番茄社区

RaDonda Vaught, the Tennessee nurse convicted after a medical error led to a patient's death, was to 3 years of supervised probation, evading a possible prison sentence of up to 8 years.

Today's sentencing caps a years-long process, including delays caused by the COVID-19 pandemic, that brought to light Vaught's medical error, led to her prosecution, and sparked a national outcry from the medical community.

Vaught, 38, was convicted on March 25 of negligent homicide and impaired adult abuse over the medication error, which resulted in the death of 75-year-old Charlene Murphey at Vanderbilt University Medical Center (VUMC) in 2017. Vaught received concurrent sentences of 3 years probation for the adult abuse charge and 2 years probation for the reckless homicide charge.

The lighter-than-expected sentence still sparked criticism from the nursing community, including the American Nurses Association, which released a afterward highlighting the larger concerns -- like insufficient staffing and negative workplace culture -- raised during the course of the trial.

"A typical nurse's shift is fast-paced and high stakes, with constant patient turnover, inadequate staffing levels, varying patient acuity, exposure to infectious disease, and risk of work-related injury and violence," the statement read. "All of these factors impede the delivery of safe patient care, and nurses too often find themselves working under conditions that increase the likelihood of adverse outcomes from tragic mistakes."

This sentiment was shared by several nurses who spoke with 番茄社区 after the sentencing, including Todd Haines, RN, the immediate past president of the Tennessee chapter of the Emergency Nurses Association (ENA).

"Nurses don't go to nursing school and invest all that life to get a license to kill people," he told 番茄社区. "It's a bad enough sentence to know that you killed somebody."

"Even if we get a patient that we've done everything we can right for, and they die, those patients, they're still with you. Every single one," he said. "I think 3 years' probation was best-case scenario. She won't do any prison time or jail time. The fact is her sentence is going to be lifelong."

John Fraleigh, RN, the chair of government affairs and advocacy for the Arizona chapter of the ENA and a nurse with 25 years of experience, said that the entire case set a bad precedent. The sentencing was a victory for Vaught on a personal level, but he cautioned that this should not be seen as victory for nurses around the country.

"I'm glad she didn't do jail time," he told 番茄社区 Medical Today. "But it's really unfortunate that she even got prosecuted in the way that she did, and it's concerning."

Fraleigh, who also teaches nursing students, worries that this kind of case is sending the wrong message to his students about accountability and honesty when it comes to reporting medical errors. His other major concern is that the conclusion of this case could bring an end to the national push for improved working condition for nurses.

"The anger that people felt that she was even charged in the first place is going to dissipate, because people feel like, 'oh great, she didn't get sentenced,'" he said. "But she actually shouldn't have gotten brought to trial."

The fatal error happened when Vaught, a nurse at VUMC at the time, was preparing Murphey for a PET scan on the day after Christmas. Murphey had complained of feeling anxious ahead of the scan and was ordered 2 mg of IV versed. Vaught mistakenly administered 10 mg of vecuronium to the patient instead, according to a on the incident. Murphey was transported to radiology for imaging, coded in the scanner, and died shortly after.

Vaught was fired from VUMC on Jan. 3, 2018. The hospital negotiated an out-of-court settlement with the patient's family, one that required them not to speak publicly about Murphey's death or the error, according to a report from . An eventually reported the error to state officials in October 2018, and Vaught was charged by prosecutors in February 2019.

The case has stirred up a national conversation around the implications of criminal prosecution for medical errors, an uncommon punishment for what many medical societies consider to be accidents born out of high pressure and high-risk environments. A combination of factors that has several nurses on the verge of leaving the profession.

"I literally have been a nurse for 31 years, and I am contemplating not nursing anymore," Misty Coburn, RN, a psychiatric mental health nurse at Ascension Health in Indianapolis, Indiana, told 番茄社区.

"We've all made errors. There's not a nurse alive that has not made a [medical] error at some point," she said. "The fact that they are criminalizing it now and pressing charges on people for [medical] errors. It's scary."

Coburn said that she "personally" knows at least four other nurses who are considering quitting because of the trial.

Vaught's case has also become a symbol of the policy problems that several experts say can lead to these kinds of errors.

"This is an excruciating case for nurses, because it is so abundantly clear that the conditions under which this particular nurse was working made it impossible for her to practice in a manner that ensured patient safety," Patricia Pittman, PhD, of the Milken Institute School of Public Health at George Washington University, told 番茄社区 via email. "It is a tragic example of what happens when nurse-to-patient ratios are too low. There is over twenty years of research showing this relationship, but policymakers and some healthcare leaders still don't get it."

The leniency of the sentence for Vaught was not enough to erase the damage done in Pittman's eyes though. While the lesser sentence is a positive outcome for Vaught, Pittman still sees the trial as a symbol of a problematic message being sent to nurses across the country.

"The case is also a horrifying example of how moral injury works -- a situation in which health workers feel betrayed by those in authority and forced to practice in ways that violate their professional ethics," said Pittman, who is also director of the Fitzhugh Mullan Institute for Health Workforce Equity. "This leads to shame and a sense of helplessness and is a major driver of nurses' resignations."

Shannon Firth contributed reporting to this story.

Comment