This unfortunate situation here for this nurse and a scary one, and I could stop thinking also other possibilities; I just became paranoid and wondered if this situation was a setup. 1. why was a PET scan ordered instead of CT if they were assessing the brain bleed? 2. what a coincidence that she was called to cover this case? 3. I wonder about the role of the student nurse and the radiology tech.
Thank you for highlighting the critical points in this tragic discussion.
1. It was mentioned that a corporation cannot be prosecuted criminally. That is incorrect. It's rather common.
2. Vanderbilt seems to meet the burden for criminal intent. They settled without reporting the case. I think you could make a strong argument they have a legal obligation to report it to the state. They used a non-disclosure agreement to keep the parties quiet. That seems to support an intent to hide wrongdoing. But I am not familiar with Tennessee's reporting duties. This is something that should be discussed. I'm curious what your attorney has to say about it.
3. The attorney who prosecuted the case worked part time for Vanderbilt. He should have been disqualified. But, I have not heard this mentioned.
Finally, I'm curious what the whistle-blower's motive was. Punish the nurse or out the organization? Seems like Vanderbilt got off pretty easy.
This is a reply from Attorney Marc Calvert in regards to Roberts comments.
1. Criminal prosecution of corporations: (Gita Pensa side edit: I believe the confusion here is that I asked a question thinking that was not possible, and Attorney Calvert answered in terms of whether prison was a possible outcome of that, which it is not.)
On this specific point, I don’t believe that I said that “a corporation cannot be prosecuted criminally”. What I thought I said, or certainly intended to say, was something like you cannot put a building or an institution in a jail. That is, with the facts of this case, the district attorney obviously felt that he had a clear case of cascading negligence by Nurse Vaught which directly caused the patient’s death. And he could prove that in 4 days, versus a 4 month (or longer) siege against an institution with an array of lawyers and political influence, struggling to connect institutional faults and flaws of Vanderbilt to the actual death of this patient. The D.A. chose the former and I do not think it is a surprise. Why? Because you can put a guilty person in jail, and, rightly or wrongly, he felt that Nurse Vaught had an obvious smoking gun in her hand and no one else did.
Vanderbilt seems to meet the burden for criminal intent. They settled without reporting the case. I think you could make a strong argument they have a legal obligation to report it to the state. They used a non-disclosure agreement to keep the parties quiet. That seems to support an intent to hide wrongdoing. But I am not familiar with Tennessee's reporting duties. This is something that should be discussed. I'm curious what your attorney has to say about it.
2. Vanderbilt and criminal intent: Here are a few thoughts. These questions and points do not pertain to the specific events related to the core of the criminal case against Nurse Vaught, which was the main thing we were talking about. The central questions, I believe, were (1) did the actions of Nurse Vaught rise to the level of criminally negligent homicide? And, (2) should healthcare providers now be fearful that there will be an increased risk of criminal prosecutions for medical mistakes?
Respectfully, you are focusing on what happened after the patient died rather than what caused her death. If this is Watergate, there was the break-in and then there was the cover-up. We were talking, primarily, about the “break-in” on the podcast, not what happened afterwards. Now, I agree that the actions of Vanderbilt, before and after the death, could be subject to question. It just wasn’t the main focus of the podcast. But every doctor and nurse I have spoken to about this has referred to Vanderbilt! The shiny object. I get it, but it does not absolve a nurse from failing to carry out many basic tasks that result in an avoidable death. That was the gist of the criminal case, and the essence of our discussion.
Criminal intent is mentioned. As someone who has defended hospitals and facilities, I would like to emphasize that there are many different considerations pertaining to things like settlement, reporting, and releases that contain confidentiality. I am not a Tennessee law expert, but settlements happen all the time and are not necessarily “reported” to the state. For example, large medical bills are written off and no lawsuit is pursued. Most releases signed by patients have confidentiality clauses so that the details are not divulged…that is common. Doctors and Hospitals do not want a billboard posted on the freeway setting out the terms of a settlement against them. So, I would submit that “to keep the parties quiet” is one way to look at it, but another way to look at it is defendants wanting to buy their peace and not being perpetually haunted by a decision to settle a case that they feel needs to be settled. Here, the family did divulge they had settled, but the amount was confidential. This is standard. And, one of the family members testified at the Vaught trial. So, there does not seem to be any glaring attempts to muzzle or hide beyond what is done routinely when cases are negotiated. You may have more facts than I do, but I have not heard anything that supports a finding of criminal intent.
3. The attorney who prosecuted the case worked part time for Vanderbilt. He should have been disqualified. But, I have not heard this mentioned. 4. Finally, I'm curious what the whistle-blower's motive was. Punish the nurse or out the organization? Seems like Vanderbilt got off pretty easy.
Thank you. I do not know one way or the other about the attorneys and their work histories. I wonder if that was brought up at all in the trial. The conflict of interest would be, at least in part, if Vanderbilt would escape legal scrutiny if their employee, Nurse Vaught, was criminally convicted. Then the lawyer’s connections would be, or should be, subject to some strict inspection. I do not know, but my hunch is no, convicting Nurse Vaught does not eliminate potential repercussions for Vanderbilt. There are other potential crimes and causes of action which can be looked at, I believe. Maybe there is more to come.
I am not defending Vanderbilt, I just do not have enough information to either clear them or criticize them. Providers are victimized all the time by facilities and institutions, so I can appreciate the frustration and even anger. In my opinion, the focus on Vanderbilt is not relevant to this Vaught case unless it can be shown that her series of mistakes were actually caused by Vanderbilt and not by her decision making. My glimpse at the record reveals that there is support for the argument that she missed so many signs and chances, some of which are elementary in nature such as reading the bottle of medication, that Vanderbilt could be the worst set-up on earth and yet no nurse would have messed up this bad unless they were grossly negligent.
Thank you for the points, and I welcome further discussion. As I have said, I feel very sorry for this nurse. I also feel very sorry for this patient. A doctor told me recently that this would have been a bad way to die, and she had no one even near her as the medication first paralyzed her and then suffocated her. I am a defense attorney, but juries are never going to accept the “this hospital is such a bad system and that is why I did not stop at 8 red lights” defense.
Thanks for the interesting discussion. In addition to the warning overrides and needing to reconsitute vecuronium as a powder, another key nursing point where this could have just been a concerning med error where the outcome would have been much different would have been where she stays with the patient, recognizes that her patient isn't breathing, and then bags them until the vecuronium wears off while alerting additional critical care team members. This should have been the reaction for someone who has had basic critical care training. So one wonders, did she have that? Do the staff at your intitution have that? Do you regularly practice or simulate uncommon 'turns toward the worse' with your team?
Thank you. Doctors I have spoken to have emphasized this point. They were surprised that she did not stay with her to see how she reacted to the medicine, particularly since she was anxious about the procedure.
I don’t know if institutions commonly require it, but it seems to be a preferred practice: stay with the patient to make sure that the impact of the medication is as anticipated.
Thanks,
Marc
Calvert, Leever & Ostler
Attorneys at Law
15201 Mason Road, Suite 350
Cypress, Texas 77433
713.290.0272
www.calvertfirm.com
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Emergency NP - April 21, 2022 3:00 PM
This unfortunate situation here for this nurse and a scary one, and I could stop thinking also other possibilities; I just became paranoid and wondered if this situation was a setup.
1. why was a PET scan ordered instead of CT if they were assessing the brain bleed?
2. what a coincidence that she was called to cover this case?
3. I wonder about the role of the student nurse and the radiology tech.
Thank you for highlighting the critical points in this tragic discussion.
Mike W. - April 22, 2022 9:03 AM
Don't know why a PET scan was ordered... weird. Thx for the comments and agree, what a tragic case!
M
Robert M. - May 9, 2022 6:41 PM
A couple of points:
1. It was mentioned that a corporation cannot be prosecuted criminally. That is incorrect. It's rather common.
2. Vanderbilt seems to meet the burden for criminal intent. They settled without reporting the case. I think you could make a strong argument they have a legal obligation to report it to the state. They used a non-disclosure agreement to keep the parties quiet. That seems to support an intent to hide wrongdoing. But I am not familiar with Tennessee's reporting duties. This is something that should be discussed. I'm curious what your attorney has to say about it.
3. The attorney who prosecuted the case worked part time for Vanderbilt. He should have been disqualified. But, I have not heard this mentioned.
Finally, I'm curious what the whistle-blower's motive was. Punish the nurse or out the organization? Seems like Vanderbilt got off pretty easy.
Gita P. - May 10, 2022 11:17 AM
This is a reply from Attorney Marc Calvert in regards to Roberts comments.
1. Criminal prosecution of corporations:
(Gita Pensa side edit: I believe the confusion here is that I asked a question thinking that was not possible, and Attorney Calvert answered in terms of whether prison was a possible outcome of that, which it is not.)
On this specific point, I don’t believe that I said that “a corporation cannot be prosecuted criminally”. What I thought I said, or certainly intended to say, was something like you cannot put a building or an institution in a jail. That is, with the facts of this case, the district attorney obviously felt that he had a clear case of cascading negligence by Nurse Vaught which directly caused the patient’s death. And he could prove that in 4 days, versus a 4 month (or longer) siege against an institution with an array of lawyers and political influence, struggling to connect institutional faults and flaws of Vanderbilt to the actual death of this patient. The D.A. chose the former and I do not think it is a surprise. Why? Because you can put a guilty person in jail, and, rightly or wrongly, he felt that Nurse Vaught had an obvious smoking gun in her hand and no one else did.
Vanderbilt seems to meet the burden for criminal intent. They settled without reporting the case. I think you could make a strong argument they have a legal obligation to report it to the state. They used a non-disclosure agreement to keep the parties quiet. That seems to support an intent to hide wrongdoing. But I am not familiar with Tennessee's reporting duties. This is something that should be discussed. I'm curious what your attorney has to say about it.
2. Vanderbilt and criminal intent: Here are a few thoughts. These questions and points do not pertain to the specific events related to the core of the criminal case against Nurse Vaught, which was the main thing we were talking about. The central questions, I believe, were (1) did the actions of Nurse Vaught rise to the level of criminally negligent homicide? And, (2) should healthcare providers now be fearful that there will be an increased risk of criminal prosecutions for medical mistakes?
Respectfully, you are focusing on what happened after the patient died rather than what caused her death. If this is Watergate, there was the break-in and then there was the cover-up. We were talking, primarily, about the “break-in” on the podcast, not what happened afterwards. Now, I agree that the actions of Vanderbilt, before and after the death, could be subject to question. It just wasn’t the main focus of the podcast. But every doctor and nurse I have spoken to about this has referred to Vanderbilt! The shiny object. I get it, but it does not absolve a nurse from failing to carry out many basic tasks that result in an avoidable death. That was the gist of the criminal case, and the essence of our discussion.
Criminal intent is mentioned. As someone who has defended hospitals and facilities, I would like to emphasize that there are many different considerations pertaining to things like settlement, reporting, and releases that contain confidentiality. I am not a Tennessee law expert, but settlements happen all the time and are not necessarily “reported” to the state. For example, large medical bills are written off and no lawsuit is pursued. Most releases signed by patients have confidentiality clauses so that the details are not divulged…that is common. Doctors and Hospitals do not want a billboard posted on the freeway setting out the terms of a settlement against them. So, I would submit that “to keep the parties quiet” is one way to look at it, but another way to look at it is defendants wanting to buy their peace and not being perpetually haunted by a decision to settle a case that they feel needs to be settled. Here, the family did divulge they had settled, but the amount was confidential. This is standard. And, one of the family members testified at the Vaught trial. So, there does not seem to be any glaring attempts to muzzle or hide beyond what is done routinely when cases are negotiated. You may have more facts than I do, but I have not heard anything that supports a finding of criminal intent.
3. The attorney who prosecuted the case worked part time for Vanderbilt. He should have been disqualified. But, I have not heard this mentioned.
4. Finally, I'm curious what the whistle-blower's motive was. Punish the nurse or out the organization? Seems like Vanderbilt got off pretty easy.
Thank you. I do not know one way or the other about the attorneys and their work histories. I wonder if that was brought up at all in the trial. The conflict of interest would be, at least in part, if Vanderbilt would escape legal scrutiny if their employee, Nurse Vaught, was criminally convicted. Then the lawyer’s connections would be, or should be, subject to some strict inspection. I do not know, but my hunch is no, convicting Nurse Vaught does not eliminate potential repercussions for Vanderbilt. There are other potential crimes and causes of action which can be looked at, I believe. Maybe there is more to come.
I am not defending Vanderbilt, I just do not have enough information to either clear them or criticize them. Providers are victimized all the time by facilities and institutions, so I can appreciate the frustration and even anger. In my opinion, the focus on Vanderbilt is not relevant to this Vaught case unless it can be shown that her series of mistakes were actually caused by Vanderbilt and not by her decision making. My glimpse at the record reveals that there is support for the argument that she missed so many signs and chances, some of which are elementary in nature such as reading the bottle of medication, that Vanderbilt could be the worst set-up on earth and yet no nurse would have messed up this bad unless they were grossly negligent.
Thank you for the points, and I welcome further discussion. As I have said, I feel very sorry for this nurse. I also feel very sorry for this patient. A doctor told me recently that this would have been a bad way to die, and she had no one even near her as the medication first paralyzed her and then suffocated her. I am a defense attorney, but juries are never going to accept the “this hospital is such a bad system and that is why I did not stop at 8 red lights” defense.
John C. - May 19, 2022 3:08 AM
Thanks for the interesting discussion.
In addition to the warning overrides and needing to reconsitute vecuronium as a powder, another key nursing point where this could have just been a concerning med error where the outcome would have been much different would have been where she stays with the patient, recognizes that her patient isn't breathing, and then bags them until the vecuronium wears off while alerting additional critical care team members. This should have been the reaction for someone who has had basic critical care training. So one wonders, did she have that? Do the staff at your intitution have that? Do you regularly practice or simulate uncommon 'turns toward the worse' with your team?
Mike W. - May 19, 2022 7:44 AM
Thank you. Doctors I have spoken to have emphasized this point. They were surprised that she did not stay with her to see how she reacted to the medicine, particularly since she was anxious about the procedure.
I don’t know if institutions commonly require it, but it seems to be a preferred practice: stay with the patient to make sure that the impact of the medication is as anticipated.
Thanks,
Marc
Calvert, Leever & Ostler
Attorneys at Law
15201 Mason Road, Suite 350
Cypress, Texas 77433
713.290.0272
www.calvertfirm.com