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.

[OyWithThePoodles, RN]

I've read through all 41 pages, and I will add is this:

I see some saying "The family forgives her, we should too."

From someone who has had two family members murdered (granted not from medical error) I forgave, but that doesn't mean I don't want the man to spend the rest of his life in jail for what he did.

I am incredibly sad for both the family and the nurse, but plain and simple, she admitted to not even reading the bottle label. THAT is reckless. It's not up to me if she should go to jail, but in my daily practice as a nurse... I know that any single decision I make could end a patients life. And I admit, I've relied on the barcode scanning too much, BUT (BUT) in the event that the medicine wouldn't scan, or the computer was down, I ALWAYS QUADRUPLE CHECK. Not having those extra safety measures there should make you even more cautious.

I have override rights in my hospital but I can only override certain meds. Meds that are pertinent to my area. Meaning, I couldn't pull Versed. While she was trained to give Versed, she shouldn't have been able to pull Vec.

All of that to say: It doesn't matter what she pulled, she could have actually typed in Versed and the pyxis could have been stocked wrong, none of that matters because she didn't simply check. the. label.

[mtnNurse., BSN]

14 hours ago, juan de la cruz said:

I get that med errors happen some with catastrophic outcomes to good nurses but the egregious nature of her actions makes me want to think of a nurse who is "over-confident", "reckless", "non-chalant" despite knowing better.

I understand why you think that. We can only imagine what type of nurse she usually is because we don't know. I imagine her to be usually prudent and then horrible circumstances led her to fail to be as aware / critically-thinking / present-in-the-moment as nurses "should be" every second of the work day without fail, regardless of the work environment and regardless of circumstances. I picture her in those 30 min. or hour or longer (sorry I forget how long from the time she was delegated to do the med. pass and pushing the med) accidentally grabbing the wrong medicine, preparing it, pushing it, and failing to monitor afterwards. I also picture her being in a mindless rush and can imagine many environmental circumstances leading her to be in a mindless rush. Just one example, could miscommunication have led her to believe that someone else would have eyes on the patient -- NOT an excuse as someone would argue, that SHE should not have monitored herself. But none of what I am saying is an excuse for her failing to do everything the right way. There could be many excuses though of why the criminal charges don't apply and why she ought not to be locked up in prison and labeled a felon.

There's a big difference between being reckless, stupid, and momentarily mindless...and in fact therein maybe lies the difference in whether criminal charges could apply. Two years is not a lot of experience. "Should have known" and "did know" are two different things.

I do think I'm more prone to want to give her the benefit of the doubt (again, not in excusing what she "should have" done as a nurse but excusing that what she did do is not criminal behavior) than some of you awesome superstar critical care nurses who have decades of experience under your belts, because it's more recent in my mind how overwhelming the first couple years of work are. Maybe she didn't have enough experience to be in the resource role she was in. Maybe she was striving so hard to be a "good worker" and didn't know yet how to prioritize better and how to stand up to pressures to work faster. Can any of you try harder to imagine what that day was like for her, and so imagine that perhaps consequences such as loss of licensure is warranted, but years in prison and life-time label as felon for this is cruel and unusual punishment?

[Corey Narry, MSN, RN, NP]

26 minutes ago, mtnNurse. said:

I do think I'm more prone to want to give her the benefit of the doubt (again, not in excusing what she "should have" done as a nurse but excusing that what she did do is not criminal behavior) than some of you awesome superstar critical care nurses who have decades of experience under your belts, because it's more recent in my mind how overwhelming the first couple years of work are. Maybe she didn't have enough experience to be in the resource role she was in. Maybe she was striving so hard to be a "good worker" and didn't know yet how to prioritize better and how to stand up to pressures to work faster. Can any of you try harder to imagine what that day was like for her, and so imagine that perhaps consequences such as loss of licensure is warranted, but years in prison and life-time label as felon for this is cruel and unusual punishment?

To be honest, I'm vacillating in terms of my opinion of what should happen to her because of the yet unanswered questions about the circumstances in the case.

Like I said before, I still would not want to see a criminal prosecution because I feel that it is not the venue for resolving these events. It's going to be a bunch of lawyers strategizing, coaching witnesses, manipulating the angles...it's going to be a circus. I know that this nurse's error led to this patient's death no question about that. I still vote for a BON investigation, let's deal with our own problem child so to speak.

You are probably right that I likely would not cause such a mistake even if I were busy. "Inattention blindness" aside, there are many cues that already exist in my brain about what a Versed vial looks like and how paralytic agents are packaged. I administer them frequently as part of my role. However, we are all prone to mistakes and I hope to never forget to be careful with my actions every time. I do procedures as an NP and you bet I have a healthy dose of nervousness even though I've done them hundreds of times.

[ronny1067]

Vanderbilt should be ashamed of themselves.... Ultimately they are responsible.

[Horseshoe, BSN, RN]

Let's assume for the sake of argument that YES, all of the criteria for a criminal charge and conviction of this nurse have been met. I believe that the purpose of criminal charges and incarceration are twofold: to punish criminals and to deter others from doing the same.

If RV is convicted, yes, the punishment part of the equation will have been met. People can get their pound of flesh and be happy that a criminal has been taken off the street and out of the hospital corridors.

Will it result in deterrence? Will fewer medication errors be made because this particular nurse was held to account in a criminal court, thus scaring the rest of us straight and making us think twice about skipping any part of the processes that are in place to prevent such errors? I imagine that a lot of us will think about this case as we go about our days.

The problem I see here is that it is highly likely that though PERHAPS medication errors may decrease by some small percentage in the very short term, the VOLUNTARY REPORTING of medication errors will suffer a HUGE hit. No one wants to suffer criminal consequences of a mistake, no one wants to see their peers suffer criminal consequences of a mistake. Even though the chances of being criminally charged for a medication error are still small, there will now be a *perception* that in addition to the usual consequences of medication errors, now we can be arrested for making a medication error.

I think when weighing the public benefit of putting a nurse in jail for a pretty egregious series of negligent acts vs. the inevitable deterioration of a process intended to analyze and correct reasons for medication errors, thus preventing more of the same in the future, we need to be really really careful. It may feel good in the short term to punish someone for incredible stupidity, to get retribution for taking a life (in a terrible manner) and for breaking down public trust in our profession as a whole. In the long run and big picture, putting her in jail doesn't do anything to further protect the public. I think in the long run, it puts the public in even more peril because now errors will be covered up, a culture of secrecy is implicitly encouraged, and we lose the chance at the self reflection that allows the discovery of new ways to improve patient safety.

JMO.

[Susie2310]

2 hours ago, Horseshoe said:

The problem I see here is that it is highly likely that though PERHAPS medication errors may decrease by some small percentage in the very short term, the VOLUNTARY REPORTING of medication errors will suffer a HUGE hit. No one wants to suffer criminal consequences of a mistake, no one wants to see their peers suffer criminal consequences of a mistake. Even though the chances of being criminally charged for a medication error are still small, there will now be a *perception* that in addition to the usual consequences of medication errors, now we can be arrested for making a medication error.

I think when weighing the public benefit of putting a nurse in jail for a pretty egregious series of negligent acts vs. the inevitable deterioration of a process intended to analyze and correct reasons for medication errors, thus preventing more of the same in the future, we need to be really really careful. It may feel good in the short term to punish someone for incredible stupidity, to get retribution for taking a life (in a terrible manner) and for breaking down public trust in our profession as a whole. In the long run and big picture, putting her in jail doesn't do anything to further protect the public. I think in the long run, it puts the public in even more peril because now errors will be covered up, a culture of secrecy is implicitly encouraged, and we lose the chance at the self reflection that allows the discovery of new ways to improve patient safety.

JMO.

In regard to your first paragraph above, new methods need to be employed to protect against licensed practitioners dishonestly failing to report medication errors. Many errors in care are not currently reported, 'just culture' or not.

The general public have the most power in my opinion, not the health care industry. The health care industry relies on the confidence of the general public. If as a result of this the general public become more politically active in advocating for safe care I believe that could yield significant improvements in patient safety.

I have known since nursing school that nurses can face criminal charges for providing care that is below the standard of care when patients suffer harm/death.

I find your second paragraph self-serving, as I do many of the replies here. Of course we know that nurses don't like to think of themselves being criminally charged in similar circumstances. Also, being charged with a criminal offense is not the same as being found guilty of a criminal offense.

The general public has the right to be protected from licensed health professionals who practice below the standard of care and cause or contribute to patient injuries/deaths.

[Wuzzie]

2 hours ago, Horseshoe said:

It may feel good in the short term to punish someone for incredible stupidity, to get retribution for taking a life (in a terrible manner) and for breaking down public trust in our profession as a whole.

I don't think any of us who agree with the indictment are breaking out the champagne over this. I am certainly not celebrating this nurse's downfall. I hope you weren't implying that.

[Horseshoe, BSN, RN]

14 minutes ago, Wuzzie said:

I don't think any of us who agree with the indictment are breaking out the champagne over this. I am certainly not celebrating this nurse's downfall. I hope you weren't implying that.

I don't think you are. But I think there are some who are absolutely taking a sick kind of pleasure in it. The public reaction goes far beyond AN.

[Horseshoe, BSN, RN]

22 minutes ago, Susie2310 said:

The general public has the right to be protected from licensed health professionals who practice below the standard of care and cause or contribute to patient injuries/deaths.

Of course they do. Throwing them in jail is not the only way to accomplish that, as we all know. Even nurses found to have diverted medications in some really outrageous circumstances rarely find themselves charged criminally.

[Horseshoe, BSN, RN]

31 minutes ago, Susie2310 said:

In regard to your first paragraph above, new methods need to be employed to protect against licensed practitioners dishonestly failing to report medication errors. Many errors in care are not currently reported, 'just culture' or not.

I find your second paragraph self-serving, as I do many of the replies here. Of course we know that nurses don't like to think of themselves being criminally charged in similar circumstances.

It's not self serving to state the obvious conclusion which can be drawn from my statement: because nurses don't want to go to jail and don't want to see their peers go to jail, the transparency that we ALL should want to see with regard to medication errors or other unsafe practices will be eroded even further than it already is.

I'm not likely to make a medication error: I'm a circulator in an elective cosmetic surgery OR. I don't give drugs in there, and any error I might make will be witnessed and immediately noted by the 3 other professionals in the room before I could possibly harm a patient. It doesn't really serve myself to state that I don't believe nurses should go to jail if they make medical errors. I would feel the same if I were completely retired. It doesn't really serve the public well in the big picture. Any incompetent nurse can be removed from the profession without sending her to prison.

[Susie2310]

5 minutes ago, Horseshoe said:

Of course they do. Throwing them in jail is not the only way to accomplish that, as we all know. Even nurses found to have diverted medications in some really outrageous circumstances rarely find themselves charged criminally.

Why are you using such hyperbole? To my knowledge no-one has been convicted yet, let alone thrown in jail. You seem desperate to influence people.

[Horseshoe, BSN, RN]

3 minutes ago, Susie2310 said:

Why are you using such hyperbole? To my knowledge no-one has been convicted yet, let alone thrown in jail. You seem desperate to influence people.

The stated goal of any prosecutor is to get a conviction or guilty plea, give me a break. I'm no more "desperate" (talk about hyperbole) than you to state my opinion, and my opinion doesn't seem to be any more firmly held than your own.