A former nurse whose medication error killed a patient in Tennessee was sentenced to three years of probation on Friday, ending a case that had prompted concern among health care workers fearful that medical mistakes will be criminalized.
The nurse, RaDonda Vaught, apologized to the relatives of the 75-year-old victim, Charlene Murphey, who was injected with a fatal dose of vecuronium, a paralyzing drug, instead of Versed, a sedative, while at Vanderbilt University Medical Center for a brain injury on Dec. 26, 2017, according to court papers.
Ms. Murphey had been scheduled to get a PET scan that day and wanted medication to control her anxiety, a lawyer for Ms. Vaught said.
“Saying ‘I’m sorry’ doesn’t seem like enough,” Ms. Vaught, 38, who broke down in tears, told Ms. Murphey’s family at the sentencing. “But you deserve to hear that. You deserve to know that I am very sorry for what happened.”
Ms. Vaught, who was found guilty in March of gross neglect of an impaired adult and negligent homicide, was also issued a judicial diversion, which would expunge her criminal record if she successfully completes probation.
“This offense occurred in a medical setting,” Judge Jennifer Smith of the Davidson County Criminal Court said at the sentencing. “It was not motivated by any intent to violate the law, but through oversight and gross negligence and neglect, as the jury concluded. The defendant also accepted responsibility immediately. She made every effort in the moment that she recognized her error to remedy the situation.”
Ms. Vaught’s criminal conviction jolted nurses across the country, who have complained of being exhausted by working conditions during the pandemic and persistent staff shortages at hospitals. Her case was viewed as yet another threat to the profession — one that could have a chilling effect on patient care if nurses become more hesitant to report mistakes.
Ms. Vaught said in March that the jury’s decision in her case would “have more of an impact on the nursing community and health care overall.”
The American Nurses Association agreed, saying in a statement in March that it was “deeply distressed by this verdict and the harmful ramifications of criminalizing the honest reporting of mistakes.”
On Friday, the association said it was “grateful to the judge for demonstrating leniency in the sentencing.”
“Unfortunately, medical errors can and do happen, even among skilled, well-meaning, and vigilant nurses and health care professionals,” the association said.
The Davidson County district attorney’s office, which prosecuted the case, did not immediately respond to a request for comment on Saturday. Prosecutors did not oppose the probation sentence on Friday.
“We’re very pleased and relieved with the outcome of the sentencing,” Peter Strianse, Ms. Vaught’s lawyer, said on Saturday.
Ms. Murphey’s son, Michael Murphey, told the court on Friday that “knowing my mom, the way my mom was and stuff, she wouldn’t want to see” Ms. Vaught serve prison time.
“That’s just mom,” he said. “Mom was a very forgiving person.”
The Associated Press reported that Ms. Murphey’s husband did want Ms. Vaught to serve a prison sentence.
As she waited to hear the judge’s sentencing, Ms. Vaught visibly shook and took deep breaths. After the sentencing, while others left the courtroom, she placed tissues on her eyes, rested her head on the table and cried.
Outside the courthouse, nurses wearing purple gathered in support and cheered, News Channel 5 in Nashville reported.
Speaking to reporters in March, Ms. Vaught said that what had happened in 2017 “was something that will always be with me.”
“Any time you take care of a patient and you have some sort of thing that bonds you, you don’t — good or bad — you don’t forget that as a nurse or as any good health care provider,” she said.
Mr. Strianse had argued that Ms. Vaught’s mistakes were partly made because of systemic problems at the hospital, such as communication problems with the pharmacy department.
But prosecutors had argued that her mistakes were criminally negligent. She overrode the medical system on a computer when she could not find the Versed medication, typed in “VE” and chose the first medication (the paralyzer vecuronium) on the list, according to a Tennessee Bureau of Investigations report.
She then “failed to respond to a number of ‘red flags,’” according to the report: The vecuronium comes in powder form, unlike the liquid Versed, and the vecuronium has a red cap that states “Warning: Paralyzing Agent.”
Ms. Vaught later admitted to investigators that she had been “distracted with something” at the time and should not have “overrode the medication because it wasn’t an emergency,” according to the report. Ms. Vaught eventually lost her nursing license.
Erik Knutsen, a professor of medial malpractice law at Queen’s University in Ontario, Canada, said on Saturday that while he does not blame nurses for being concerned, especially during a pandemic, Ms. Vaught’s case does not signal “an open season on nurses.”
Health care workers are accustomed to negligence lawsuits in which patients seek financial compensation, he said. Criminal prosecutions, however, are rarer and “feel personal” because, unlike other negligence lawsuits, the potential price is prison time.
“A district attorney’s office, before they even think about bringing a criminal charge, would have to think, ‘Gee, do we have a reasonable shot here of convicting this person?’” Mr. Knutsen said.
To have a chance at a conviction, the district attorney was likely to have believed that Ms. Vaught’s mistakes were particularly “egregious and preventable,” he said.
It’s likely that prosecutors wanted to send a message and “deter that kind of behavior in the workplace that can hurt or kill,” Mr. Knutsen said.
“I think this is going to be a very, very rare, one-off occurrence,” he said. The prosecutor, he added, had sent a clear message: “Nurses, be careful.”