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

523 members have participated

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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.

8 hours ago, Pippynurseuk said:

I've read the report and I have a question. They interviewed everyone except the orientee who was with her. She was a direct witness. Why would they have not talked to her? I suppose it wouldn't have added anything extra, they've clearly got all the facts but even still....

That's actually a really good point. It would give us an idea about the nurse's state of mind that day. Or why was the swallow evaluation so important?

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17 hours ago, Wuzzie said:

We all know why we do the 5 rights. We do it so as not to harm the patient. No one has a moment where they forget why we do them. They just choose not to do them. If they know why but opt not to do them then it is not unreasonable to say that they knew there was a risk involved.

I agree it is not unreasonable to say that. But I also think it's not unreasonable to give the nurse the benefit of doubt; maybe she did not stop even for a second to consider the fact that her actions risked killing that patient. Please understand everyone, that what should have been in her mind and what was or was not in her mind are two different things, and isn't that difference what determines which criminal charges (if any) she could be found guilty of? Isn't that difference what determines how many years in prison she could be facing?

And as horrible as it is, nurses who are very experienced, well respected, and 9.9 times out of 10 highly prudent might actually forget one of the med rights. We've heard stories from such on this thread. They did not choose to not adhere to the right which they forgot. They chose to adhere to every single right...then whoops, brain-fart or distraction, and a step was left out. She left out more than one step. By choice? Or by being mindless? As far as I can tell with descriptions of those criminal charges, the answer to that makes the difference with whether she should be found guilty.

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18 hours ago, Wuzzie said:

The unit was clearly not understaffed as they had enough nurses to actually staff a resource nurse.

But the resource nurse was for several areas not just that unit, so it seems to me that clearly the unit was understaffed. And if the Neuro-ICU nurse had to double-up on patients so someone could take a lunch break, in my opinion that's never a good idea and means they should've had more staff to avoid that unsafe situation.

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1 minute ago, mtnNurse. said:

I agree it is not unreasonable to say that. But I also think it's not unreasonable to give the nurse the benefit of doubt; maybe she did not stop even for a second to consider the fact that her actions risked killing that patient. Please understand everyone, that what should have been in her mind and what was or was not in her mind are two different things, and isn't that difference what determines which criminal charges (if any) she could be found guilty of? Isn't that difference what determines how many years in prison she could be facing?

And as horrible as it is, nurses who are very experienced, well respected, and 9.9 times out of 10 highly prudent might actually forget one of the med rights. We've heard stories from such on this thread. They did not choose to not adhere to the right which they forgot. They chose to adhere to every single right...then whoops, brain-fart or distraction, and a step was left out. She left out more than one step. By choice? Or by being mindless? As far as I can tell with descriptions of those criminal charges, the answer to that makes the difference with whether she should be found guilty.

Again, although the omission of completing the 5 rights is what everyone focuses on it is not what killed this patient. It was the lack of standard monitoring after giving an IV push medication. That is where the recklessness comes in. Had she properly observed this patient it would have become immediately evident that the patient was in trouble and she could have intervened. Had she done this and even if the patient died I would not be advocating for criminal charges.

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14 hours ago, juan de la cruz said:

That's certainly possible given the gross lack of caution and common sense displayed in this nurse's actions. She seems like a lost cause at this point but it's hard to wrap one's mind around how a person can finish a BSN and work in an ICU for 2 years and not kill someone sooner if that is how she practiced nursing.

You cannot conclude that this awful day in this nurse's life represents how she always practiced nursing. She may have been the most prudent nurse in the world up until that day for all we know. Two years is not necessarily enough experience to become a highly competent nurse who is capable of resource-nurse role. It's not hard for me to wrap my head around many possibilities, such as: she was highly competent and then this happened; she was highly incompetent but a well-meaning hard-worker, just not the brightest crayon in the box, and thus far lucked out.

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5 minutes ago, Wuzzie said:
13 minutes ago, mtnNurse. said:

I agree it is not unreasonable to say that. But I also think it's not unreasonable to give the nurse the benefit of doubt; maybe she did not stop even for a second to consider the fact that her actions risked killing that patient. Please understand everyone, that what should have been in her mind and what was or was not in her mind are two different things, and isn't that difference what determines which criminal charges (if any) she could be found guilty of? Isn't that difference what determines how many years in prison she could be facing?

And as horrible as it is, nurses who are very experienced, well respected, and 9.9 times out of 10 highly prudent might actually forget one of the med rights. We've heard stories from such on this thread. They did not choose to not adhere to the right which they forgot. They chose to adhere to every single right...then whoops, brain-fart or distraction, and a step was left out. She left out more than one step. By choice? Or by being mindless? As far as I can tell with descriptions of those criminal charges, the answer to that makes the difference with whether she should be found guilty.

Again, although the omission of completing the 5 rights is what everyone focuses on it is not what killed this patient. It was the lack of standard monitoring after giving an IV push medication. That is where the recklessness comes in. Had she properly observed this patient it would have become immediately evident that the patient was in trouble and she could have intervened. Had she done this and even if the patient died I would not be advocating for criminal charges.

I understand what you've said about how she should've monitored, and of course that is true. But I don't understand how that changes how my first paragraph above applies to the "should have been thinking of monitoring" as well? I think she took it for granted her belief (as erroneous a belief it was) that there was no harm about to come to that patient, despite all she'd been taught and all she should've known. For all we know, she thought multiple eyes in radiology were on that patient from then on -- this would NOT be an excuse for safe practice, and we all know she should have monitored -- but it would explain her erroneous belief that there was no risk of impending death. But whether she believed that patient had a chance to be killed from lack of monitoring or anything else determines the relevant criminality, does it not?

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14 hours ago, JKL33 said:

Well, Nurse #2 (primary nurse) is the one who got on the phone and argued with the rad techs after they said their nurses wouldn't push a med because the patient needed to be monitored. She shut that right down and told them that the patient didn't need to be monitored and that she would send someone down to give the med...

[Still not excusing Nurse #1!!]

I agree with this. The primary nurse is the one who knows the patient more than the one who gave the vec.

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Specializes in Pediatrics, Pediatric Float, PICU, NICU.
15 minutes ago, mtnNurse. said:

I understand what you've said about how she should've monitored, and of course that is true. But I don't understand how that changes how my first paragraph above applies to the "should have been thinking of monitoring" as well? I think she took it for granted her belief (as erroneous a belief it was) that there was no harm about to come to that patient, despite all she'd been taught and all she should've known. For all we know, she thought multiple eyes in radiology were on that patient from then on -- this would NOT be an excuse for safe practice, and we all know she should have monitored -- but it would explain her erroneous belief that there was no risk of impending death. But whether she believed that patient had a chance to be killed from lack of monitoring or anything else determines the relevant criminality, does it not?

I guess I struggle with where to draw the line like others have mentioned. I am no lawyer, but in regards to criminality I think her intent is the main thing that matters which is why she isn't being charged with murder because it is clear that she did not intend to kill anyone.

Are you saying that a truck driver who was driving longer than they are legally able to in a 24 hour period who killed someone due to many factors including lack of sleep, mindlessness, pressure from the company to meet deadlines, etc. should bear no criminal responsibility for directly killing someone in an accident simply because he/she believed that they were putting nobody in risk of impending death?

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Also, Wuzzie, you've had the good question of "where do we draw the line". What I described above is where I think the line should be drawn. If she were consciously aware in the moments of administering that medicine that pushing that med had the chance to kill that patient, yet she did it anyway, I think that is called reckless homicide. If instead, she erroneously believed in the moments of administering that medicine that her action had the chance to kill but the risk was so low that she just didn't consider it was possible, I think that is called criminal negligence. If instead, she erroneously believed in the moments of administering that medicine that there was zero chance to kill that patient, I believe she should not be criminally charged.

What she should've believed and what she did believe, as far as I can tell, determines the criminality of this case.

And I do believe she erroneously believed in the moments of administering that medicine that there was zero chance to kill that patient. I believe that, from what I've heard of the case so far, because I think she was being mindless, in a rush, and took it for granted that all was well.

(disclaimer: But again, each of my sentences could be preceded by "I humbly think" (@Homebound) or ended with a question mark regarding what the charges imply. Would still love to hear from a nurse-lawyer if one pops in here.)

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59 minutes ago, mtnNurse. said:

But the resource nurse was for several areas not just that unit, so it seems to me that clearly the unit was understaffed. And if the Neuro-ICU nurse had to double-up on patients so someone could take a lunch break, in my opinion that's never a good idea and means they should've had more staff to avoid that unsafe situation.

Yikes, that provides more insights in the situation. Apparently the primary nurse of the patient was also covering for somebody else which is why she sought out help from the resource nurse. So they probably have staffing issues if they have the resource nurse covering multiples areas, she was probably overwhelmed, running around and not thinking properly as she was performing her nursing duties.

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7 minutes ago, JadedCPN said:

I guess I struggle with where to draw the line like others have mentioned. I am no lawyer, but in regards to criminality I think her intent is the main thing that matters which is why she isn't being charged with murder because it is clear that she did not intend to kill anyone.

Yes, of course intent would've made it murder, which no one suspected and she was not charged with. But lack of intent does not automatically make it a lesser criminal charge, as I explained what I think those criminal charges would imply above. Obviously I'm not a lawyer, but I've yet to hear another interpretation of the difference in those criminal charges and whether "should have been aware" vs "was aware" makes the difference in her reckless homicide charge.

Since she's not even charged with murder, why do you say intent is the main thing that matters here? The issue with her charges is whether she gets 6 years, 12 years, or no years in prison...whether she is a felon for the rest of her life or not.

I don't think your analogy applies well to this case, and I'll pass for now unless you start a separate analogy thread.

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Specializes in Psych, Corrections, Med-Surg, Ambulatory.
1 hour ago, mtnNurse. said:

You cannot conclude that this awful day in this nurse's life represents how she always practiced nursing. She may have been the most prudent nurse in the world up until that day for all we know. Two years is not necessarily enough experience to become a highly competent nurse who is capable of resource-nurse role. It's not hard for me to wrap my head around many possibilities, such as: she was highly competent and then this happened; she was highly incompetent but a well-meaning hard-worker, just not the brightest crayon in the box, and thus far lucked out.

I have a hard time believing any circumstance could make "the most prudent nurse in the world" type in V-E and grab the first thing that came up. That is the part that I will never get my head around. We've all had experience with look-alike and sound-alike drugs. But a warning popped up on the Pyxis; there was a warning on the vial cap. It needed to be reconstituted. She used the wrong thing to reconstitute. And there was a second RN with her, because she was precepting.

I agree with the others; I want to hear the perspective of the orientee.

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