The fate of a former Tennessee nurse whose patient died after she accidentally injected him with a paralyzing drug was brought to justice this week.
RaDonda Vaught, 38, is charged with reckless homicide for administering vecuronium, a powerful anesthetic, to 75-year-old Charlene Murphey, instead of the sedative Versed, on December 27, 2017.
Vaught was stripped of her nursing license and now she’s on trial in Nashville for charges of reckless homicide and of gross negligence of a disabled adult.
If convicted, she faces 12 years in prison.
the fatal mistake
Murphey had been admitted to the Neurology Intensive Care Unit (ICU) on December 24, 2017, after suffering a brain hemorrhage. Two days later, doctors trying to determine the cause of the bleeding ordered a CT scan.
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Because the woman was claustrophobic, doctors prescribed Versed for her anxiety, according to a testimony. When Vaught failed to find Versed in an automatic medicine dispensing cabinet he accidentally took vecuronium instead of her.
Although state investigators found that Vanderbilt University Medical Center bore a “heavy burden of responsibility” for the medication error, only filed criminal charges against the nurse and not against the hospital, according to a lead investigator who testified Wednesday.
The former nurse’s attorney, Peter Strianse, questioned in closing statements whether prosecutors had proven beyond a reasonable doubt that the vecuronium injection caused Murphey’s death.
Strianse noted that the original death certificate identified intracerebral hemorrhage and cardiac arrest as the cause of death. Only a year later, a new death certificate was issued that identified vecuronium poisoning as the cause, and it was issued without an autopsy.
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Testimony from a Tennessee Bureau of Investigation agent appears to support the defense’s argument that the Vaught’s fatal mistake was made possible by systemic failures at the hospital. Strianse said her client was used as a scapegoat to protect the reputation of Tennessee’s most prestigious hospital.
We are immersed in a game of musical chairs and blame distribution. And when the music abruptly stopped, there was no chair for RaDonda Vaught.”
defense attorney Peter Strianse
“We are immersed in a game of musical chairs and blame distribution. And when the music abruptly stopped, there was no chair for RaDonda Vaught,” Strainse said during opening remarks.
Medical examiner Feng Li had previously told an investigator that he did not believe a small dose of vecuronium would be very harmful.
Prosecutors argued at trial that Vaught injected a much higher dose than the prescribed milligram. They presented the used syringe as evidence, but there was a dispute among the witnesses as to whether the amount of medicine left in the syringe supported that idea. Among other things, it passed through several hands before being handed over to the authorities.
Vaught also did not read the name of the drug, he failed to notice a red warning on the top of the medication and did not stay with the patient to see if she had an adverse reaction, according to the testimony.
“How can you ignore so many warnings without consulting your training and experience or even common sense?”, Deputy District Attorney Brittani Flatt asked the jury.
Vaught readily admitted her medication error as soon as she realized it, and prosecutors used her words against herself in closing statements.
Citing Vaught’s interview with a Tennessee Bureau of Investigation agent, Flatt said: “I definitely should have paid more attention. I should have called the pharmacy. I shouldn’t have cancelled, because it wasn’t an emergency.”
Strianse in closing statements quoted BIT investigator Ramona Smith as saying to Vaught at the end of that same interview: “The mistake is the mistake. We’re all human”.
“A Reckless Act”
When the automated drug dispensing locker failed to produce Versed, Vaught activated an override that unlocked a much larger swath of drugs, then went back to searching for “VE.” This time, the cupboard offered vecuronium.
Prosecutors said Versed’s nullification was a reckless act and a basis for Vaught’s reckless homicide charge. Some experts have said cabinet overrides are commonplace in many hospitals, reported Kaiser Health News.
Vaught insisted in his testimony before the board of nursing last year that overrides were common at the hospital and that a 2017 upgrade to the hospital’s electronic health records system was causing rampant backlogs at medicine cabinets. Vaught said the hospital facility instructed nurses to use overrides to circumvent delays and obtain medications as needed.
“Annulling was something we did as part of our practice every day”, Vaught then testified before the board of nursing . “You couldn’t get a fluid bag for a patient without using an override feature,” he added.
With information from The Associated Press and Kaiser Health News.