why they are getting it- here is your 5mg amlodipine, brand name Norvasc, for your high blood pressure, etc), and another time when I open them.

If it’s an IV infusion I also always check that the med matches the infusion info that is programmed into the pumps. We have some meds that the concentration has changed because of manufacturing issues- what may have been in 100ml now might be only in 50ml. If I select the med and strength and go with the pre-programmed information the patient will get the med in 15 minutes instead of the intended 30 minutes (as ordered).

I’ve also had it where the next shift left me a new bag on the WOW for a continuous gtt that was running low. I once correctly scanned a med and verified it was correct, but then picked up the wrong one from the WOW. I’m so meticulous with checking the bag, the pump, and my MAR that I caught my mistake. If I had hung the other med and programmed it as the one that I had scanned out the patient in all likelihood would have died. Never leave spare meds on your workstation- it’s a disaster waiting to happen.

TriciaJ, RN

4,328 Posts

Specializes in Psych, Corrections, Med-Surg, Ambulatory.

I just looked up Tennessee law on reckless homicide and criminally negligent homicide. I also read the report posted on page 14 of this thread. All factors considered, the State of Tennessee certainly has what they need to make a case for reckless or criminally negligent homicide.

How it all plays out in the system and whether she gets convicted of anything remains to be seen.

mtmkjr, BSN

453 Posts

2 hours ago, mtnNurse. said:

Molemedic, critical care nurses have given good reasons for the essential override function multiple times so I hope you read them. Yes, we all think she should not have bypassed the patient rights of medication administration, she should have monitored the patient, she should have done many things differently, or she perhaps should never have become a nurse (or she was actually a prudent nurse and unimaginable things happened that day to cause her to be so mindless). Most comments are displaying shock of all that she should have done yet did not do. BUT...and I would love for a nurse-lawyer to weigh in on this -- doesn't "reckless homicide" imply that in the moments of pushing that med and walking away, she was consciously thinking her patient has a good chance of dying from what she just did? In contrast, wouldn't "criminal negligence" imply that she did not stop to think in those moments that she was gambling with that patient's life? I know my questions will bring more of the same "she SHOULD have known, there is NO excuse for not being AWARE every single second of every single day as a nurse!" -- and yes, we all agree she is to blame for that and it's tragic and she should, should, should have to infinity and beyond. But that does not answer these questions I have about the criminal charges being put on her.

I don't think anyone here thinks she did it on purpose, and we all know there does not have to be intent to kill to be guilty of reckless homicide (if it were intended, there would be a harsher murder charge). But though not intended, several do not like it being called a mistake or error. So is "failure" an ok word to use for you? I think-that-we-all-think-that her failure should have consequences. My question is, if you were to assume the very best of this nurse, meaning she was incompetent but well-meaning: does her failure warrant 12 years in prison, alongside those who killed on purpose, followed by a life-time of trying to get by in this country as a felon?

And yes, Molemedic, you are right that some of us fear criminal consequences for future unintended failures we have. I wholeheartedly agree with those who have said tragedies such as this are a good wake-up call to always, always, always be 100% aware of what you are doing and why when you are working as a nurse. Yet I also know despite all our best efforts, we as humans might fail when we least expect it. No, you will never ever fail in the way this nurse failed, those of you who have have claimed that many times. But you might fail in another way that you can't imagine right now. And most of us agree this nurse badly failed and is to blame. What surprises me are the nurses who don't think ANY changes to the unsafe work environments could make ANY difference in preventing future failures like this, despite several people pointing out some very good ideas that could help in prevention.

Let's all strive to be as aware as Wuzzie always is in her practice, and also while we're at it, let's be aware of how the environment can affect our awareness and how to improve that environment along with ourselves.

We are held to the standard of care that would be expected of a prudent nurse in a similar situation.

She will not be judged on what she was thinking in that particular moment, but on the actions of any other prudent nurse.

And yes if I were in that situation I would be thinking that there is a good chance I could cause a person's death if I were to grab the first vial the machine popped out for me, shoot it into the patient and walked away.

TriciaJ, RN

4,328 Posts

Specializes in Psych, Corrections, Med-Surg, Ambulatory.

Agree with above; the prosecution will likely call nurses to the witness stand to testify about standards of care and what could be reasonably expected of a prudent nurse.

If you look up definitions for reckless homicide or criminally negligent homicide in Tennessee, it appears this situation meets criteria for being charged with one or the other.

Horseshoe, BSN, RN

5,879 Posts

38 minutes ago, TriciaJ said:

Agree with above; the prosecution will likely call nurses to the witness stand to testify about standards of care and what could be reasonably expected of a prudent nurse.

If you look up definitions for reckless homicide or criminally negligent homicide in Tennessee, it appears this situation meets criteria for being charged with one or the other.

Just because they can doesn't mean that they are required to do so. Prosecutors decline to press charges all the time for all kinds of reasons.

What I wonder when I think about this case is this:

Will charging and convicting and sending to jail this particular nurse cause nurses in great numbers to be even more careful-will the effect of this case result in positive change?

OR: Will this case cause nurses to be even less likely to report errors? Errors that go unreported cannot be assessed to find causes and solutions to prevent further such occurrences.

I personally believe it will be the latter rather than the former, which is the exact opposite that anyone who values patient safety would want.

We say this all of the time in health care: "Just because you can doesn't mean you SHOULD."

Horseshoe, BSN, RN

5,879 Posts

People keep saying that no system corrections would ever be needed if nurses would just practice the 5 rights. I can't argue with that, but...

Reading comments to a video on this by ZDoggMD, and saw several that noted that their pyxis doesn't allow overrides on paralytics. One said that when you put in for vec, a window pops up asking "Is this patient on a vent or about to be intubated?" A no answer will give you a message that the drug cannot be dispensed.

It's those kinds of things that can prevent human error like this. I UNDERSTAND and agree that if this nurse had followed the 5 rights, such a protective mechanism would be unnecessary, but we KNOW that humans make mistakes, take shortcuts, or do incredibly stupid things. Some humans in hospitals purposely do things to harm patients. If there is a way to prevent these human errors, egregious and unfathomable as they may be, why shouldn't they be utilized?

Think of the person you love most in the whole world. Do you want their care to be 100% based on what doctors, nurses, pharmacists, etc. SHOULD DO and SHOULD NEVER DO with no backup plan in case that threshold is not met? I sure don't.

In a perfect world, nurses don't do 5 stupid things in a row that could kill someone. We now should understand that our world is imperfect and nurses do in fact act in ways that are completely counter to their training. Any process that can be put into place that anticipates that embarrassing and shameful reality is a good thing.

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Rose_Queen, BSN, MSN, RN

6 Articles; 11,663 Posts

Specializes in OR, Nursing Professional Development.

I think the nurse made egregious errors that go well beyond a systems issue. There are indeed systems issues as well, but she bears the brunt of the responsibility here for not acting as a prudent nurse and making sure she was giving the right medication, especially as the back up adjunct of bar code wasn't available.

Do I think she should be charged? I'm torn on that. I also believe they may have gone for the more serious of the charge and will likely have an opportunity for the jury to drop to the lesser charge- you see that frequently in criminal trials.

DVB, BSN, RN

11 Posts

We set a dangerous precedent being supportive of homicide charges for this case for all nurses. We make nurses the hospital scapegoat for a tragic incident. They wonder why most RNs get out of nursing the first five years? Things like this. We will never get or keep reliable staff if we are filing criminal charges for a medication error. Things that should have happened? Disable to override function. Make it so you have to call the pharmacy to escape the override. The pharmacist can verify with the MAR and RN what you intend to give. Medication refresher course for her if this is her first medication error. Continuing education for staff and clinicians alike. Disciplinary action, perhaps even up to a loss of license. However criminal charges will chase away many people from seeking nursing as a career.

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