A Tale of Two Trials // Patients were killed by a nurse and a doctor 

Two medical professionals. Two trials for the deaths of patients. Two verdicts. And an abundance of cause for concern.

Last month, RaDonda Vaught, who worked as a registered nurse in Nashville, Tennessee, was sentenced to three years of supervised probation after being convicted of reckless homicide in March for having caused the death of a patient under her care.

Ms. Vaught made a fatal error when she overrode a hospital safety medication dispensing mechanism in order to access a drug and grabbed the wrong one.
The nurse had been working in the ICU at Nashville’s Vanderbilt University Medical Center, where a 75-year-old woman with a subdural hematoma had been transferred for a PET scan to ascertain the cause of the brain bleed. The patient, however, was claustrophobic and so needed to be sedated for the procedure.

The sedative prescribed was the frequently used midazolam, trade-named Versed. Ms. Vaught was tasked with retrieving and administering the medication.
When she couldn’t find it in the dispensary, though, she disabled a safeguard, allowing her access to other drugs. And, tragically, she mistakenly pulled vercuronium, a powerful muscle relaxant that led to her patient being unable to breathe, which in turn caused cardiac arrest and, eventually, death.

Medical mistakes happen more often than we like to think, and sometimes with grave consequences. When Ms. Vaught realized her error, she became distraught and didn’t deny what she had done. Convicted of causing the death of a patient, she lost her nursing license and received her sentence.

Two weeks earlier, 400 miles to the north, a Columbus, Ohio, jury acquitted Dr. William Husel of murder. He had initially been indicted on 25 counts, but a judge dismissed 11.

Working at Mount Carmel Hospital West, Dr. Husel had administered the narcotic fentanyl to physically compromised patients. Typical doses are 100 micrograms. He chose doses ranging from 500 to 2,000, the latter considered by the DEA to be potentially lethal.

Over 50 witnesses, including doctors and nurses, testified for the prosecution, contending that the doses were intended to kill the patients. Relatives described their loved ones’ sudden and quick declines.

Dr. Husel did not testify in his defense. His lawyers called only one witness, another doctor, who testified that the 14 patients had severe and terminal illnesses that caused their deaths.

That same doctor, though, was quoted by prosecutors as having said that Dr. Husel had administered “doses of fentanyl at a level that they [the staff] internally believed were inappropriate and not for a legitimate medical purpose” and, one prosecutor contended, “were designed to hasten the death of the patients that were being treated.”

But the prosecution could not conclusively prove a motive for Dr. Husel’s actions, and Ohio has no law defining the maximum dosage of fentanyl, allowing doctors to use the drug as they see fit. Hence Dr. Husel’s acquittal.

Ms. Vaught’s crime was an accident. Dr. Husel’s, at least in the view of the prosecution, was intentional. Certainly, he knew that large doses of fentanyl would imperil the lives of the patients who died under his care. Whatever his motivation and whether or not his actions were criminally prosecutable, he seemingly spurned the medical principle “First do no harm.”

There is much to unpack here. Just how often are preventable medical mistakes made by nurses? Does prosecuting those that are discovered do societal harm by discouraging nursing as a profession? Or does it help ensure that nurses are more careful and that hospitals don’t overwork them?

How common is it for doctors, protected by rules allowing them broad judgments, to take upon themselves the role of deciding whether someone’s life is worth maintaining or whether the person would best be “relieved” of living?

The state of medical care in our country has plenty of problems. From the inflated and outrageous costs of drugs and treatments, to an insurance industry in perpetual tugs-of-war with health providers, to lawsuit-fear-driven unnecessary diagnostic procedures and treatments to paperwork overloads that waste time and resources.
But it shouldn’t be too much to ask that nurses be meticulously careful when administering drugs.

And that doctors not consider themselves judges of the value of patients’ lives.


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