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RaDonda Vaught Update - State Health Officials Reverse Decision and File Medical Disciplinary Charges

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Do you agree with the charges?

  1. 1. Do you agree with the recent charges? (Place additional comments in the comment section below the article)

    • 78
      Yes
    • 19
      No
    • 33
      I need more information
  2. 2. Do you agree with the original criminal charges filed by the prosecutors?

    • 42
      Yes
    • 63
      No
    • 25
      I need more information

130 members have participated

Why did the Tennessee Board of Nursing reverse their decision on RaDonda Vaught?

Tennessee State Health officials have reversed their prior ruling that RaDonda Vaught's fatal medical error did not warrant professional discipline. Charges that will affect her license have now been filed.

RaDonda Vaught Update - State Health Officials Reverse Decision and File Medical Disciplinary Charges

We have had multiple discussions here on allnurses about RaDonda Vaught’s fatal medical error two years ago in which she accidentally administered a fatal dose of a paralytic drug to a patient. Many have expressed opinions pro and con regarding the Tennessee Department of Health’s decision that RaDonda’s error did not warrant professional discipline. Not much additional information has been released about the case...until now.

Although this information was not made public until this week, on September 27, 2019, the decision was reversed by the Tennessee Board of Nursing and RaDonda is now being criminally prosecuted and being charged with unprofessional conduct and abandoning or neglecting a patient that required care...

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“The new medical discipline charges, which accuse her of unprofessional conduct and neglecting a patient that required care, are separate from the prosecution and only impact her nursing license.”

Vaught’s attorney was quoted in an email saying, “

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"It seems obvious that the District Attorney’s Office and the Tennessee Department of Health are working in concert in the pending criminal/administrative matters,” Strianse wrote in an email, adding later: “The Board of Health likely feels some public pressure to reverse its position in light of the attention that has surrounded this unfortunate accident.”

In February, Vaught was charged with reckless homicide and impaired adult abuse. In a previous court appearance, Vaught publicly admitted she made a mistake but pleaded not guilty to all criminal charges.

Since Vaught's arrest, this case elicited an outcry from nurses and medical professionals across the country. Many have accused prosecutors of criminalizing an honest mistake.

A hearing is scheduled for November 20, 2019.

Click here to see the discipline charges.

What do you think about the recent charges?


References

RaDonda Vaught: Health officials reverse decision not to punish ex-Vanderbilt nurse for fatal error

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232 Comment(s)

Best I can tell, professional discipline from the state board of nursing up to and including loss of her license is the most appropriate response to her error.

Criminal charges were and still are overkill in response to a professional mistake/incompetence without malice or any obvious callousness. Criminal charges also seem suspiciously like an effort to divert all responsibility and accountability for systemic errors that put a clearly incompetent nurse in that position in the first place onto the shoulders of said incompetent nurse.

Rose_Queen, BSN, MSN, RN

Specializes in OR, education. Has 15 years experience.

When this story first broke, I was shocked by the charges and also by the lack of professional discipline. However, after reading the CMS report, I leave it to the jury to decide. Saying everything is a systems error cheapens the system- there are simply cases of gross lack of individual accountability. Based on the CNS report and the list of places where basic nursing roles and responsibilities such as the rights of medication administration were bypassed points to this going beyond a systems error. The correct med was ordered, the correct med was profiled, etc. At the very least, subpar nursing should have resulted in some disciplinary action and required remediation.

Sounds to me like the Tennessee BON got caught with their pants down and now are scrambling to do what they should have done in the first place. I hope they pull her license. As much as I don’t wish misfortune on any human being she has proven herself unworthy of it and there is no guarantee if they continue to let her practice she won’t do something like this again. Regardless of what anybody says this was NOT a simple med error nor was she a victim of the system. Yes, the hospital’s response to the event was inexcusable and they should pay for that but that is an entirely different issue.

As far as the criminal charges. She knew better and CHOSE to practice in an unsafe manner. She was negligent and a vulnerable person died as a result. If that doesn’t fit the definition of negligent homicide I don’t know what does.

I agree with Rose_Queen and Wuzzie.

Edited by Susie2310

CharleeFoxtrot, ADN, RN

Has 7 years experience.

Do I agree with the original change and the TN BON finally getting around to doing something beside irrevocably damaging the public faith in that entity? Absolutely.

Vaught's actions that night should be used as the dictionary definition of "egregious".

MunoRN, RN

Specializes in Critical Care. Has 10 years experience.

Her string of failures were certainly disturbing, and I get that given the outcome there's a desire to see her punished, but I don't agree that the precedent that has to be set to make that happen is worth it.

The precedent set by the charges against her is that use of the "override" function is now a criminal act, regardless of whether it's justified by the clinical situation or even clearly stated policy. As a result, my organization has removed the medication "profile" for patients in our ADCs (we use Pyxis) so there is no longer a need for the "override" function, according to our legal team this will likely become common. Despite not helping in the Vaught case, not finding a medication in the profile is an important mechanism for preventing a nurse from pulling the wrong drug, or at least it used to be.

I agree with action against the license.

As to the rest of it, I'm pretty much still of the opinion that there is too much unchecked insanity going on in hospitals that affects patient care. I maintain my stance that this whole episode began with a fake emergency. Priorities are dangerously skewed. The time to be outraged is before someone is hurt.

This fatal day isn't the first day that a rather half-assed get 'er done attitude was employed--it is every day and it is typically rewarded. But now we've all had to argue about how much carelessness and mediocrity is tolerable. I adamantly believe that the demarcation between tolerable and not tolerable is not whether or not it benefits the hospital. If it is fine up until the day someone gets killed, that is....I don't know. Just mind-boggling. Indefensible.

VivaLasViejas, ASN, RN

Specializes in LTC, assisted living, med-surg, psych. Has 20 years experience.

When I first heard of this case, I felt that the criminal charges were an overreaction to an unfortunate mistake, but failed to understand why RV's license hadn't been pulled. As I've learned more, however, I've come to believe that both criminality and incompetency are present here, and I support both the charges and some sort of disciplinary action against her license, preferably revocation.

I know I probably sound like a hard-liner, but I cannot feel much empathy for a nurse who completely disregarded the safety measures put in place for everyone's well-being and walked away when she should have had both eyes on the patient. I don't hope for a prison sentence, but she should never be allowed to work as a nurse again.

1 hour ago, MunoRN said:

The precedent set by the charges against her is that use of the "override" function is now a criminal act, regardless of whether it's justified by the clinical situation or even clearly stated policy.

Surely the point is that the "override" function is to be used along with the Five Rights and other medication administration safety checks.

1 minute ago, Susie2310 said:

Surely the point is that the "override" function is to be used along with the Five Rights and other medication administration safety checks.

Well we all know that is true, but the override itself certainly caused enough outrage on its own and was portrayed as if she broke into the federal reserve vault by doing that.

MunoRN, RN

Specializes in Critical Care. Has 10 years experience.

3 minutes ago, Susie2310 said:

Surely the point is that the "override" function is to be used along with the Five Rights and other medication administration safety checks.

That's not the basis of the criminal charges against her, the basis is that any use of the "override" function constitutes criminal reckless endangerment, regardless of whether any errors or harm occurs.

Yeah, the initial override was never an issue for me. It’s a necessary evil. But anytime I override you can be darn sure I double and triple check things. Unfortunately there were several more overrides that occurred in this tragedy. One would think that would make a prudent nurse go 🤔.

MunoRN, RN

Specializes in Critical Care. Has 10 years experience.

5 minutes ago, Wuzzie said:

Yeah, the initial override was never an issue for me. It’s a necessary evil. But anytime I override you can be darn sure I double and triple check things. Unfortunately there were several more overrides that occurred in this tragedy. One would think that would make a prudent nurse go 🤔.

And I would argue the override function is safe when used with other safety measures, the legal precedent that's well on it's way to being established is that using the override function is itself criminal.

That leaves facilities with two options; either prohibit the use of the override function, which in many circumstances will lead to patient harm, or negate the existence of the override function by no longer having a patient medication profile, which is an important safety measure.

I don’t disagree with you Muno.

9 hours ago, Susie2310 said:

Surely the point is that the "override" function is to be used along with the Five Rights and other medication administration safety checks.

I had nine “rights” in nursing school, and there’s probably twenty or thirty “rights” now.

which “rights” are we talking about?

I don’t have any “rights” printed out on the back of my nursing license..

I didn’t take a “pledge” to adhere to “the xxx rights” of med administration to get my license..

is there a “rights” question on the NCLEX now that everyone gets?

8 hours ago, MunoRN said:

And I would argue the override function is safe when used with other safety measures, the legal precedent that's well on it's way to being established is that using the override function is itself criminal.

That leaves facilities with two options; either prohibit the use of the override function, which in many circumstances will lead to patient harm, or negate the existence of the override function by no longer having a patient medication profile, which is an important safety measure.

What should be actually criminal here is calling a search function an “override”.

further, if searching is criminal - then the prescriber and pharmacy and drug cabinet maker should all be co defendants.

why would you prescribe “Prilosec” when someone actually needs omeprazole?

why would you put a system in place that dispenses omeprazole when the doc clearly ordered Prilosec?

this case actually breaks the prescription system if it is allowed to stand.