RaDonda Vaught's Arraignment - Guilty or Not of Reckless Homicide and Patient Abuse?

[tnbutterfly - Mary]

A group of nurses plans to appear in their scrubs at Vaught's arraignment hearing on February 20th show their support. Included in this group is Janie Harvey Garner, founder of Show Me Your Stethoscope.

For those who are interested in showing their support by attending the arraignment, here are the details:

When?

Wednesday, February 20 @ 9:00 AM

Where?

Justice A. A. Birch Building

408 2nd Ave N,

Court Room 6D

Nashville, TN 37201

Judge: Jennifer Smith

What is Arraignment?

Once the accused is represented by counsel, the more formal part of the arraignment, the reading of the charges, takes place. The accused is expected to enter a plea: usually guilty, not guilty, or no contest. The no-contest plea means that the accused is not admitting guilt but will not contest the charges.

What is the verdict going to be???

In the following video, Janie Harvey Garner talks more about the arraignment process.

UPDATED TO ADD VIDEO RE. RADONDA VAUGHT'S NOT GUILTY PLEA

Nurse Gives Lethal Dose of Vecuronium Instead of Versed

Nurse Charged With Homicide

Nurses Call the Governor of Tennessee

[Luchador, CNA, EMT-B]

46 minutes ago, mtnNurse. said:

I don't understand why you think nurses would be more prone to see a warning label if they knew they could be criminally charged if they don't see it.

. Do you really think that would have prevented her accident?

Based on the whinging, hand-wringing and shock I've seen here, yes, I actually do think it will make nurses more cautious.

By the way, she is being charged with accidentally killing somebody, so you can call it an accident and that doesn't mitigate the stupefying amount of things she bypassed and ignored. People get charged with accidentally killing folks all the time. Google "vehicular homicide."

Regarding your question about what would have prevented her from accidentally killing the patient-- I'm not sure any thing would have. She was clearly a menace. And since we are speculating, if she didn't kill that pt it was only a matter of time until she killed somebody else. Maybe a cattle prod to her temporal lobe would have stopped her.

I'm really wondering if she was charged because the BON didn't yank her licence. The DA's jaw probably dropped and he felt he had no choice because she clearly shouldn't be passing meds to anyone.

[TriciaJ, RN]

2 hours ago, mtnNurse. said:

So are you saying that the criminal charges and verdict will serve as a deterrent to purposely ignoring warning labels? If so, why do you think that would serve as a better deterrent than the horrific possibility of killing a patient would serve as a deterrent?

If the horrific possibility of killing a patient is not enough to make us look at a medication label at least once before giving it to a patient, maybe we'll do it to save our own skin.

[Jory, MSN, APRN, CNM]

10 hours ago, ForeverYoung018 said:

If she goes to jail; then all of the unsafe politics in hospitals needs to stop. Hospitals better start going on a hiring frenzy because there are many hospitals, who put their nurses in unsafe situations daily! Being mandated, working 16 hour shifts, high nurse to patient ratios, taking unsafe assignments. Yet if you speak up to administration, they throw it under the rug, but if a nurse dares refuses to work in unsafe conditions, they can be slapped with patient abandonment. This could have easily been me making this error on one of my MANDATED 16 hour shifts!

Actually, you cannot be charged with patient abandonment for refusing to accept an unsafe assignment. That...does NOT happen.

To qualify, under the Nurse Practice Act, for patient abandonment, you have to accept the assignment first. Showing up for work is not accepting the assignment. Keeping the patient after report is.

When I worked the floor, I can think of twice where after report, I refused the assignment. One patient was a psychiatric hold on a med-surg floor that had already injured two other nurses. I said I would accept the assignment if security went in with me and restrained the patient while I gave meds, wound care, etc..b/c this patient broke one nurses arm plus several fingers during this process. I was told that was not possible...so I told them I was refusing the assignment. Guess what? Security suddenly became available.

I also had a patient circling the drain that required extensive monitoring and was given a heavier than normal patient load due to a staffing shortage. I told them I was not going to accept the assignment because it was unsafe staffing due to the one high-acuity patient. They suddenly had another nurse available when they realized I was dead serious.

Yes, feathers got ruffled each time...but it blew over. I also got what I needed to provide appropriate care.

[Here.I.Stand, BSN, RN]

A few thoughts...

For those who point out “why was Versed used in the first place?” What in the world does that have to do with anything when you aren’t checking your Rights? What if they had ordered Ativan... she could just as easily typed “A-T” and overridden atracurium.

I don’t know that anyone is calling for her to be charged with MURDER... but is there evidence that she was negligent? CLEARLY she was. Did her negligence result in the death of a human? Yes. I don’t get why a charge of negligent homicide (or whatever TN’s equivalent is... I don’t recall) is inappropriate.

Say an overwhelmed, sleep deprived new mother doses her baby with a syringe of something, rather than check the bottle and the dose? Eh... it kind of looks like infants Tylenol. But it wasn’t, and the baby died. She could reasonably be charged in the baby’s death, no? So why does a licensed professional get a pass? Should we not hold ourselves to a higher standard?

Just Culture does not mean nurses get a pass for egregiously unsafe nursing practice. We are not talking about firing a nurse for giving Colace to the wrong patient. Do systems issues contribute to errors sure. But at the end of the day we and nobody else is responsible for our own nursing practice. RV’s nursing practice was... I have no words.

How can we expect respect as a PROFESSION, if we are going to defend such incompetence?

Shame on the TN BON. Just about every first semester nursing student practices more safely than that... but it is acceptable to allow her access to the public?? While others who have gotten help for the DISEASE of addiction, gotten healthy years before... but are subjected to monitoring programs? What the [againstTOS]?????

I wonder how the deceased woman’s family felt seeing all of the strangers in scrubs at the arraignment?

Nurses don’t hold a monopoly on on-the-job stress. Air traffic controllers, military, firefighters, hostage negotiators etc have way more stress. Sorry, it’s true. If they screw up, people die. Why is it that when a nurse screws up and kills someone, we say “oh but she probably had distractions... she had phone calls and people demanding turkey sandwiches!!”

Really? REALLY??

Do I think she needs to hang NO...but held legally accountable for her negligence which caused a woman to die? And a horrible death at that? (It’s been said in news pieces that vec is used in lethal injections? Even serial murderers get sedated before getting a neuromuscular block!) ABSOLUTELY.

[JKL33]

6 hours ago, Luchador said:

I'm really wondering if she was charged because the BON didn't yank her licence. The DA's jaw probably dropped and he felt he had no choice because she clearly shouldn't be passing meds to anyone.

I'm pretty convinced, at least until I learn otherwise, that the indictment had something to do with the fact that there was quite a span where this seemed like a successful cover-up by the institution, and then the need to make sure an individual was publicly skewered STAT arose when it was clear the details were going to come out; including (minimal) details of their cover-up. In particular, the abuse charge and the instant publicizing of how she accessed what the public now believes was some kind of locked up vault in order to get access to death row medications that are used to purposely kill people would lead me to believe there was major PR damage control involved as part of the decision to prosecute. I will hope you are right about the motivation, though, Luchador.

But if it were just about jaw-dropping I would think interfering with a death investigation would qualify and colluding to cover it up a death as much as possible thereby preventing any real-time investigation of anything would also qualify. Apparently V is being left alone to be dealt with by CMS, and actually will not have to answer to the public.

[JKL33]

12 minutes ago, Here.I.Stand said:

A few thoughts...

For those who point out “why was Versed used in the first place?” What in the world does that have to do with anything when you aren’t checking your Rights? What if they had ordered Ativan... she could just as easily typed “A-T” and overridden atracurium.

It's no excuse, and there are reasons that Versed may have been chosen over other IV options - - but the fact is, it was not necessary to prescribe any IV anxiolytic for a patient downgraded from ICU care and waiting unmonitored in an outpatient department for a run-of-the-mill test that is normally performed on an outpatient basis. Not only that but this patient had to wait before the test was going to be performed anyway, so the reason for using Versed itself doesn't hold up all that well either.

Anyway, if we're going to talk about everything that could possibly have changed this scenario, the issue is fair game.

That said, I think it is incumbent upon the patient's nurse to clarify/question such things if it seems that an order may not be necessary or appropriate under the circumstances.

[TriciaJ, RN]

21 minutes ago, JKL33 said:

But if it were just about jaw-dropping I would think interfering with a death investigation would qualify and colluding to cover it up a death as much as possible thereby preventing any real-time investigation of anything would also qualify. Apparently V is being left alone to be dealt with by CMS, and actually will not have to answer to the public.

I do not think Vanderbilt's culpability mitigates RV's culpability, but they are equally culpable. If she was a good nurse who got tripped by bad conditions, they are culpable. If they kept a substandard nurse on the payroll until she killed someone, they are culpable. Their failure to report a sentinel event, failure to report her to the BON, ditto. They had to have given her a reference so she could work at another hospital - culpable.

The supportive crowd in their "colorful scrubs" needs to descend on Vanderbilt and demand accountability from them, too. I agree that they should not be allowed to skate on this.

[Anonymous865]

I would say that Tennessee DAs have a legitimate concern that hospitals and professional boards are not protecting the public.

Consider a few cases that have been in the news recently (warning this is long).

Christopher Duntsch

Christopher Duntsch (a.k.a. “Dr. Death”) – got his MD/PhD and did his neurosurgery fellowship at University of Tennessee Health Sciences Center (UTHSC). He moved to Texas and proceeded to maim and kill patients.

He was so incompetent that a surgeon in Texas called UTHSC to find out if he really had completed neurosurgery training. When the Texas surgeon was assured by UTHSC attendings that Duntsch did complete training, the surgeon faxed a photo of Duntsch to his attendings at UTHSC. The Texas physician felt sure Duntsch was an imposter. He wasn’t. The UTHSC attendings told the Texas physician that Duntsch was great! Brilliant!

Texas wasn’t any better than Tennessee. The board got at least a half dozen complaints from physicians and lawyers begging them to do something about Duntsch. They didn’t.

One hospital would fire him, and he would just move to another hospital.

He was eventually tried and sentenced to life in prison.

News organizations investigated Duntsch and talked with neurosurgeons. Neurosurgeons stated that a neurosurgery trainee should participate in at least 1800 surgeries in order to complete their training. Documentation showed that Duntsch was actually IN an OR for only 100 surgeries while at UTHSC. (He wasn’t necessarily even PARTICIPATING in those surgeries. UTHSC still said he successfully completed his training.

[Anonymous865]

Next look at Dr. Michael Anthony Lapaglia.

Lapaglia first came to the attention of a medical board in 2002 when he was a psychiatric resident in NC for having an “inappropriate relationship” with an inpatient psychiatric 16 year old female patient. This relationship continued after the patient was released. He also tested positive for marijuana.

The contested charges were eventually dismissed without prejudice in 2005 (3 YEARS LATER), because his resident training license became inactive before the case was adjudicated.

This allowed him to move to another state and apply for a license with a clean record.

He did an emergency medicine residency from 2004-2007 in Hershey, PA

He shows up in Tennessee in 2007 and begins to practice as an emergency physician.

The first the public hears of him is in 2011 when the newspaper reports that Anderson County law enforcement officers have been transporting drug suspects to the ED at Methodist Medical Center in Oak Ridge (a city in Anderson County). Lapaglia has been doing cavity searches for them without patient consent or a warrant. In at least 3 cases Lapagalia sedated, paralyzed, and intubated these patients without their consent in order to facilitate his drug search.

Lapaglia found drugs in only 1 person. This case went to trial and the courts threw it out as a 4th amendment violation and stated that Lapaglia’s actions “shocked the conscience.”

Two individuals sued Lapaglia, the hospital, Lapaglia’s employer, the county, and others. The suit was settled and the terms of the suit were confidential.

Lapaglia next shows up in the news in 2013 when Knox County law officers are called to his home on a domestic disturbance complaint. His girlfriend reported that Lapaglia had threatened to use his medical knowledge to kill her and dispose of her body.

When officers entered his home, they foundd more than two pounds of high-grade marijuana in various strains; 52 diazepam (Valium) pills; 24 oxycodone pills; 22 amphetamine pills; 11 vials of Xylocaine; seven vials of succinylcholine; two bottles of propofol; two vials each of Marcaine and Lydocaine; and one vial each of bupivacaine, flumazenil, midazolam, fentanyl, and morphine.

Because he was a physician, the DA allowed the medical board to handle his discipline. His license was suspended for 6 months while he received inpatient drug treatment. Then he was allowed to return to practicing medicine. They did restrict him from prescribing controlled substances.

He’s back in the news in November of 2018 when he is arrested for selling prescriptions for a 1 month supply of the controlled substance of your choice for $300. Lapaglia was seeing “patients” at his home, the patients’ homes, MacDonald’s parking lot.

How is this possible, since he no longer had a DEA certificate to prescribe controlled substances? Well his buddy Charles Brooks, MD was giving him blank signed prescriptions. Lapaglia was giving Brooks $150 of the $300 he was making on each prescription.

Dr. Brooks had also been before the Board of Medical Examiners in the past.

Also note that the arrest of Drs. Brooks and Lapaglia occurred at the same time the Vanderbilt made the news.

[Anonymous865]

A few nurse examples would include:

Genene Jones

Charles Cullen

John Meehan (a.k.a. “Dirty John”)

[Jory, MSN, APRN, CNM]

I knew of a physician that pulled five years in prison for exchanging sex for drugs out of his clinic.

Guess what they did when he got out of prison? Gave him his license back.

Would the BON do that for an NP? Heck no they wouldn't.

The medical board completely protects MDs. I have seen families file complaints over the years for very serious infractions that you would think at minimum, would result in probation. In most cases, they do nothing.

[LilPeanut, MSN, RN, NP]

16 hours ago, JKL33 said:

That is not what the report says.

There is plenty else to condemn.

It's a little fuzzy, IMO. But basically, the other nurse informed her nearby to the providers. She was not the one who discovered it.

13 hours ago, mtnNurse. said:

What I bolded in your post is one of my points. Nurses have to quit or be willing to be fired in order to 100% adhere to standards of practice at many or even most nursing jobs (but even in ideal conditions they can't guarantee 100% because that would be saying they're perfect and can't ever make a mistake). You did the right thing and quit. So now you're gone and nothing has changed. The unsafe work environment is still there. If one of those co-workers you left behind caused a bad outcome down the road, how would it change the unsafe work environment to fire her and criminally charge her? What good does it do?

Your questions using analogies are not consistent with this case. Had the nurse been aware she was risking killing that patient in the moments of the fatal accident, she would have been aware enough to catch her mistakes. I believe she erroneously, fallaciously "KNEW" she had no chance of killing that patient. We'll probably have to agree to disagree on that.

I love the idea of hotlines, whistleblower lines, and unions! I also agree people shouldn't just throw their hands up and consent to give substandard care. But there is often more subtlety there then consciously choosing to give substandard care. For example, if an overloaded nurse is going as fast as she can and doing her absolute best to be safe and adhere to all standards of practice and then an accident happens, that is a very different thing than if she instead just throws her hands up and says, "I give up on giving good care".

In my case, it was providers that were unwilling to change, not administration. Administration may have been lax on enforcing it on them, but the main fault laid on the feet of the providers.

But even then, I still did not practice unsafely and they could not force me to.

She should have known that any time you administer a medication, especially a sedative, you have a risk of killing someone. That's the whole point of nursing kind of. We are supposed to be educated about drug administration, that's why people off the street don't do it. People who run red lights don't think they are going to kill anyone, same with people who run stop signs, nor who text and drive. People who drive drunk don't even think they will kill someone. They don't walk into it planning to kill people. They think it won't happen to them, they're safe enough.

And this was not an accident. This was a failure to perform even the barest minimum of nursing duties.

13 hours ago, mtnNurse. said:

Oh. Then replace my bolded phrase above with "in well-meaning efforts to do their jobs and not hurt anyone". So no, ideal work conditions would not change how I feel about criminal charges. And yes, I feel that way about anybody not just nurses. I think a moral society would opt for remedial rather than penal solutions -- though I feel differently for violent crimes. And I think licensing agencies should handle cases of professional accidents (again, 'accident' meaning she did not kill on purpose, so it was an accident that she killed the patient).

Have you ever heard of a hospital that has adequate staffing, light workloads, reasonable work expectations, sufficient breaks in a 12-hr shift, and is conducive in every way to keeping a nurse's brain sharp throughout that LONG work day?

Yes, I have. And what do we do when licensing boards do not take action or shield people?

9 hours ago, Luchador said:

Based on the whinging, hand-wringing and shock I've seen here, yes, I actually do think it will make nurses more cautious.

By the way, she is being charged with accidentally killing somebody, so you can call it an accident and that doesn't mitigate the stupefying amount of things she bypassed and ignored. People get charged with accidentally killing folks all the time. Google "vehicular homicide."

Regarding your question about what would have prevented her from accidentally killing the patient-- I'm not sure any thing would have. She was clearly a menace. And since we are speculating, if she didn't kill that pt it was only a matter of time until she killed somebody else. Maybe a cattle prod to her temporal lobe would have stopped her.

I'm really wondering if she was charged because the BON didn't yank her licence. The DA's jaw probably dropped and he felt he had no choice because she clearly shouldn't be passing meds to anyone.

I don't know if it will prevent other people, but it definitely will prevent this nurse from making more errors.

I also think she was charged because the board didn't pull her license.

2 hours ago, JKL33 said:

I'm pretty convinced, at least until I learn otherwise, that the indictment had something to do with the fact that there was quite a span where this seemed like a successful cover-up by the institution, and then the need to make sure an individual was publicly skewered STAT arose when it was clear the details were going to come out; including (minimal) details of their cover-up. In particular, the abuse charge and the instant publicizing of how she accessed what the public now believes was some kind of locked up vault in order to get access to death row medications that are used to purposely kill people would lead me to believe there was major PR damage control involved as part of the decision to prosecute. I will hope you are right about the motivation, though, Luchador.

But if it were just about jaw-dropping I would think interfering with a death investigation would qualify and colluding to cover it up a death as much as possible thereby preventing any real-time investigation of anything would also qualify. Apparently V is being left alone to be dealt with by CMS, and actually will not have to answer to the public.

I am not as impressed by the "cover up" as others clearly are. There was one doc who hedged to the ME about a med error, likely trying to protect the nurse. And not reporting to medicare properly, that's absolutely needing repercussions. But I agree with others I think her charges are more about the fact that she is still practicing freely with no oversight. Her name was not published with the CMS report. If it had come out that she had been disciplined and/or lost her license from the BoN, I don't think there would be any of this happening.

1 hour ago, TriciaJ said:

I do not think Vanderbilt's culpability mitigates RV's culpability, but they are equally culpable. If she was a good nurse who got tripped by bad conditions, they are culpable. If they kept a substandard nurse on the payroll until she killed someone, they are culpable. Their failure to report a sentinel event, failure to report her to the BON, ditto. They had to have given her a reference so she could work at another hospital - culpable.

The supportive crowd in their "colorful scrubs" needs to descend on Vanderbilt and demand accountability from them, too. I agree that they should not be allowed to skate on this.

I do agree Vanderbilt has culpability in the fact they had a clearly negligent nurse working for them, and then they pawned her off on another hospital without regard to patient safety, they didn't report things properly to the government. But they did not make her be negligent and not follow any nursing processes.