Class debate group work

Group Members: Yesenia Rangel Sosa, Ilianni Aguilar, Andrea Lee, Khamila Gutierrez, Shanyah Geddes, Marilyn Carchipulla, Melanie Rosario

Date: 10-31-24

Thesis: RaDonda Vaught’s actions demonstrate a clear deviation from professional nursing standards. Her failure to adhere to critical safety protocols, disregard for medication verification procedures, and inadequate response to known patient risks collectively led to a fatal error, underscoring her responsibility in the patient’s death and highlighting the importance of accountability in nursing practices.

Summary of the case: RaDonda Vaught was a nurse at Vanderbilt University Medical Center she had been a nurse since 2015. In December 2017, she administered the wrong drug to Charlene Murphy, a patient in the intensive care unit which ended with Charlene losing her life. As a result, RaDonda lost her nursing license and the district attorney charged her with “Reckless homicide” and “Abuse of an impaired adult” in 2019. Due to the seriousness of the charges nurse advocate groups came together to take a stance against the charges brought against RaDonda and argue that it was a mistake and that RoDonda should not be charged for a mistake she made. In March of 2022, the jury of her case returned a guilty verdict on the charge of “Criminally negligent homicide” and on the charge of “Abuse of an impaired adult”. She was sentenced to 3 years of supervised probation.

1. Marilyn C- In healthcare, medical personnel must work together to treat their patients. It is a job that requires constant attention and caution because it is the lives of their patients that are at risk. In this case of involuntary manslaughter , the nurse is guilty because despite it is a joint work, she as a professional which is expected to be highly qualified, considering the parameters that are asked of health professionals , she skipped many warnings of the medicine she administered , besides being the wrong one. It was a total lack of attention to the procedure. We must also consider that her patient was in critical condition which was one more reason to be alert about the medications to be administered. Y ou cannot dismiss her case and not blame her, because in the end her job is to be cautious of what she does and what other workers do, but she was not at all, and she killed a person willingly or unwillingly. The fact is that her patient died because of her carelessness. In this case people let themselves be treated relying on the experience and knowledge of the doctors and nurses who have the duty to treat their patients in the best possible way and with the correct medication.

2. Anays Sanchez-ETHOS As a licensed nurse, The nurse is guilty because she lacked responsibility as a healthcare professional. Nurses need to have a good understanding of medications and medical procedures. RaDonda Vaught's actions showed that she didn’t meet these important standards. Patients depend on healthcare workers to keep them safe and give them the right care, but in this case, that responsibility was not fulfilled. These actions showed that Vaught needed to be attentive in her work, as even small mistakes can lead to serious problems.- "Medication Errors: Causes and Prevention" by Barbara A. Blaskiewicz – This article discusses the prevalence of medication errors in healthcare settings and emphasizes the need for nurses to verify medications and follow protocols. "Understanding the Impact of Nursing Errors on Patient Outcomes" by Michael S. H. Johnson – examining how nursing errors affect patient safety and emphasizes the necessity for vigilance and thoroughness in nursing practice.

3. Khamila- RaDonda Vaught, a registered nurse, held an individual responsibility to ensure patient safety through following established medical protocols and procedures. In this incident, V aught bypassed the required double-check procedure for high-risk medications, opting not to consult a colleague—a critical step that could have caught her error before it reached the patient. This disregard of double-checking was a conscious choice, not a hospital failing, as any trained nurse would understand the importance of verifying such medications. Additionally, V aught neglected to use cognitive aids, like checklists, which are simple yet essential tools that prevent errors in high-stakes settings. Her decision to rely solely on memory, rather than utilizing these available tools, reflects a personal oversight. Vaught further deviated from safety culture principles by not seeking assistance or clarification when in doubt, despite a hospital environment that encourages staff to consult others to avoid mistakes. Her actions in a critical care setting also lacked situational awareness, ignoring her patient’s condition and environment—both critical in high-stakes care. When the error became apparent, Vaught delayed informing her supervisors, preventing a timely response that might have mitigated harm. This series of individual decisions, from bypassing protocol to delaying disclosure, underscores her personal responsibility in the incident. While the hospital provided a robust system of protocols, Vaught's failure to adhere to these safeguards directly compromised patient safety, making her accountable for these preventable oversights.

4. Ilianni A- The nurse initially typed “VE” to search for Versed, a sedative, instead of entering “Midazolam,” the generic name of the drug. This action didn’t yield the expected result, so she assumed a system glitch and manually overrode the dispenser safeguards, which unlocked a broader range of medications, including high-risk drugs. Using an override should always prompt extra caution, especially with potentially hazardous medications, underscoring the need for double-checking both the drug and dosage. When she entered "VE," the system presented her with vecuronium, a paralytic agent, but she mistakenly assumed it was Versed. As she selected the drug, multiple pop-up alerts appeared on the dispenser, clearly warning that this was a paralytic agent, not a sedative. She dismissed these alerts without verifying the medication. Additionally, since she had a trainee with her, this was an opportunity to demonstrate correct procedures by reading the medication name aloud and asking the trainee to do the same. This practice is a standard safety measure in hospitals, designed to reinforce awareness and verification at each step, especially when using high-risk overrides. By not doing so, she bypassed an essential teaching moment, as well as an added layer of safety. In such cases, the combination of overriding the system without cross-checking, ignoring clear alerts, and missing verification procedures—especially with a trainee present—suggests negligence in maintaining patient safety and adhering to protocol, ultimately placing the patient at serious risk. Failure to Follow the Five Rights: Nurses are trained to follow the Five Rights of medication administration: the right patient, right drug, right dose, right route, and right time. If a nurse fails to verify these aspects, they can be held accountable since these checks are standard safeguards designed to prevent medication errors.

5. Melanie R.- This also isn’t a question of receiving the wrong medication. As after receiving it, there was a sequence of events that should’ve concerned Vaught. First being that despite being a nurse she would have to read the instructions before administering the drug, where she would have seen the label for Vecuronium. It is also known that she did read these instructions considering the fact that she shook the bottle, which isn’t process used for Versed. Even before drawing the medication, she would have to look directly at the red cap with the words, “Warning: Paralyzing Agent”. In the end, she left the patient alone for 30 whole minutes after administering the dose, neglecting the observation period nurses must have to make sure that the patient doesn’t react negatively to the dose.

6. Andrea L.- Around 40% of malpractice against nurses are death related. In Figure 2, it shows a direct comparison of non nurse care casualties compared to the nurse. While medicdication related incident is lower it’s still accounts for almost 10% including the statistic of patient monitoring. Which is double the medication malpractice. In all categories there are more malpractice against the trained nurse. As each nurse are held to different standard it’s there job to be update with new procedures and protocol as it is also a legal requirement. Nurse are also sworn to a moral code it’s stated that it the hospital had stated the cause as a natural death when, V aught knew it was her mistake and reported it. She did not come clean to the family themselves, who didn’t have the chance to say goodbye and instead the situation had to resurface years later when the truth came out not out of her mouth.

Shanyah Geddes- Vaught's failure to effectively handle recognized patient dangers reveals a major lack in judgment and oversight. Nurses are responsible for monitoring their patients' status and identifying potential consequences. In this situation, Charlene Murphy had recognized health problems that necessitated strict monitoring. However, Vaught's failure to accurately diagnose Murphy's health, as well as her rapid reaction to the drug error, aggravated the issue. The American nursing Association highlights the importance of nursing not only administering drugs correctly, but also responding immediately and aggressively to adverse effects. In this scenario, Vaught's delayed response to the error—failing to see the risk and take corrective action—contributed to Murphy's deteriorating condition. By neglecting to take responsibility for the mistake and moving quickly to alleviate harm, Vaught exhibited a disrespect for the patient’s well-being. Such failures, compounded by the disregard for critical safety checks, underscore Vaught’s accountability in this tragic event. The case emphasizes the importance of adhering to nursing protocols and acting quickly to rectify any errors, as even a slight delay can lead to severe consequences.

7. Counterclaim: Yesenia RS- Some might argue that Nurses already have to deal with a lot on the job and that charging nurses when they commit medical malpractice would lead to a decline in the number of people who will want to become nurses, therefore, nurses like Rodonda in this instance don’t deserve to be charged because it was an accident. However, it is important to note that Medical Malpractice was the second major killer among adults in a 2013 report (see Figure 1), and according to McMathLaw, medication errors kill 7,000 to 9,000 people per year and an estimated 250,000 people lose their lives from preventable medical errors many survive but with irreversible harm. Not many doctors are taken to court and tried for medical malpractice and never see consequences for their actions.

    If we argue that a nurse should not be held accountable for medical malpractice, we implicitly suggest that doctors, too, should be exempt from such charges, fostering a culture where medical errors are not addressed. This lack of accountability has directly contributed to ongoing patient fatalities under medical supervision. While it’s true that nurses often work under difficult conditions and are generally compensated less than doctors, these issues should be addressed independently. Both doctors and nurses undergo extensive education and training to care for patients safely and competently. Regardless of workload, healthcare professionals—especially those in critical care settings—must be vigilant in their duties, as patient safety is paramount. Where do we draw the line? The lack of consequences for their actions is the reason why people keep dying under medical supervision. It is clear that when you’re in the intensive care unit you should be attentive to what you’re doing. They have similar duties and should be held responsible when they make a mistake as big as this that results in someone losing their life. 

Figure 1: Major Killers in Adults where Medical Errors come out as the second leading cause of death. Courtesy of The US Military.

Figure 2: Nursing and non nursing malpractice comparison.

Works Cited

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