Friday, March 31, 2023

Op-ed: the RaDonda Vaught trial


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Story by Will Chappell, Contributing Writer

Mistakes are inevitable, but this was not.

Late last month, former Vanderbilt nurse Radonda Vaught was found guilty of criminally negligent homicide after giving her patient Charlene 

Murphey the incorrect medication leading to her death in 2017.

Following the verdict, the American Nurses Association criticized District Attorney Glenn Funk for the prosecution, saying that it set a dangerous precedent of criminalizing mistakes in the complex setting of medical care.

They argue that prosecuting Vaught will discourage other healthcare workers who make similar mistakes from admitting to them, as Vaught did. They say that the matter should be dealt with in a civil court rather than criminalizing these errors. They further point out that Vaught’s admission and cooperation led to updated drug storage policies to protect patients from a similar mistake.

I find this argument, later taken up by both of Funk’s opponents in the upcoming elections for District Attorney, unconvincing.

Nursing in a hospital is an incredibly difficult job. Nurses work 12-hour shifts and care for multiple patients, each with their own medical issues, stressors and personalities. It is a complex job that has become even more taxing during the last two-plus years of the pandemic.

But that should not exempt medical personnel from responsibility when they behave incompetently and someone dies or is seriously injured.

Vaught immediately admitted that she had made a series of mistakes that led to Murphey’s death. After overriding a medication dispensation system, she didn’t check the label of the medication she was giving to Murphey at multiple fail-safe points in the process, even as she was adding liquid to the drug to give it as an injection, whereas the correct drug came in a vial, ready to inject. After the injection, she failed to observe Murphey’s reaction as she was paralyzed and died in the following minutes.

“I definitely should have paid more attention. I should have called the pharmacy. I shouldn’t have overridden because it wasn’t an emergency,” Vaught said.

We all make mistakes, but at some point, a tragic yet explicable series of errors becomes an act of negligence that merits accountability.

While nursing is a difficult job, it also requires a huge amount of trust from the public. When a patient goes into a hospital, they are putting their life in the hands of the staff. It is a job that requires concentration and diligence. There should be room for forgiveness for lapses that lead to mistakes, but Vaught’s case passes that point.

To me, the tipping point in this case is the fact that the drug came in a different form than expected. As someone who has taken medication daily for twenty years, this is an inexplicable oversight.

When I get a prescription, I double-check the bottle to ensure that it is what I ordered, even if I’ve had it before. I also look at the pills before I take them to make sure they look like what I’ve come to expect, and if they do not, I check the description on the bottle to confirm I have the correct prescription.

On multiple occasions in the hospital, I’ve been presented daily medications that were in a different pill or dose than I was expecting, and I ask the nurse to double-check the medications were correct.

Vaught was supposed to be giving Murphey Versed, a medication for anxiety that is not uncommon. I’ve had it prescribed while in hospital on numerous occasions, and it is a medication that doctors, in my experience, are willing to provide and with which nurses are familiar. 

It seems to me that even though the medication dispensing cabinets and labels failed to catch Vaught’s attention, needing to make a powder into a liquid solution should have been an unmistakable sign that this was not the quotidian medicine that had been ordered.

Mistakes are inevitable, but this was not.

While keeping deadly medications that are only used in limited circumstances in the same cabinet as frequently administered drugs is ill-advised, that did not cause Murphey’s death. A nurse on autopilot who failed to check the medication she was giving to a patient even once caused Murphey’s death.

The ANA’s position raises the inevitable question of what they would consider a criminally negligent workplace action. If this case does not meet the bar, it is hard to imagine what more a nurse would have to do to deserve punishment.

There should not be blanket immunities for people simply because they are working, and that is the precedent that the ANA would seem to like set.

Medical personnel should not operate under fear of criminal prosecution for any mistake. But if there are no nonprofessional consequences under any circumstance for medical workers, how can society ensure that caregivers are conscientious in protecting their patients’ lives?

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