Tennessee Nurse Found Guilty of Criminal Medical Negligence

A recent criminal case in Tennessee has generated significant discussion and concerns for health care providers across the country.  While concerning, the case does not have legal precedential impact in Virginia, and by all indications is an outlier both in terms of (1) the egregiousness of the negligence and severity of the outcome, and (2) the decision of a local Tennessee prosecutor to try the case.  There have been no criminal prosecutions for medical negligence in our area, and we know of no such cases in Virginia.  That said, concerns about the case and decision to prosecute are legitimate, and the Trust will be vigilant about tracking the impact of it at both the state and national level.

Last Friday a Tennessee nurse was found guilty of negligent homicide and gross neglect of an impaired adult following a multi-day criminal trial in Nashville.  RaDonda Vaught, a former nurse with Vanderbilt University Medical Center, will be formally sentenced in May and based on guidelines is expected to receive a prison term of 3-6 years.

Ms. Vaught, 38, was charged with various criminal offenses after she injected the decedent, Charlene Murphy, 75, with a lethal dose of vecuronium, a powerful paralyzer, in 2017.  Ms. Murphy, who had been admitted to Vanderbilt for a brain injury, was being prepared for discharge at the time she received the fatal dose.

According to the prosecution, Ms. Vaught had been tasked with retrieving Versed, a sedative, from Vanderbilt’s computerized medication cabinet (Acudose) prior to Ms. Murphy’s PET scan.  She typed in the letters “ve” in Acudose and incorrectly chose the vecuronium prompt instead of the correct Versed prompt.  Ms. Vaught then ignored and proactively overrode five separate warning signals in the Acudose system.  In addition to the overrides, the prosecution argued that Ms. Vaught ignored or failed to respond to five subsequent “red flags” between the time she removed the paralyzing agent from the cabinet and administered the drug to Ms. Murphy.  Included in these “red flags” was the fact that vecuronium comes in powder form, whereas Versed comes in liquid form.  Vecuronium also contains a red cap with a label stating “Warning: Paralyzing Agent.”  Despite the overrides, warnings and other “red flags,” Ms. Vaught administered the vecuronium and promptly left Ms. Murphy unattended on a mobile bed in the PET room. Testimony from the chief medical examiner determined that Ms. Murphy died from the vecuronium, though the defense disputed this conclusion.

In a separate administrative proceeding before her trial, Ms. Vaught admitted before the Tennessee Board of Nursing that it was “completely her fault” that she incorrectly administered the vecuronium to Ms. Murphy.  Despite the honesty, she attempted to justify the error by arguing that overrides were “common” and a seemingly everyday occurrence at Vanderbilt.  The Board of Nursing was not swayed and revoked Ms. Vaught’s license in July 2021.

While the facts of this case are egregious, it is nevertheless unsettling to see a prosecutor go after a healthcare worker in this manner.  Unlike civil medical malpractice cases which are brought by individuals or estates, all criminal matters must be brought by government prosecutors and are used to punish and incarcerate individual defendants.  Although criminal medical negligence cases have been brought against healthcare providers before, such cases are very rare and almost always involve extreme facts and reckless and/or intentional behavior.

Importantly, this case was brought by state prosecutors in Tennessee, not Virginia.  Thus, the only legal precedent established applies to Tennessee providers.  To our knowledge no Virginia prosecutor has charged a Virginia provider with criminal medical negligence (criminal charges have been filed against Virginia providers, though they typically involve healthcare fraud).  So while this case is alarming, there is no immediate legal crisis for Virginia providers at this time.  Of course, if you have any questions or concerns please contact PLT at (434) 296-2100.