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RaDonda Vaught, the former nurse who was convicted of negligent homicide for a patient's death, has lost her bid to get her nursing license back.

Last week, a Tennessee judge rejected Vaught's appeal of the state nursing board's 2021 decision to revoke her license, .

Vaught's next steps are unclear, and her lawyer, Peter Strianse, of the Nashville-based law firm Tune, Entrekin & White, did not return a request for comment from MedPage Today. The Tennessee attorney general's office, which represented the nursing board, didn't return a request for comment either.

Vaught's case drew national attention, as it's rare for healthcare workers to be criminally prosecuted for medical errors. Many raised concerns about whether prosecuting these sorts of cases would ultimately result in a culture of silence around reporting such errors.

The case also came at a time when nurses were reporting substantial burnout, due both to the pandemic and other healthcare industry pressures.

Vaught's saga began in late December 2017, when she gave 75-year-old Charlene Murphey the paralytic vecuronium instead of the sedative midazolam (Versed) for her anxiety ahead of a PET scan. Murphey went into cardiac arrest and died on Dec. 27, 2017.

Vaught had reportedly typed "VE" for Versed into an electronic medicine cabinet at Vanderbilt University Medical Center (VUMC) in Nashville, but when nothing came up, she hit an "override" that brought up more medications. She searched "VE" again and the cabinet produced the paralytic vecuronium, according to reports.

Nurses, including Vaught, have argued that it's common to use an override to obtain needed medications. In addition, Vaught has said she was distracted that day because she was orienting a trainee.

She reported the mistake as soon as she realized it to the patient's doctors and to other Vanderbilt officials, according to court documents. She took full responsibility for her actions and cooperated with several investigations.

Still, Vanderbilt fired Vaught in January 2018, and the facility eventually reached a settlement with the patient's family -- one that required them not to speak publicly about Murphey's death or the error.

Then, an anonymous tipster reported the error to state officials around the fall of 2018, and Vaught was indicted by a grand jury for reckless homicide and gross neglect of an impaired adult in February 2019.

The nursing board issued a notice of charges against Vaught in September 2019, alleging she was guilty of unprofessional conduct and failure to maintain appropriate nursing records and that she abandoned or neglected a patient requiring nursing care, according to court documents.

Her license was revoked in July 2021, and Vaught filed an appeal to get it back in September 2021.

After a 3-day criminal trial in March 2022, Vaught was convicted of gross neglect of an impaired adult and negligent homicide. She was ultimately sentenced in May 2022 to 3 years of supervised probation, involving concurrent sentences of 3 years for the adult abuse charge and 2 years for the reckless homicide charge.

During her appeal to reinstate her license, Vaught argued that new evidence had come to light after the board's administrative hearings -- particularly, a May 2022 letter from Terry Bosen, PharmD, director of the medication safety program at VUMC, that had been presented to the criminal court judge for consideration during her sentencing.

Bosen's letter "urged the judge to consider that flaws in VUMC's automated medication dispensing system contributed to the patient's death," according to court documents.

Nonetheless, the court found that Bosen's letter didn't render the board's record incomplete nor its proceedings unlawful, the final order stated.

Vaught has had the support of the nursing community behind her. Even though her May 2023 sentence was lighter than expected, it still riled nursing groups and advocates.

At the time, the American Nurses Association said the following in a statement: "A typical nurse's shift is fast-paced and high stakes, with constant patient turnover, inadequate staffing levels, varying patient acuity, exposure to infectious disease, and risk of work-related injury and violence. All of these factors impede the delivery of safe patient care, and nurses too often find themselves working under conditions that increase the likelihood of adverse outcomes from tragic mistakes."

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