Kentucky First State to Decriminalize Medical Errors

Kentucky has become the first state to decriminalize medical errors -- a move many medical associations support.

HB 159 was signed by Kentucky's Democratic Gov. Andy Beshear on March 26 after passing the state legislature earlier that week. The bill states that "a health care provider providing health services shall be immune from criminal liability for any harm or damages alleged to arise from an act or omission relating to the provision of health services." It does not apply to "gross negligence or wanton, willful, malicious, or intentional misconduct."

The bill is popular among some medical associations. Last month, the Kentucky Nurses Association urged members to ask their Senators to support the bill, citing that fear of criminal charges could contribute to the ongoing nursing shortage in the state. They also said voluntary reporting and cooperation are vital for updating systems and processes when earnest mistakes happen -- which the possibility of criminal charges could discourage.

Nancy Galvagni, president and chief executive officer of the Kentucky Hospital Association, told MedPage Today in an email that HB 159 was a good piece of legislation the group has been happy to support. "Our nurses should not be held criminally liable for a mere mistake and the legal system already has ample means available to address any true negligence," she said.

Similarly, Chris Dellinger, BSN, RN, president of the Emergency Nurses Association (ENA), told MedPage Today in an email that ENA "is supportive of this bill for decriminalizing honest mistakes that might occur during the delivery of care" and that this law "provides everyone with clarity as to the legal threshold prosecutors must consider when assessing medical errors in Kentucky."

"Emergency nurses, and all members of the emergency care team, hold themselves to the highest standards for delivering care to patients in their moment of need, but they will always be humans working in a fast-paced, oft-challenging, environment," Dellinger said. "Although every effort is made through training, best practices, and evidence-based guidelines to prevent mistakes, they do happen."

The Kentucky law takes effect in the aftermath of the high profile case of RaDonda Vaught, a former nurse at Vanderbilt University Medical Center in Nashville, Tennessee. In 2017, a 75-year-old woman died after Vaught gave her the paralytic vecuronium rather than the sedative midazolam (Versed) by mistake.

Court documents have shown that Vaught reported her mistake to doctors and Vanderbilt as soon as she realized it. Still, Vaught was charged with reckless homicide and impaired adult abuse, of which she was then convicted in 2022. She was sentenced to 3 years of probation, though she evaded any prison time. Last December, Tennessee courts rejected Vaught's bid to get her nursing license back.

While Vaught's case happened in neighboring Tennessee, HB 159 in Kentucky addresses concerns nurses and other healthcare professionals have raised about how criminal punishment for honest mistakes can discourage transparent reporting and potentially put patients at higher risk.

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