RaDonda Vaught, a licensed nurse in the state of Tennessee, was found guilty of criminally negligent homicide and gross neglect this spring after mistakenly giving a patient the paralyzing drug vecuronium rather than Versed. Prosecutors in the case did not allege that Vaught intended to hurt the patient or was impaired by any substance when she made the mistake—making her prosecution a rare instance of a health care worker facing prison time for a medical error. But where does medical malpractice end and criminal prosecution begin?
FACTS OF THE CASE
Vaught, 38, was arrested in 2019 and charged with reckless homicide and gross neglect of an impaired adult in connection with the killing of Charlene Murphey, who died at Vanderbilt University Medical Center in December of 2017.
Murphey, 75, was admitted to Vanderbilt for a brain injury in 2017. Murphey was prescribed the sedative Versed to calm her before undergoing an MRI scan. Vaught, using a computerized medicine cabinet, accidentally retrieved vecuronium. According to the prosecution, Vaught overlooked several warning signs as she retrieved the incorrect drug and continued to inject Murphey. The powerful paralyzer left Murphey brain-dead.
At trial, Vaught’s attorney argued that she made an “honest mistake that did not constitute a crime” and that she “earnestly believed” she had the right drug. Prosecutors brought to light testimony from Vaught in a proceeding in front of the Tennessee Board of Nursing last year where she testified that she allowed herself to become “complacent” and “distracted” while using the medication cabinet despite having multiple opportunities to make sure she had grabbed the correct drug.
Vaught was sentenced on May 13, 2022 to three years supervised probation.
RECKLESSNESS
Vaught’s criminal prosecution brings to light a number of issues that are beyond the scope of this article, such as the chilling impact of criminal charges on peer review and patient safety. Instead, this update focuses on the legal difference between civil medical malpractice and criminal involuntary manslaughter under Idaho law. To prove medical malpractice, a plaintiff must show by a preponderance of the evidence (more probably true than not true) that the health care provider breached the local standard of care. However, in an attempt to exceed Idaho’s cap on non-economic damages, plaintiffs’ attorneys, in practically every case, present evidence that the provider was “reckless.” In the civil context, “reckless misconduct means conduct in which a person makes a conscious choice as the person’s course of conduct under circumstances in which the person knows or should know that such conduct both creates an unreasonable risk of harm to another and involves a high probability that such harm will actually result.” Utilizing this definition, the issue of recklessness is a heavily litigated issue in almost every medical malpractice case.
On the other hand, in order to be guilty of Involuntary manslaughter in Idaho, the state must prove beyond a reasonable doubt that the “conduct was such that an ordinary person would anticipate that death might occur under the circumstances” and that the conduct, “although ordinarily lawful, was committed with a reckless disregard of consequences and of the rights of others.” The manslaughter statute does not define “reckless.” As such, while we are not aware of Idaho ever prosecuting a medical provider for the death of a patient, there appears to be significant overlap between the typical proof we see presented in a civil wrongful death lawsuit and criminal involuntary manslaughter – a reckless disregard for the patient’s safety.
GF INSIGHTS
In many emergency medical situations and medical specialties, every decision made during a “typical” work day involves some level of risk to the patient, including that “death might occur.” Unfortunately, at this point in time, Idaho’s statutes do not carve out exceptions for health care providers. The legislature should make clear in the Idaho Medical Malpractice Act that recklessness in the civil context cannot be used as evidence in a criminal prosecution. However, it is important to remember that while recklessness is heavily litigated in civil malpractice cases, the criminal prosecution of medical mistakes is extremely rare, which makes the prosecution of RaDonda Vaught so newsworthy.
Please contact a Gjording Fouser lawyer at 208.336.9777 if you would like any additional information about this topic or any other issues facing your company.