美国护士因致命的药物错误被判疏忽和过失杀人罪

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Nurse convicted of neglect and negligent homicide for fatal drug error

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RaDonda Vaught, a former nurse criminally prosecuted for a fatal drug error in 2017, was convicted of gross neglect of an impaired adult and negligent homicide Friday after a three-day trial that gripped nurses across the country.

Vaught faces three to six years in prison for neglect and one to two years for negligent homicide as a defendant with no prior convictions, according to sentencing guidelines provided by the Nashville district attorney's office. Vaught is scheduled to be sentenced May 13, and her sentences are likely to run concurrently, said DA spokesperson Steve Hayslip.

Vaught was acquitted of reckless homicide. Criminally negligent homicide was a lesser charge included under reckless homicide.

Vaught's trial has been closely watched by nurses and medical professionals across the country, many of whom worry it could set a precedent of criminalizing medical mistakes. Medical errors are generally handled by professional licensing boards or civil courts, and criminal prosecutions like Vaught's case are exceedingly rare.

Janie Harvey Garner, the founder of Show Me Your Stethoscope, a Facebook nursing group with more than 600,000 members, worried the conviction would have a chilling effect on nurses disclosing their own errors or near-errors, which would have a detrimental effect on the quality of patient care.

"Health care just changed forever," she said after the verdict. "You can no longer trust people to tell the truth because they will be incriminating themselves."

Vaught, 38, of Bethpage, Tennessee, 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 late December 2017. The neglect charge stemmed from allegations that Vaught did not properly monitor Murphey after she was injected with the wrong drug.

Murphey, 75, of Gallatin, Tennessee, was admitted to Vanderbilt for a brain injury. At the time of the error, her condition was improving, and she was being prepared for discharge from the hospital, according to courtroom testimony and a federal investigation report. Murphey was prescribed a sedative, Versed, to calm her before being scanned in a large, MRI-like machine.

Vaught was tasked to retrieve Versed from a computerized medication cabinet but instead grabbed a powerful paralyzer, vecuronium. According to an investigation report filed in her court case, the nurse overlooked several warning signs as she withdrew the wrong drug — including that Versed is a liquid but vecuronium is a powder — and then injected Murphey and left her to be scanned. By the time the error was discovered, Murphey was brain-dead.

During the trial, prosecutors painted Vaught as an irresponsible and uncaring nurse who ignored her training and abandoned her patient. Assistant District Attorney Chad Jackson likened Vaught to a drunken driver who killed a bystander, but said the nurse was "worse" because it was as if she was "driving with [her] eyes closed."

"The immutable fact of this case is that Charlene Murphey is dead because RaDonda Vaught could not bother to pay attention to what she was doing," Jackson said.

Vaught's attorney, Peter Strianse, argued that his client made an honest mistake that did not constitute a crime and became a "scapegoat" for systemic problems related to medication cabinets at Vanderbilt University Medical Center in 2017.

But Vanderbilt officials countered on the stand. Terry Bosen, Vanderbilt's pharmacy medication safety officer, testified that the hospital had some technical problems with medication cabinets in 2017 but that they were resolved weeks before Vaught pulled the wrong drug for Murphey.

In his closing statement, Strianse targeted the reckless homicide charge, arguing that his client could not have "recklessly" disregarded warning signs if she earnestly believed she had the right drug and saying that there was "considerable debate" over whether vecuronium actually killed Murphey.

During the trial, Dr. Eli Zimmerman, a Vanderbilt neurologist, testified it was "in the realm of possibility" Murphey's death was caused entirely by her brain injury. Additionally, Davidson County Chief Medical Examiner Feng Li testified that although he determined Murphey died from vecuronium, he couldn't verify how much of the drug she actually received. Li said a small dose may not have been lethal.

"I don't mean to be facetious," Strianse said of the medical examiner's testimony, "but it sort of sounded like some amateur 'CSI' episode — only without the science."

Vaught did not testify. On the second day of the trial, prosecutors played an audio recording of Vaught's interview with law enforcement officials in which she admitted to the drug error and said she "probably just killed a patient."

During a separate proceeding before the Tennessee Board of Nursing last year, Vaught testified that she allowed herself to become "complacent" and "distracted" while using the medication cabinet and did not double-check which drug she had withdrawn despite multiple opportunities.

“I know the reason this patient is no longer here is because of me,” Vaught told the nursing board, starting to cry. “There won’t ever be a day that goes by that I don’t think about what I did.”

全文翻译（仅供参考）

RaDonda Vaught 是一名前护士，因 2017 年因致命的药物错误而被刑事起诉，在经过为期三天的审判后，在全国各地的护士进行了为期三天的审判后，他于周五被判犯有严重忽视成人和疏忽杀人罪。

根据纳什维尔地区检察官办公室提供的量刑指南，沃特因疏忽而面临三到六年的监禁，作为没有事先定罪的被告，将面临一到两年的过失杀人罪。DA 发言人史蒂夫海斯利普说，沃特定于 5 月 13 日被判刑，她的刑期可能会同时执行。

沃特因鲁莽杀人罪被判无罪。刑事疏忽杀人是鲁莽杀人下的一项较轻的指控。

Vaught 的审判受到全国护士和医疗专业人员的密切关注，他们中的许多人担心这可能会开创一个将医疗错误定为刑事犯罪的先例。医疗差错通常由专业许可委员会或民事法庭处理，像 Vaught 案这样的刑事诉讼极为罕见。

拥有超过 600,000 名成员的 Facebook 护理小组 Show Me Your Stethoscope 的创始人 Janie Harvey Garner 担心，如果护士们披露自己的错误或接近错误，这会产生寒蝉效应，这会对质量产生不利影响的病人护理。

“医疗保健永远改变了，”她在判决后说。“你不能再相信人们会说真话，因为他们会自责。”

沃特现年 38 岁，来自田纳西州贝斯佩奇，于 2019 年被捕，并被控与 2017 年 12 月下旬在范德比尔特大学医学中心去世的夏琳·墨菲 (Charlene Murphey) 有关的鲁莽杀人罪和严重忽视一名受损成年人。指控沃特在注射了错误的药物后没有正确监控墨菲。

来自田纳西州加拉廷的 75 岁的墨菲因脑损伤而被范德比尔特录取。根据法庭证词和联邦调查报告，在错误发生时，她的病情正在好转，她正在准备出院。墨菲被开了一种镇静剂 Versed，让她平静下来，然后在一台类似 MRI 的大型机器中进行扫描。

Vaught 的任务是从计算机化的药物柜中取回 Versed，但取而代之的是一种强大的麻痹剂维库溴铵。根据在她的法庭案件中提交的一份调查报告，这位护士忽略了几个警告信号，因为她撤回了错误的药物——包括 Versed 是一种液体，但维库溴铵是一种粉末——然后给墨菲注射了墨菲，让她接受扫描。当错误被发现时，墨菲已经脑死亡。

在审判期间，检察官将沃特描绘成一个不负责任、冷漠的护士，忽视了她的训练并抛弃了她的病人。助理地区检察官查德杰克逊将沃特比作一名醉酒司机杀死一名旁观者，但表示护士“更糟糕”，因为她好像“闭着眼睛开车”。

杰克逊说：“这个案子的不变事实是，夏琳·墨菲已经死了，因为拉东达·沃特懒得注意她在做什么。”

Vaught 的律师 Peter Strianse 辩称，他的当事人犯了一个不构成犯罪的诚实错误，并于 2017 年成为范德比尔特大学医学中心药物柜相关系统性问题的“替罪羊”。

但范德比尔特大学的官员在看台上进行了反驳。范德比尔特的药房药物安全官 Terry Bosen 作证说，该医院在 2017 年在药物柜方面存在一些技术问题，但在 Vaught 为墨菲拉错药物前几周，这些问题就得到了解决。

在他的最后陈述中，斯特里安斯针对鲁莽杀人指控，辩称如果她真的相信自己拥有正确的药物，他的当事人不可能“鲁莽地”无视警告信号，并说关于维库溴铵是否真的杀死了墨菲存在“相当大的争论”。

在审判期间，范德比尔特的神经学家 Eli Zimmerman 博士作证说，墨菲的死完全是由她的脑损伤造成的，“在可能性范围内”。此外，戴维森县首席法医冯莉作证说，虽然他确定墨菲死于维库溴铵，但他无法证实她实际服用了多少药物。李说，小剂量可能不会致命。

“我不想开玩笑，”斯特里安斯谈到法医的证词时说，“但这听起来有点像业余的‘CSI’情节——只是没有科学依据。”

沃特没有作证。在审判的第二天，检察官播放了沃特与执法官员面谈的录音，其中她承认了药物错误，并说她“可能刚刚杀死了一名病人”。

去年在田纳西州护理委员会的另一次诉讼中，沃特作证说，她在使用药柜时让自己变得“自满”和“分心”，尽管有多次机会，她没有仔细检查她撤回了哪种药物。

“我知道这个病人不再在这里的原因是因为我，”沃特告诉护理委员会，开始哭泣。“永远不会有一天我不去想我做了什么。”

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