BEFORE THE TENNESSEE BOARD OF NURSING In The Matter of: RaDonda Vaught R.N. License No. 205702 Docket Respondent 5 NOTICE OF HEARING AND CHARGES AND a MEMORANDUM FOR ASSESSMENT OF CIVIL PENALTIES :3 s: 32 ?it The Tennessee Department of Health (State) would show as follows: <33 9? 1?5 I. Jurisdiction and Authority Pursuant to Tennessee Code Annotated Section (TENN. CODE ANN. 63-7-10], et seq. (Code), the Tennessee Board of Nursing (Board) regulates and supervises the practice of nursing in the State of Tennessee in part by promulgating administrative rules, TENN. COMP. R. REGS. 1000-01-01, et seq. (Rules), and entering administrative orders (Order). If a licensee violates the Code, Rules, or an Order, the Board has the power and the duty to: a) suspend, probate, or revoke a license, TENN. CODE ANN. 63-7-115 and 120; b) assess a civil penalty against the licensee of up to $1,000.00 for each day of each violation, TENN. CODE ANN. and and TENN. COMP. R. REGS. 1000?01?04; c) assess the costs against the licensee directly related to the prosecution ofthis case, including the cost of the State?s attorney, TENN. CODE ANN. 63?1?144; 63-7- 115(d); and TENN. COMP. R. REOS. or d) otherwise discipline a licensee. II. Allegations of Fact Respondent engaged in the following acts and conduct: 3. Respondent has been at all times pertinent hereto licensed by the Board as a registered nurse in the State of Tennessee, having been granted license number 205702 on February 13, 2015 which currently has an expiration date of January 31, 2020: Respondent?s registered nurse license bears a multistate privilege to practice nursing in states which have entered into the Interstate Nurse Licensure Compact. 4. On or about December 26, 2017, Respondent was employed as a ?help?all? nurse at Vanderbilt University Medical Center. 5. Patient #1 was admitted to the hospital on December 24, 2017 with a diagnosis of a brain bleed. 6. Patient #1 ?3 physician ordered that Patient #1 undergo a Positive Emission Tomography (PET) scan. At the time of her arrival in radiology, Patient #1 was awake, alert, and oriented. 7. Patient #1 expressed anxiety about the PET scan, as she was claustrophobic, and asked the radiology tech on duty for medication to ease her discomfort. 8. The radiology tech then went to the primary nurse assigned to Patient The primary nurse for Patient #1 then obtained a verbal order from Patient #1 ?3 physician to receive Versed one (1) milligrams intravenously for PET scan. The primary nurse assigned to Patient #1 then called Respondent and asked her to administer Versed to Patient 9. Patient #1 ?5 physician order for Versed was entered on December 26, 2017 at 2:47 RM. The pharmacy veri?ed the order for Versed at 2:49 PM. 10. Respondent failed to verify the physician order with either the pharmacy or the physician. Instead. at 2:59 P.M.. Respondent typed in the letters in the override function of the automatic dispensing cabinet. A medication with the letters popped up and Respondent removed the medication out of the cabinet. 1 1. Respondent actually removed Vecuronium ten (10) milligrams from the dispensing cabinet located in the Neuro Intensive Care Unit (ICU) using the override feature instead of removing the Versed which was ordered for Patient l2. Respondent looked at the back of the medication for directions on how to reconstitute the medication. Respondent did not check the name of the medication. 13. After Respondent removed the medication, Respondent reconstituted and administered the Vecuronium at Patient #1 ?s bedside in Radiology. Respondent did not stay with Patient #1 after administering the medication. 14. Patient #1 was found unresponsive approximately thirty (30) minutes later and required cardiOpulmonary resuscitation (CPR) and mechanical ventilation. 15. Patient #1 was placed on life support and expired within twelve (12) hours following the administration of Vecuronium. l6. Respondent failed to follow all of the ?ve rights of medication administration; right patient, right medication, right dose, right route, and right time to adhere to the prescribed frequency and time of medication to Patient l7. Respondent failed to monitor Patient 18. Respondent failed to document in Patient #1 ?5 medical record that she had administered Vecuronium to Patient 19. On or about February 4. 2019, the Davidson County Grand Jury indicted Respondent for reckless homicide, in violation of Tenn. Code Ann. 39?13?215, a Class felony. Respondent was also indicted for knowing physical abuse or gross neglect of an impaired adult, in violation of La.) Tenn. Code Ann. 71-6?119, a Class felony. Alleged Violations Respondent?s acts and conduct establish the following Alleged Violations and constitute grounds for discipline as follows: 20. 21. 22. Respondent?s acts and conduct enumerated in paragraphs four (4) through eighteen (18) constitute violations of TENN. CODE ANN. (F) ls guilty of unprofessional conduct. Respondent?s acts and conduct enumerated in paragraphs four (4) through eighteen (18) constitute violations of TENN. COMP. R. REGS. Failure to maintain a record for each patient which accurately re?ects the nursing problems and interventions for the patient and/or failure to maintain a record for each patient which accurately re?ects the name and title of the nurse providing care; and Abandoning or neglecting a patient requiring nursing care. Respondent?s acts, conduct, and violations as set out above constitute grounds for discipline, including suspension, probation, revocation, assessment of a civil penalty, assessment of costs, and other discipline as may be imposed by the Board. IV. Assessment of Civil Penalties and Costs The State proposes the assessment of three (3) Type A Civil Penalties in the amount of one thousand dollars each, for a total of three thousand dollars in accordance with TENN. COMP. R. REGS. based upon consideration ofthe following factors: a. Whether the amount imposed will be a substantial economic deterrent to the violator; b. The circumstances leading to the violation; 24. 25. C. The severity of the violation and the risk of harm to the public; d. The economic bene?ts gained by the violator as a result of the noncompliance; and e. The interest of the public. Upon good cause shown, the Board may assess a type and amount of civil penalty which was not recommended by the State, either more or less than the State?s assessment. TENN. COMP. R. REGS. 1000-01?04. In addition, the State proposes that Respondent pay the costs of this action pursuant to TENN. CODE ANN. 63-7-115(d) and TENN. COMP. R. REGS. These costs will be established by an Assessment of Costs prepared by the State. Costs may include all attorney and paralegal time; all costs incurred by the Of?ce of Investigations in connection with the prosecution of the matter; and all costs incurred by administrative law judges, court reporters and witnesses including, but not limited to, travel and lodging during the prosecution of this matter. The State proposes that costs assessed to Respondent in this matter do not exceed sixty thousand dollars V. Notice and Petition for Relief WHEREFORE, premises considered, STATE hereby: 26. 27. Issues to Respondent a copy of this Notice of Hearing and Charges and Memorandum for Assessment of Civil Penalties and ?les the original with the Of?ce of the Secretary of State, Administrative Procedures Division, 312 Eighth Avenue North, 8'h Floor, William R. Snodgrass Tennessee Tower, Nashville, Tennessee 37243. Gives Notice that if Respondent does not enter an appearance and defend, a default judgment may be entered. 28. Gives Notice that this matter will be presented for full hearing as a contested case to a panel ofthe board on November 20, 2019, beginning at 8:30 a.m. C.S.T., or as soon thereafter as the Board may take up this matter, at First Floor, MetroCenter, 665 Mainstream Drive, Nashville, Tennessee 37228, or at a location yet to be determined. 29. Petitions that, at the hearing of this cause, the Board determine that Respondent is guilty of violating the provisions of TENN. CODE ANN. 63-7?101 et seq. and the TENN. COMP. R. determine whether the proposed civil penalties shall be af?rmed or whether a different type and amount of civil penalty is justi?ed; and determine whether Respondent?s license to practice as a nurse should be suspended, revoked or otherwise disciplined. 30. Gives Notice that the hearing will be conducted in accordance with the Uniform Administrative Procedures Act, TENN. CODE ANN. 4-5?101, et seq. Respondent has the right to be represented by counsel, to subpoena witnesses to testify at the hearing, and to present evidence and testimony in defense of the charges. 31. Gives Notice that Respondent may be eligible for free or low cost counsel from a legal services organization. Respectfully submitted this 27th day of September, 2019. Caroline R. Tippens (BPE .1 5) Senior Associate General Counsel Tennessee Department of Health Of?ce of General Counsel 665 Mainstream Drive. Second Floor Nashville. Tennessee 37243 (615) 741?161] CERTIFICATE OF SERVICE The undersigned hereby certi?es that a true and correct copy of this document has been served upon the Respondent, by and through her Counsel, Peter J. Strianse, Tune Entrekin White, Attorneys at Law, 315 Deaderick Street, Suite 1700, Nashville, TN 37238, by United States mail, certi?ed, number 7017 0190 0001 0037 3043, return receipt requested, and by United States mail, First Class, with suf?cient postage thereon to reach its destination. This 27th day of September, 2019. Caroline R. Tippens '3 Senior Associate General Counsel LITIGATION TRANSMITTAL FORM TENNESSEE DEPARTMENT OF HEALTH NAME OF CASE TENNESSEE DEPARTMENT OF HEALTH 343.10-17_ BOARD OF NURSING (AGENCY CODE (AGENCY CASE [{al?Joncla Vaught, R.N. AGENCY: Tennessee Department of Health, Board of Nursing HEARING DATE AND TIME: November 20, 201?) 8:30 am. CT HEARING LOCATION: MetroCenter. First Floor. 665 Mainstream Dr., Nashville, TN 37228 MANNER OF CONDUCTING HEARING: AGENCY HEAD ALJ CASE DESCRIPTION: Disciplinary action for alleged violation of statutes and rules of the Tennessee Board of Nursing EXPEDITED OR SPECIAL ARRANGEMENTS: ALJ ASSIGNED: HEARING TIME ESTIMATE: COURT REPORTER: NAME, ADDRESSES AND PHONE NUMBERS OF PARTIES AND ATTORNEY (including agency attorney); Attorney for the Respondent Attorney for the State Peter J. Strianse Caroline R. Tippens, Esq. Tune Entrekin White Senior Associate General Counsel Attorneys at Law Tennessee Department of Health 315 Deaderick Street, Suite 1700 Of?ce of General Counsel Nashville, TN 37238 665 Main Stream Drive, 2?d Floor (615) 244-2770 (615) 741?3907 OTHER INFORMATION: Contested Case Transmittal Form to be ?led with the initial case record no later than three (3) business days after: the Notice of Hearing is mailed; the case has been scheduled with the APD. if no hearing date has been set (unless waived by the Division).