NASHVILLE — A former Vanderbilt University Medical Center nurse accused of inadvertently injecting a patient with a deadly dose of a paralyzing drug has been indicted on charges of reckless homicide and impaired adult abuse.

Radonda Leanne Vaught, 35, was indicted on Friday, according to a Monday announcement from the Tennessee Bureau of Investigation.

The TBI announcement also identified the deceased patient, Charlene Murphey, for the first time. Public records list Murphey as a 75-year-old resident of Gallatin.

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The deadly mistake at Vanderbilt occurred in December 2017 but was not publicly revealed until a federal investigation report from the Centers of Medicare and Medicaid Services was made public in November 2018.

That report said the nurse, who at the time was not identified, intended to give the patient a routine sedative but instead injected vecuronium, a powerful drug used to keep patients still during surgery. Vecuronium is also part of the deadly three-drug cocktail used to execute death row convicts in Tennessee and some other states.

The deadly mix-up

The medication error occurred on Dec. 26, 2017 while Murphey was being treated at Vanderbilt for a subdural hematoma that was causing a headache and loss of vision. Despite these symptoms, she was alert, awake and in improving condition, according to the federal investigation report.

Murphey was taken to Vanderbilt’s radiology department to receive a full body scan, which involves lying inside a large tube-like machine. Because the patient was claustrophobic, a doctor prescribed a dose of Versed, which is a standard anti-anxiety medication.

A nurse then went to fill this prescription from one of the hospital’s electronic prescribing cabinets, which allow staff to search for medicines by name through a computer system. The nurse could not find the Versed, so she triggered an “override” feature that unlocks more powerful medications, according to the investigation report.

The nurse then typed the first two letters in the drug’s name – “VE” – into the cabinet computer and selected the first medicine suggested by the machine, not realizing it was vecuronium, not Versed.

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'This isn't Versed'

The drug was then given to Murphey, who was put into the scanning machine before anyone realized a medication mistake had been made. The patient was left alone to be scanned for as long as 30 minutes, according to the investigation report, before someone realized the patient was not breathing and medical staff began CPR.

At this point, the report states, the medication error was discovered. A second nurse found a baggie that was left over from the medication given to the patient.

“Is this the med you gave (the patient?)” the second nurse asked the first nurse, showing her the baggie, according to the report. “This isn't Versed. It's vecuronium."

According to the federal investigation report, the drug appears to have caused Murphey to lose consciousness, suffer cardiac arrest and ultimately be left partially brain dead. She died one day later after being taken off of a breathing machine.

VUMC's actions after the death

John Howser, a VUMC spokesman, has said previously that the hospital acted swiftly after the death, including taking "personnel actions" and notifying the patient's family.

“We have cooperated fully with regulatory and law enforcement agencies investigating the incident," Howser said on Monday after the indictment became public. "That includes providing background information about the event itself, along with physical evidence, requested health records information and other documents.”

The death ultimately triggered an investigation by the Centers for Medicare and Medicaid Services, which said in November it might suspend Vanderbilt's Medicare reimbursement payments, which amount to about one fifth of hospital revenue. Vanderbilt quickly provided CMS with a corrective action plan so the hospital’s reimbursements were no longer in jeopardy.

Despite numerous requests, the corrective action plan has not been made public by the federal government.

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Follow Brett Kelman on Twitter at @brettkelman.