When Does Reckless Conduct Become Criminal?

Medication Errors

There has been many articles about the case of RaDonda Vaught. Vaught killed a woman. She was criminally charged, prosecuted, and found guilty by a jury of her peers and fellow citizens. Normal so far, right? The criminal charges include reckless homicide and felony abuse of an impaired adult.

But in this case, Vaught is a nurse. Her reckless medication error stopped the patient’s breathing and left her brain-dead.

Vaught admitted her fault at a Tennessee Board of Nursing hearing last year. She admitted she was “complacent” in her job and “distracted” by a trainee. The Board of Nursing revoked her RN license.

Her prosecution is a rare example of a health care worker facing criminal charges for a reckless medical error. However, Vaught’s multiple choices to disregard safety measures was not a “simple mistake”. The fatal error was anything but a common mistake any nurse could make. The jury found that she ignored a cascade of warnings that led to the deadly error. The facts are not in dispute.

Criminal Neglect

The nurse’s use of an electronic medication cabinet showed a reckless indifference to all safety measures. Evidence shows that Vaught ignored or bypassed at least five warnings or pop-ups saying she was withdrawing a dangerous paralyzing medication.

The victim was prescribed Versed, a minor sedative. Nurse Vaught withdrew a vial from an electronic medication cabinet. Vaught initially tried to withdraw Versed from a cabinet by typing “VE” into its search function. She should have been looking for its generic name, midazolam.

When the cabinet did not produce Versed, Vaught triggered an “override” that unlocked the cabinet for vecuronium, a powerful paralyzer.

She also did not recognize that Versed is a liquid but vecuronium is a powder that must be mixed into liquid.

After a brief deliberation, the jury for the case of ex-Vanderbilt nurse RaDonda Vaught delivered their verdict: guilty of criminally negligent homicide and gross neglect of an impaired adult. Vaught’s sentencing will be in May. Until then she is out on bail. The medical profession continues to defend her actions.

“Medical errors, including ones that cause serious injury or death, occur all the time. Doctors, nurses, and hospital administrators are all human beings. They all make mistakes. Most medical errors, moreover, are due to “system” errors rather than individual errors.”

Vanderbilt Hospital

According to the investigation, the hospital never disclosed that a medication error had been made to the patient’s family. Vanderbilt never reported the error to state or federal authorities, which requires med error reporting by law. The hospital actively tried to prevent the state and federal officials from finding out. Vanderbilt even told the family she had passed from “natural causes” despite the known fatal medication error. They refused to order an independent autopsy to confirm cause of death.

However, a whistleblower informed officials of the truth. The Tennessee Department of Health decided the case did not violate any rules and sent Vaught a letter that no further action would be taken. CMS was contacted.

Federal investigators discovered that 1) Vaught’s error led to the patient’s death and 2) Vanderbilt actively tried to cover it up. CMS threatened to take away Medicare reimbursement for Vanderbilt unless they admit the error and take steps to overhaul their medication dispensing system.

Vanderbilt also settled for an unknown amount with the patient’s family in exchange for not speaking about the death or error.