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.

[SeasonedOne, RN]

"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."

In reading the answers, I wonder if many are responding from the heart or the head. When looking for answers from a nursing perspective, it may be very difficult to be objective as we all have been in positions of stress, overwhelmed and over worked. Yet, when giving medications are we not all responsible to give the right medication; to the right patient; at the right time; in the right dose; using the right route?

Thankfully most medication errors don't result in the death of a patient, but the risk is always present. The potential for harm from a nurse's action is always there. This is why we double check insulin, blood types and other dangerous medications in an effort to minimize the risk.

We don't know all the circumstances of this nurse's knowledge, patient load, stressors or details of the day's actions. This charge should cause any nurse to evaluate their practice to minimize the risk. Each of us could be in this nurse's place with a lapse in judgement, skill or momentary distraction. It is difficult not to place ourself in her shoes. To hope that we would be judged with empathy and understanding. We see the devistation probably more than most as we are exposed to life's challenges on a daily basis. It is where nurses come from. We care and that can be a conflict for our objectivity. We understand how vulnerable we would be.

Ultimately this will play out in a court of law where each side will have the opportunity to make their positions known. It also makes a point that we never know when a decision that makes us vulnerable might show up at our doorstep. It is a reason where nursing Liability Insurance can provide a bit of security to our practice.

Perhaps better questions to ask may be... "Did this nurse follow the usual and accepted practice guidelines? Would her education, knowledge and experience support her decision making and actions? Was facility procedure followed? The answers to those questions will determine if she in fact was reckless in the death of this patient.

Nursing isn't a profession for the faint of heart. If a nurse is never worried of making a mistake, then perhaps this isn't the profession for you.

[Crow31]

I've been thinking more about this. Can anyone tell me why this is a criminal charge instead of malpractice? Is there more to this than just a medication error leading to death? Was she intentional in trying to hurt this person or something else that may explain the criminal aspect?

[Crow31]

9 hours ago, SeasonedOne said:

I "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."

In reading the answers, I wonder if many are responding from the heart or the head. When looking for answers from a nursing perspective, it may be very difficult to be objective as we all have been in positions of stress, overwhelmed and over worked. Yet, when giving medications are we not all responsible to give the right medication; to the right patient; at the right time; in the right dose; using the right route?

Thankfully most medication errors don't result in the death of a patient, but the risk is always present. The potential for harm from a nurse's action is always there. This is why we double check insulin, blood types and other dangerous medications in an effort to minimize the risk.

We don't know all the circumstances of this nurse's knowledge, patient load, stressors or details of the day's actions. This charge should cause any nurse to evaluate their practice to minimize the risk. Each of us could be in this nurse's place with a lapse in judgement, skill or momentary distraction. It is difficult not to place ourself in her shoes. To hope that we would be judged with empathy and understanding. We see the devistation probably more than most as we are exposed to life's challenges on a daily basis. It is where nurses come from. We care and that can be a conflict for our objectivity. We understand how vulnerable we would be.

Ultimately this will play out in a court of law where each side will have the opportunity to make their positions known. It also makes a point that we never know when a decision that makes us vulnerable might show up at our doorstep. It is a reason where nursing liability insurance can provide a bit of security to our practice.

Perhaps better questions to ask may be... "Did this nurse follow the usual and accepted practice guidelines? Would her education, knowledge and experience support her decision making and actions? Was facility procedure followed? The answers to those questions will determine if she in fact was reckless in the death of this patient.

Nursing isn't a profession for the faint of heart. If a nurse is never worried of making a mistake, then perhaps this isn't the profession for re

Thank you for your response. I appreciate the definition of reckless homicide. Really does scare me though because really all medication errors could fit in that definition if they lead to death. Just a side note though, I was told by coworkers that malpractice insurance wouldn't help in this situation because these are not civil charges of malpractice, but criminal charges. (SO SCAREY) She is at the mercy of the court now. I do hope this judge understands that given the details we know of the situation, does intend to charge her and sentences her to prison there will be dire consequences for sure not only in nursing, but medicine in general.

If this woman is sentenced to prison for a fatal medication error I want this case to be taught in nursing school. You're right nursing isn't for the faint of heart and in some ways we are the "soldiers" of medicine. Teachers will have to start saying "I look at you all today and know all of you will do great things. All of you will make mistakes and learn and some of you will go to prison." I wish someone had told me that was a possibility because I would had said "Wait, what? Umm... I gotta go." ? I am one of those "faint of heart" you speak of I assume then. I want to help people and God forbid ever hurt anyone, but I'm not as so sacrificial as to give up my life in prison for this profession. I'm out!

I wish people would more understand this is more than "Oh, that will never be me." or even "I think this is wrong and I feel bad for her." These charges are insulting to nursing and especially if followed through ever will change nursing/medicine as we know it.

[Crow31]

On ‎2‎/‎12‎/‎2019 at 8:30 AM, Horseshoe said:

If any of you follow ZDoggMD's Youtube channel, you may have seen his video on the Vanderbilt medication error. Like most of us, he was shocked and appalled.

After watching this, I saw he posted his reaction to the criminal charges. I was a little surprised at his passion, based on his original video.

His take will upset a lot of nurses here on AN.

One good thing about seeing these videos is that it reminded me of him and his channel. I binged watched a bunch of his videos and found a lot of them to be quite thought provoking.

OH MY GOSH THANK YOU, THANK YOU, THANK YOU FOR SHARING THIS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

His second video has been my whole point all along. Reading this responses and the responses people had to my comments was frustrating and depressing. Reading the comments I could see that nurses were not getting the magnitude of this situation.

THANK YOU! THANK YOU!

[Luchador, CNA, EMT-B]

54 minutes ago, Crow31 said:

If this woman is sentenced to prison for a fatal medication error I want this case to be taught in nursing school.

I'm in nursing school and we're already discussing it in class. We're dumb-founded on how reckless she was and ignored very basic things we have hammered into us during the first semester.

For example, we had a simulation with a Pyxis and passing a pt's morning meds. When it was my turn I spotted the following things-

• I was ordered to give a med the pt was allergic to.
• The Pyxis was stocked with the wrong med but said it was the right one.
• The pt was not that right pt
• There were a couple of other traps dealing with contraindications

The other day in the hospital I had to give a postpartum woman an Ibuprofen. I checked it 3 times. Who passes a med without even looking at it? That's not just crazy, it's reckless.

[Corey Narry, MSN, RN, NP]

1 hour ago, Crow31 said:

I've been thinking more about this. Can anyone tell me why this is a criminal charge instead of malpractice? Is there more to this than just a medication error leading to death? Was she intentional in trying to hurt this person or something else that may explain the criminal aspect?

Malpractice is usually dealt with in a civil court case when those who are affected by the act sue for damages. In some extreme cases, malpractice can become a criminal offense and this nursing case is not the first to be dealt with in this manner. Criminal prosecution does not always require intent on the part of the accused.

I found this article very helpful:

https://www.nursingcenter.com/cearticle?an=00128488-200901000-00003&Journal_ID=260876&Issue_ID=848807

[Wuzzie]

1 hour ago, Crow31 said:

These charges are insulting to nursing and especially if followed through ever will change nursing/medicine as we know it.

No they aren't. Her cavalier approach to medication administration is what's insulting. She didn't make one lapse in judgment. She literally messed up every single step of the way. When we are in nursing school we are taught that we need to be careful when administering medications because the wrong medication, route, timing and/or dose can harm a patient. This is a basic nursing principle that every single one of us comes out of school understanding. You don't just "forget" those kind of things. She was reckless in her practice and another human being was harmed. She needs to stand before a judge and explain herself. I understand your position and your apprehension, I really do, but we have to set a limit somewhere. I think this is the limit. We aren't above the law. This should be a wake up call to all of us that we need to scrutinize our practice and always, always do things the right way.

[Ruby Vee, BSN]

On 2/12/2019 at 8:30 AM, Horseshoe said:

If any of you follow ZDoggMD's Youtube channel, you may have seen his video on the Vanderbilt medication error. Like most of us, he was shocked and appalled.

After watching this, I saw he posted his reaction to the criminal charges. I was a little surprised at his passion, based on his original video.

His take will upset a lot of nurses here on AN.

One good thing about seeing these videos is that it reminded me of him and his channel. I binged watched a bunch of his videos and found a lot of them to be quite thought provoking.

This nurse isn't upset by his second video. This is what I have been trying to say all along. If we're going to throw the nurse under the bus with charges, we should also be charging all of the administrators who did nothing to change either the safeguards or the culture at Vanderbilt. Throw them all in jail, not just the nurse who made a fatal ERROR. It's a mistake -- a horrible one, to be sure, but it was a mistake. If we're going to hang the nurse let's hand management with her.

[Crow31]

1 hour ago, Luchador said:

I'm in nursing school and we're already discussing it in class. We're dumb-founded on how reckless she was and ignored very basic things we have hammered into us during the first semester.

For example, we had a simulation with a Pyxis and passing a pt's morning meds. When it was my turn I spotted the following things-

• I was ordered to give a med the pt was allergic to.
• The Pyxis was stocked with the wrong med but said it was the right one.
• The pt was not that right pt
• There were a couple of other traps dealing with contraindications

The other day in the hospital I had to give a postpartum woman an Ibuprofen. I checked it 3 times. Who passes a med without even looking at it? That's not just crazy, it's reckless.

You're completing missing the point. Think about it. This isn't about her. This is about the charges brought against her. When you make your first med error let me know how you think about what she did. You'll learn all medication errors are made in similar fashions.

[Crow31]

50 minutes ago, juan de la cruz said:

Malpractice is usually dealt with in a civil court case when those who are affected by the act sue for damages. In some extreme cases, malpractice can become a criminal offense and this nursing case is not the first to be dealt with in this manner. Criminal prosecution does not always require intent on the part of the accused.

I found this article very helpful:

https://www.nursingcenter.com/cearticle?an=00128488-200901000-00003&Journal_ID=260876&Issue_ID=848807

Thank you for sharing. This is a bit more helpful. I guess to know this kind of case isn't the first time kind of puts my decision into perspective. I've worked in all kinds of areas. Including an ER where medications were not scanned. Right now I work at a place were something of this magnitude couldn't happen, but I would rather not work here for the rest of my life. I'll be transitioning out of nursing. Thanks again for your response.

[Crow31]

To answer the question the article originally was asking, I would suggest maybe a specific override code for paralytic medications. In hopes this may decrease the human error chance a bit because we all know that alarm fatigue is a real thing. (where my Critical Care nurses at?) Stuff pops up all the time even when we chart and get certain medications. My suggestion is just that a suggestion. Here's how the code would work. 1. Pick the paralytic you want. 2. Now a hard stop pops up something like "Paralytic code required" 3. Enter Code Maybe not a practical idea using a code, but the concept still remains. There needs to be a hard stop with certain medications. I mean crap I have a hard stop to put in a pain scale when I give Tylenol.

[mtmkjr, BSN]

6 minutes ago, Crow31 said:

To answer the question the article originally was asking, I would suggest maybe a specific override code for paralytic medications. In hopes this may decrease the human error chance a bit because we all know that alarm fatigue is a real thing. (where my Critical Care nurses at?) Stuff pops up all the time even when we chart and get certain medications. My suggestion is just that a suggestion. Here's how the code would work. 1. Pick the paralytic you want. 2. Now a hard stop pops up something like "Paralytic code required" 3. Enter Code Maybe not a practical idea using a code, but the concept still remains. There needs to be a hard stop with certain medications. I mean crap I have a hard stop to put in a pain scale when I give Tylenol.

Great idea