On December 26, 2017, 75-year-old Charlene Murphey was admitted to Vanderbilt University Medical Center for a subdural hematoma.
Two days later, she needed a sedative, a Versed, which is a generic name for midazolam, to calm her claustrophobia before an MRI scan. A registered nurse named RaDonda Vaught was assigned to get it.
What happened next took less than an hour to unfold and fifteen minutes to become irreversible.
RaDonda went to the automated medication dispensing cabinet and typed “VE” into the search function. Versed didn’t appear because the cabinet used generic names, and she hadn’t searched for midazolam.
Instead of pausing, she triggered an override that unlocked a much wider range of medications, typed “VE” again, and selected the first drug on the list.
It was vecuronium, a paralytic agent that’s primarily used to induce skeletal muscle relaxation.
Vecuronium is a medication that has to be mixed with liquid before it can be given, unlike Versed, which is ready to use straight away.
RaDonda had checked the back of the Vecuronium vial for instructions and promptly went ahead with mixing the medication. However, she never looked at the front label, which clearly stated in large print: “Warning: Paralyzing Agent.”
She had bypassed multiple separate warnings from the dispensing cabinet to get this far and administered the entire vial to Charlene and left.
Murphey went into cardiac arrest in the imaging unit. She was transferred to the ICU and placed on life support. She had experienced permanent brain damage, and life support was withdrawn the following day.
After the incident, the hospital did not report the error to federal or state regulators as required by law. They told the county medical examiner that Charlene had di*d of natural causes, with no mention of vecuronium.
It negotiated an out-of-court settlement with Charlene’s family, preventing them from speaking publicly about her de*th.
RaDonda was fired in January 2018, and by 2019, she was arrested and charged.
Her trial, held in Nashville in March 2022, became national news and split the nursing community into different factions.
Many nurses rallied around her, arguing that the case criminalized an honest mistake made inside a broken system. Over 200,000 people signed a Change.org petition requesting clemency.
Others were less forgiving. “She didn't make a mistake," wrote one ICU nurse on Reddit, listing the sequence of failures in detail. “She made gross error after error after error after error until she wiped a human life out of existence.”
On March 25, 2022, the jury convicted RaDonda of gross neglect of an impaired adult and negligent homicide. She was sentenced to three years of probation.
Then the speaking requests started arriving. And last year alone, she reportedly told her story more than twenty times, at $5,000 to $10,000 per engagement, according to NPR.
Matthew Garvey, who went to nursing school with RaDonda and worked alongside her as a nurse, said her criminal case inspired him to go to law school.
He now helps other nurses defend themselves in similar cases, but he didn’t hold back on his criticism of RaDonda, saying he would have fired her himself.
However, he still believed her voice had value.
“We can't change what happened. We can only change what we do moving forward,” Matthew told NPR. “Having the individual who can tell you the play-by-play — that was there when it actually happened — is incredibly valuable.”
Two days later, she needed a sedative, a Versed, which is a generic name for midazolam, to calm her claustrophobia before an MRI scan. A registered nurse named RaDonda Vaught was assigned to get it.
What happened next took less than an hour to unfold and fifteen minutes to become irreversible.
RaDonda went to the automated medication dispensing cabinet and typed “VE” into the search function. Versed didn’t appear because the cabinet used generic names, and she hadn’t searched for midazolam.
Instead of pausing, she triggered an override that unlocked a much wider range of medications, typed “VE” again, and selected the first drug on the list.
It was vecuronium, a paralytic agent that’s primarily used to induce skeletal muscle relaxation.
Vecuronium is a medication that has to be mixed with liquid before it can be given, unlike Versed, which is ready to use straight away.
RaDonda had checked the back of the Vecuronium vial for instructions and promptly went ahead with mixing the medication. However, she never looked at the front label, which clearly stated in large print: “Warning: Paralyzing Agent.”
She had bypassed multiple separate warnings from the dispensing cabinet to get this far and administered the entire vial to Charlene and left.
Murphey went into cardiac arrest in the imaging unit. She was transferred to the ICU and placed on life support. She had experienced permanent brain damage, and life support was withdrawn the following day.
After the incident, the hospital did not report the error to federal or state regulators as required by law. They told the county medical examiner that Charlene had di*d of natural causes, with no mention of vecuronium.
It negotiated an out-of-court settlement with Charlene’s family, preventing them from speaking publicly about her de*th.
RaDonda was fired in January 2018, and by 2019, she was arrested and charged.
Her trial, held in Nashville in March 2022, became national news and split the nursing community into different factions.
Many nurses rallied around her, arguing that the case criminalized an honest mistake made inside a broken system. Over 200,000 people signed a Change.org petition requesting clemency.
Others were less forgiving. “She didn't make a mistake," wrote one ICU nurse on Reddit, listing the sequence of failures in detail. “She made gross error after error after error after error until she wiped a human life out of existence.”
On March 25, 2022, the jury convicted RaDonda of gross neglect of an impaired adult and negligent homicide. She was sentenced to three years of probation.
Then the speaking requests started arriving. And last year alone, she reportedly told her story more than twenty times, at $5,000 to $10,000 per engagement, according to NPR.
Matthew Garvey, who went to nursing school with RaDonda and worked alongside her as a nurse, said her criminal case inspired him to go to law school.
He now helps other nurses defend themselves in similar cases, but he didn’t hold back on his criticism of RaDonda, saying he would have fired her himself.
However, he still believed her voice had value.
“We can't change what happened. We can only change what we do moving forward,” Matthew told NPR. “Having the individual who can tell you the play-by-play — that was there when it actually happened — is incredibly valuable.”