RaDonda Vaught, an ex-Vanderbilt nurse, allegedly killed a patient with a medication mix-up in 2017.

State health regulators originally decided her error did not warrant professional discipline.

But now, after Vaught was criminally charged, officials have changed their minds.

In a stark reversal of a prior decision, state health officials have filed medical discipline charges against a former Vanderbilt nurse who accidentally gave a patient a fatal dose of a paralyzing drug two years ago.

RaDonda Vaught, 35, of Bethpage, is also being criminally prosecuted for the deadly error. The new medical discipline charges, which accuse her of being unprofessional and neglectful, are separate from the prosecution and only impact Vaught’s nursing license.

But the charges do signal a new stance from Tennessee Department of Health, which previously decided that Vaught’s mistake did not warrant professional discipline. After investigating Vaught last year, the department officials sent the nurse a letter saying it didn’t plan to punish her for the error.

A spokesperson for the health department declined to comment on the case or explain why the agency reversed this decision.

Vaught’s attorney, Peter Strianse, said he believed the health department caved to pressure after being “embarrassed” by the release of an agency letter that contradicted prosecutors and “exonerated” Vaught.

“It seems obvious that the District Attorney’s Office and the Tennessee Department of Health are working in concert in the pending criminal/administrative matters,” Strianse wrote in an email, adding later: “The Board of Health likely feels some public pressure to reverse its position in light of the attention that has surrounded this unfortunate accident.”

Vaught accused of neglect, unprofessional conduct

The health department filed charges against Vaught before the Tennessee Board of Nursing on Sept. 27, but those charges were not publicly revealed until the department responded to a Tennessean public records request this week. Those records show Vaught has been charged with unprofessional conduct and abandoning or neglecting a patient that required care.

Vaught has also been charged with failing to maintain an accurate patient record because she did not document her error in Murphey’s medical records. Charging documents say Vaught could face thousands of dollars in fines and suspension or revocation of her nursing license. A hearing in the case is scheduled for Nov. 20.

RADONDA VAUGHT:Want to read the discipline charges for yourself? Click here.

Local prosecutors and federal investigators have alleged that Vaught caused the death of a Charlene Murphey, 75, of Gallatin, who died while being treated for a subdural hematoma in December 2017. According to a federal investigation report, Vaught was supposed to give Murphey a dose of Versed, a sedative, but instead injected her with vecuronium, a powerful paralyzer.

Murphey was left too paralyzed to breath, then suffered brain death before the error was discovered. She died about 12 hours later after being taken off a breathing machine.

Vaught has publicly admitted she made a “mistake” at the hospital but pleaded not guilty to all criminal charges.

The fatal medication swap triggered several separate but overlapping investigations. First, federal regulators said last November that Vanderbilt’s Medicare reimbursement was in jeopardy if the hospital did not make improvements to ensure a prevent a similar error. The death was also investigated by the Tennessee Department of Health and the Davidson County District Attorney’s Office, but the two agencies reached very different conclusions.

The health department, which works in conjunction with medical boards to oversee professional licensing and discipline, sent Vaught a letter in October 2018 saying it had investigated her case and determined it “did not merit further action.” This letter was initially confidential, but Strianse released a copy to The Tennessean in April.

Prosecuting a medical mistake

The DA’s Office, on the other hand, decided the nurse’s actions were criminal.

Vaught was charged with reckless homicide and impaired adult abuse in February. During a brief court hearing on Thursday morning, Vaught's trial was scheduled for July 2020.

Prosecutors have argued in court documents that Vaught made at least 10 mistakes during the medication swap and injected the wrong drug despite an obvious warning on the medication bottle cap that said “WARNING: PARALYZING AGENT.”

Since she was arrested, Vaught’s case has become a rallying cry for nurses and medical professionals across the country, many of whom have accused prosecutors of criminalizing an honest mistake.

Much of Vaught’s support has come from Show Me Your Stethoscope, an online nurse advocacy group that has helped raise more than $95,000 for her legal defense. Organization founder Janie Harvey Garner, who attended Vaught’s first court hearing in February, said cases like this one will make nurses afraid to be transparent about errors, ultimately leading to worse care for patients.

“If nurses are not allowed to tell the truth without fear of prison, people will die,” she said. “People will die because of this.”

Brett Kelman is the health care reporter for The Tennessean. He can be reached at 615-259-8287 or at brett.kelman@tennessean.com. Follow him on Twitter at @brettkelman.