Throughout the course of the investigation and trial, it became apparent that Vaught overrode a medication cabinet’s safeguards. The investigation also revealed that cabinet overrides were a part of the everyday practice for the hospital’s nursing staff because of a problem with the hospital’s communication among the electronic health record, the medication cabinets, and the hospital pharmacy, which caused delays in accessing medications. The hospital’s short-term work-around was to override the safeguard. According to Vaught, a simple bag of fluid could not be obtained without using the override function.
Vaught admitted her error to investigators and to the Tennessee licensing board, which reopened its investigation of the medication incident after initially deciding not to pursue disciplinary action against Vaught. Vaught always maintained responsibility for the medication error.
On March 25, 2022, the jury found Vaught guilty of criminally negligent homicide and abuse of an impaired adult, and she faced up to eight years in prison. She was sentenced on May 13, 2022, to three years of supervised probation. During the sentencing, the judge noted that the case had shifted from the victim to Vaught and expressed sympathy for the patient’s family’s loss. She also noted that Vaught did not intend to break the law and that the mistake could never be repeated again as Vaught would never work in nursing again.
Implications for the Healthcare Profession
The Vaught case brought out national support for nursing and healthcare professionals but most importantly brought concern about the impact of honest reporting of mistakes on the future of healthcare litigation (both civil and criminal). Multiple national nursing organizations, including the American Nurses Association, the Academy of Medical-Surgical Nurses, and the Tennessee Nurses Association, made statements regarding the distressing potential to create a trend of the criminalization of human error in health care and the possibility of creating a practice of covering up medical errors for fear of criminal prosecution.
The potential for charges like these to turn providers against hospital employers and vice versa—which can do nothing but harm medical care—is troubling. One of Vaught’s main defenses was the hospital’s creation of an environment requiring constant overrides of medication cabinet warnings, resulting in a lax response when presented with a warning that should have been heeded. Furthermore, in light of the hospital’s actions, critics questioned why the prosecution did not bring charges against the hospital if its goal truly was to stop similar behavior. Clearly, fear of future criminal prosecution can only breed a culture of animosity between hospitals and their healthcare employees.
Most importantly, this case shows the potential dangers and pitfalls in advising clients regarding similar errors and the possibility of a slippery slope for the criminalization of all medical malpractice resulting in the death of a patient. Some of the many questions that arise for medical malpractice litigators are as follows:
- Will a civil settlement by a provider for a malpractice claim be used against that provider in a criminal proceeding?
- Will all malpractice claims resulting in a death result in automatic referral for criminal charges in some jurisdictions?
- Will healthcare providers start looking at a state’s or city’s laws regarding criminal prosecution of malpractice before determining where to practice, and will that create a shortage of providers in certain areas?
While we do not have immediate answers to these questions, they are surely on the minds of many healthcare providers across the country and surely will impact future health care—unless healthcare providers and litigators can begin to work with each other and their city and state officials to address what can be done to foster an environment of honesty without fear of criminal prosecution.