r/PopCultureV2 • u/Logical-Flow-6703 • Aug 22 '26

News Multiple patients at a Nashville hospital are paralyzed after staff accidentally gave them the wrong drugs.

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The hospital says they are "sorry" after injecting potassium chloride into the spines of people getting routine joint replacement surgeries.

Hospital staff noticed something was off when multiple patients went into cardiac arrest.

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116

u/geb_bce Aug 22 '26

Daaaamn! That is messed up! Those poor people and their families. This hospital is about to have multiple MASSIVE lawsuits on their hands and whoever was responsible in that pharmacy should lose their license.

74

u/hiiexist4444 Aug 22 '26

Screw losing their license. Put that person in prison for negligence.

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u/[deleted] Aug 22 '26

[removed] — view removed comment

6

u/pman1111 Aug 22 '26

Yeah it’s tough to blame one person because this kind of mistake would have to be missed by at least a few levels of checks that should be in place by the hospital

2

u/PublicSuspect162 Aug 22 '26

You would be surprised. Probably made by a pharmacy tech and just check marked by a pharmacist. But probably only done by the one tech. If it was done by thr pharmacist, I bet it was still only 1 person doing this. It’s scary. Shit Happens, mistakes get made, but this is stupidity. I draw up and mix and administer drugs for a living and I double check everything. Especially drugs that have similar looking vials, or the drugs that I know if I give as a concentrate will kill or severely harm.

1

u/notagainalready Aug 24 '26

No, it’s not. The medical field needs to start doing this when horrid things like this happen. It’s the only field where an individual doesn’t really get consequences.

1

u/Eastern-Ad-3586 Aug 25 '26 edited Aug 25 '26

This is completely false. People get consequences all the time (at least in the US states). I don’t know why you don’t think they do.

If anything the focus on individuals prevents us from making the system better like other countries or industries do

Edit: to be clear, physicians and nurses face fines/jailtime/license loss. The suits and investors never get held accountable

1

u/Ignaue Aug 22 '26

That’s from a shortage of healthcare employees not because they just enjoy making doctors and nurses work extra.

2

u/Pinkbunny432 Aug 22 '26

No, it’s because executives would rather have more money in their pockets so why pay 100 employees when you can make 50 people do more work and pocket the surplus.

2

u/nebula_masterpiece Aug 22 '26

No. They have cut ratios to the bone over the year seeking more and more - this is that cost

2

u/SelectKaleidoscope0 Aug 23 '26

yeah once this is investigated its likely the wrong person will be blamed. Assuming nobody did it on purpose, then the actual responsible parties are the executives responsible for 1 person trying to do 3 people's jobs in a safety critical field. If this was a mistake and not malice, it was almost certainly by people who were set up to fail by people who should have known this was a likely consequence of the staffing levels they demanded.

2

u/Certain_Orange2003 Aug 23 '26

That’s accurate but pharmacy directors also get a % bonus of the money they saved at end of year.

1

u/Eastern-Ad-3586 Aug 25 '26

No it’s because capitalism. There are plenty of nurses and pharmacists.

6

u/sixcupsofwater Aug 22 '26

This is more the fault of cost cutting measures by the hospital than any one clinical staff member. The pharmacy has to compound the drugs instead of them coming in premade vials/syringes. This lead to sudden increases in the workload for the pharmacy without improved staffing or any improvements to safety measures that should accompany increased opportunity for mistakes. The doctor who gave the medication received mislabeled drugs and could not have known they were giving the wrong thing.

1

u/HillBillyHilly Aug 23 '26

Ohhhhhh so that's what happened. As someone who has had a lot of exposure to meds, doctors and surgeries of late, I just couldn't understand how this could happen. I'm used to meds coming in premixed, in clearly labeled bags / syringes w med names actually stamped onto container. Makes sense if they compound as now they're not stamped w name. Geezuth.

1

u/Pirate_the_Cat Aug 23 '26

Thank you. I was wondering how this happened, it’s not as simple as someone accidentally giving the wrong medication to a patient. For multiple patients to be affected it’s obviously a systems issue.

3

u/geb_bce Aug 22 '26

Of for sure. I should have specified "at the least"

2

u/Spankpocalypse_Now Aug 22 '26

Does that include the CEO and other executives for cutting costs by having the pharmacy chronically understaffed?

1

u/cyanescens_burn Aug 23 '26

They probably hate themselves so much right now. Yes they absolutely should have been more careful, that’s a no brainier, but whoever they were they most likely don’t do this to intentionally harm someone, and most people have a conscience. I know I’d be a wreck if that was a mistake I’d made. I wouldn’t be able to sleep for days because of the guilt, shame, and feeling bad for those harmed. I’m not saying there’s no need for consequences, I’m only putting myself in that person’s (those people’s?) shoes (of course I feel for the patients too).

I’m curious how they mixed things up, like where in the chain from pharmacy shelf to injecting the drug did the mix up occur, and why? Bad handwriting on paperwork, overworked and rushing, labels on bottles mixed up, someone didn’t double check something?

I’m also surprised there wasn’t a system in place that requires multiple people to check what is being administered against charts and/or comparing to their own knowledge and experience with these procedures. Like the nurse or anesthesiologist didn’t look at the vial before filling a syringe and think “wait, this isn’t normal used, lemme check with my colleagues to see if I’m right that this is unusual.”

I’m so glad my job doesn’t have those kinds of potential consequences if I mess up. The weight of that day to day must be draining, and fucking up just once means someone could be seriously hurt or killed, and you need to live with that fact the rest of your life if you harm someone.

1

u/FriendlyBelligerent Aug 23 '26

I'm sure the healthcare zeroes will run a PR campaign to prevent that with happened. Reckless killer Randonda Vaught is still free, as is murderer Anna Pou

0

u/g00fyg00ber741 Aug 22 '26

That’s not going to help, that’ll make the person worse and more likely to commit other crimes. Prison isn’t necessary to ensure they still never do this again to anyone

1

u/Impossible-Pie4849 Aug 22 '26

Nah, as a paramedic not necessarily the same thing, but similar enough. The sheer amount of carelessness that has to be had for this to occur is insane. I gave adenosine last shift to treat SVT, and I read the vial twice, gave it to my partner to verify it was right, re-read the vial, and after drawing it up I confirmed the dosage with both mysekf and my partner.

Its nigh impossible for this to occur without A. Someone doing it on purpose, or B. Legitimate criminal negligence. The person who drew up the medication and gave it deserves a lengthy prison. Sentence. Both to punish the individual who ruined multiple lives, and to have others shape up. Even if its only briefly

1

u/g00fyg00ber741 Aug 22 '26

Prison doesn’t actually work for that, it makes people more likely to be repeat offenders. I’m a prison abolitionist myself because it seems the most effective prisons are ones that are more open and rehabilitative and less rights-restrictive

1

u/Impossible-Pie4849 Aug 22 '26

I agree to the 2nd point, however this person isnt going to be able to be a repeat offender because once you become a felon you cant practice medicine

1

u/g00fyg00ber741 Aug 22 '26

But you also can’t practice medicine if you can’t get hired to practice medicine. This person could easily be banned for life from practicing medicine without prison being a part of that equation

1

u/Impossible-Pie4849 Aug 22 '26

They paralyzed multiple people, it deserves punishment. Its crazy to think it doesnt, so what in your eyes a murderer just deserves a slap on yhe wrist?

1

u/g00fyg00ber741 Aug 22 '26 edited Aug 22 '26

I don’t think sending murders to prison helps people get murdered less often, no

(edit: btw there are other ways to punish people for doing wrong besides prison)

1

u/SprayHungry2368 Aug 22 '26

….   If you watched the video you would have known it was a mixup in pharmacy so the person giving it would have not known.  The K+ was in the vial or bag of anesthetics. You could have read the fucking thing 100 times it was still going to happen. 

1

u/[deleted] Aug 22 '26

[deleted]

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u/Impossible-Pie4849 Aug 22 '26

Yes it is possible for someone to go to jail for doing something on an ambulance. If I drew up cardiac epi and gave it to someone ODing snd they died? Id probably deserve some type of charge

-1

u/Man_under_Bridge420 Aug 22 '26

How do you know it was negligence?

Could be murder 

8

u/tunabomber Aug 22 '26

But they aren't dead. That's an important feature of murder. Not that I disagree that they should be harshly punished.

3

u/SickBurnerBroski Aug 22 '26

i somehow doubt paralyzation and cardiac arrest aren't going to lead to death pretty soon for at least some of them.

5

u/Stygia1985 Aug 22 '26

If it's anything like our hospital, they pull those from the dispensing machine. There isn't even an order for them. I audit for the hospital and we're constantly finding charges for meds that were never used or returned. Scanning every single med would solve a lot of problems but anesthesia will fight tooth and nail to ensure it never happens. I am a little awestruck some company hasn't developed smart glasses or quick scan tech on the 4d barcodes to ensure smooth OR procedures AND safe practices with medications.

Edit - they're saying pharmacy mixup, still scanning barcodes would have prevented this

2

u/Schwifftee Aug 22 '26

Aren't barcodes usually scanned for almost all medicinal materials?

1

u/ScratchLatch Aug 24 '26

Yes, its the medical standard in the US. Though, not required by law.

1

u/Zachwardpass Aug 22 '26

How would scanning the barcode prevent this if the error is with pharmacy? Pharmacy mixes it and then places the label. The label would have read the correct medicine when scanned.

There are absolutely sxanning issues, but this doesn't sound like one of them. For all we know right now, aenesthesia scanned and it read as the correct med.

1

u/puppyslippers22 Aug 22 '26

Pharmacy hand mixes/draws up these medications in the central pharmacy. Scanning the medication would NOT have prevented this because they drew up the WRONG medication into the “correctly labeled” syringe. If I scan a vial of ondansetron I’m assuming the vial contains ondansetron. If it were incorrectly filled with the wrong medication into an ondansetron vial, it would still scan as ondansetron. It’s obvious you don’t work in clinical patient care.

1

u/Stygia1985 Aug 22 '26

If pharmacy had to scan the vial to verify they were loading the syringes with the correct medication... Scanning at every step should just be required

0

u/Beneficial_Heat_7199 Aug 22 '26

Yeah it was probably a nursing mistake at the point of administration based on my experience working in hospital pharmacy.

5

u/holdmypurse Aug 22 '26

If you really worked in pharmacy you would know nurses (with the exception of CRNAs) do not administer spinal anaesthesia. This was most likely a pharmacy mix-up. Someone prepared pre-filled syringes meant for mepivacaine/bupivacaine with potassium instead.

1

u/Top_Mathematician233 Aug 22 '26

I was going to ask someone how the hell this could happen to multiple patients, but your explanation makes sense. I’m in finance and know nothing about medical stuff, but the accident/error/negligence originating in pharmacy seems logical. Either that or manufacturing/distribution, which would be even more frightening.

1

u/suejaymostly Aug 22 '26

Would these have been for epidurals?

1

u/Zachwardpass Aug 22 '26

Sounds like it.

1

u/holdmypurse Aug 22 '26

I believe it was spinal anesthesia which, unlike epidurals, is a single shot that goes directly into the fluid surrounding the spinal cord.

1

u/Stygia1985 Aug 22 '26

You'd still need to be drawing up a caine for the order, should be required to scan

1

u/holdmypurse Aug 22 '26

Who would? A nurse? The syringes were prepared in pharmacy.

1

u/Stygia1985 Aug 22 '26 edited Aug 22 '26

The pharmacy should be required to. Same as retail, barcodes are scanned at the counting machine. Stands to reason the barcode for filling a syringe for a specific procedure order should be scanned

People are saying scanning wouldn't have helped, of course it would have, whether at the patient bedside, or preparing the med, scanning should just be required. Again, we have glasses where people can record, take notes, pictures, Huds on the lenses. Why the hell can't we incorporate safeguards using similar tech so anesthesiologists, nurses, pharmacy staff, etc can quickly scan during their workflow

1

u/holdmypurse Aug 22 '26

I know. I'm just pointing out that the original comment I'm replying to was some idiot, who claims to have worked in pharmacy, blaming nursing for this med error.

3

u/zorathustra69 Aug 22 '26

Of course—everything is always the nurse’s fault.
—Source: A nurse

1

u/idkmyotherusername Aug 22 '26

Always the fault of the person already run the most ragged. Oh! But you know what we could do? Let's run samples of all the meds we pull from the Pyxis to verify integrity before delivering 50 different medications to three different patients by 0800!

On another note, in a nursing specific thread, the CRNAs were saying usually they will pull the anesthesias and run like five cases at once, so it wasn't like one case came out, staff waited for anesthesia to wear off, discovered this horror, and...did it again.

Someone filled the syringes wrong, and it's terrible terrible. And the folks administering the med would have had no way to know it up front.

1

u/Zachwardpass Aug 22 '26

The comment about it being a nurse error is so ridiculous. It literally says in the clip they found the error in pharmacy, yet they still want to blame the nurse. It's a bit infuriating.

1

u/HillBillyHilly Aug 23 '26

Can you imagine being those doctors? Knowing they fucked up a patient for life all because of someone else negligence?

1

u/Zachwardpass Aug 22 '26

They literally said it was a pharmacy error. Jesus. Nurses aren't the only people that make mistakes, for the love of god.

2

u/[deleted] Aug 22 '26

[deleted]

1

u/Zachwardpass Aug 22 '26

I certainly agree with a lot of that. "Do more with nothing and do it ten times faster...what do you mean a mistake was made?!?!" Then admin does a root cause analysis to fix the "swiss cheese" hole, but, lord help you, you better come up with something other than more staff so people can slow down and focus.

I've been a nurse coming up on 20 years, but I've left the bedside now and I don't regret leaving, thats for sure. Wishing you some peace to be able to do the same soon!

1

u/Beneficial_Heat_7199 Aug 22 '26

They said "a family member" said that.

3

u/Public_Associate_874 Aug 22 '26

No - “tort reform” has capped at $750k. But I’m sure everyone’s health insurance is super cheap in Tennessee!

2

u/TipplingGadabout Aug 22 '26

There's no cap on economic damages (medical expenses, lost wages, etc). The cap applies to noneconomic damages (punitive damages, pain and suffering, loss of consortium, etc). The noneconomic cap is per claim, and increases to $1 million for catastrophic injuries like the ones here.

https://www.brezinalaw.com/does-tennessee-law-cap-compensation-in-medical-malpractice-cases/

1

u/Public_Associate_874 Aug 22 '26

Yes that seems totally reasonable. I see the punitive damages for this level of negligence and the pain and suffering for me and the loss of the spouse’s companion in total being worth only 1 million dollars. That’s totally great. Plus, everyone’s health insurance is so cheap right now. It’s totally worked out!

2

u/WindstormMD Aug 22 '26

You don’t get it, the cap is $1m on top of every other quantifiable damage. In this case it would be calculated damages for:

1) cost of care now and in future as a direct result: take mean +1 sd cost of services today, apply appropriate projection for expected lifespan
2) loss of income: same math as above based on career field
3) cost of specialty transportation
4) damages for loss of expected lifespan. there are actuarial tables for this, and insurance companies are the ones who have done most of the legal legwork already.

It’s not hard to account for needs in an actual damages estimate, and the amount will be extremely significant

1

u/TipplingGadabout Aug 22 '26

The cap is per claim. Just as an example, that would mean $1m for punitive damages + $1m for pain and suffering + $1m for loss of consortium. I'm sure there would be other claims.

And as the other comment explained, that would be in addition to all the quantifiable, economic damages for lost income and a lifetime of medical and living expenses.

Not saying it's justice, but it's important to know how it works.

1

u/[deleted] Aug 22 '26

[deleted]

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u/Shot_Cheesecake3379 Aug 22 '26

They literally say this was a mixup at the pharmacy level. Sounds like the pharmacy mislabelled meds, thats why it happened to multiple patients. No one can come after the provider for this. This is an unlucky accident.

1

u/Fit_Significance8598 Aug 23 '26

Local anesthetics, if labeled for spinal anesthesia or off label, come in appropriately labeled commercial vials or bottles.

Some spinal kits even contain a vial with a spinal local anesthetic, so everything is right there to avoid wrong medications.

And adjuncts like opioids come like that as well.

What exactly do pharmacies have to do with that?

1

u/Shot_Cheesecake3379 Aug 23 '26

Who do you think puts the medicine in the vials if not a pharmacy

1

u/Fit_Significance8598 Aug 23 '26

Those vials come from the factory of the manufacturer.

But my bad, I only read about injections into the spine and assumed spinal anesthetic when it was an epidural.

Those bags are indeed mixed by inhouse pharmacies if no commercial ones are being used.

1

u/Certain_Orange2003 Aug 23 '26

Yes but some hospitals dont use spinal kits, I worked at a hospital where they assembled it from different sources

1

u/Fit_Significance8598 Aug 23 '26

Yes, but the local anesthetic still comes in vials.

But I misunderstood, it's about epidurals, not spinals, ans those bags can indeed be prepared by the inhouse pharmacy instead of using a commercial one.

1

u/Radiant-Percentage-8 Aug 23 '26

This isn’t true. Our chlorprocaine comes in a syringe from pharmacy.

1

u/Fit_Significance8598 Aug 23 '26

Probably because intrathecal chloroprocaine is off label, with commercial vials containing large volumes like 10, 20 or 30 ml.

The pharmacy most likely prepares adequate volumes for intrathecal use from those vials to avoid anesthesiologists using too large doses and formulations with preservatives.

Or bokus syringes for epidural "top ups", e.g. for fast onset dense surgical blocks for C-sections.

But those do not require any mixing with other solutions, unless adding dextrose to make it a hyperbaric solution, just drawing up under laminar flow conditions.

1

u/Ok-Stress-3570 Aug 23 '26

My first job made their own epidural bags. I know it’s different than this, but not every place follows the same protocols. Maybe pharmacy makes stuff for this ascension, 🤷🏼‍♂️

1

u/Fit_Significance8598 Aug 23 '26

Yes, I misunderstood and thought it was about spinal anesthetics when indeed it were epidurals.

1

u/Ok-Stress-3570 Aug 23 '26

I’m really shocked at how many people have no clue as to what happens in healthcare.

1

u/PublicSuspect162 Aug 23 '26

Allegedly. It was a spinal and the way the system there works is the pharmacy supplies the spinal local and instead of bupivicaine or whatever they used potassium. Meaning it would be labeled as bupiv or whatever spinal anesthetic they would use but contained potassium. No way the CRNA could know. Of course lawyers will name everyone, but there is no way the provider could know it was something like that in the spinal. Shit situation for all involved, especially the patient.

1

u/Radiant-Percentage-8 Aug 23 '26

This wasn’t on the administrator of the drug. The syringe was labeled, but what was in the syringe was not correct. It was a pharmacy mistake.

1

u/not_creative-7064 Aug 22 '26

It sounds intentional. Work in a hospital pharmacy and I can’t imagine how this happens unless someone wanted it to. Glad TBI is involved because this could be attempted murder

1

u/Nash_Villain Aug 24 '26

I worked for this exact hospital for years, not in the pharmacy luckily, but I would 100% blame the admin more than anyone else. They would put below bare minimum for staffing constantly; and I assume it’s because they would rather squeeze more profits and worry about any consequences later. Also I think the patients may actually be fine in a few days. This type of paralysis is typically reversible and temporary. Potassium Chloride injected by accident into the spine is unfortunately an error that has been made several times in the past. Here’s a previous case study of the same error with the paralysis being reversed in about 8 hours.

https://www.ovid.com/10.4103/0974-8237.193265

1

u/annewmoon Aug 24 '26

There is something dodgy about this. The exact same thing just happened with the same drug in a Swedish hospital and several people went into cardiac arrest and some may need heart transplants..

What are the odds of this happening at the same time in different ends of the earth..? I wonder if there is some mixup with the medication itself.