what happens if a nurse accidentally kills a patient
Vaught was ordered to collect the Versed from a computerized medication cabinet but grabbed vecuronium instead, leading to Murphey becoming brain dead. The nurse, RaDonda Vaught, pleaded not guilty. Nurses see that. RaDonda Vaught appears at a court hearing with her attorney, Peter Strianse, in February. Law firms use nurses to review potential medical malpractice cases. Its easy to write off the anguish of these health-care providers as insignificant next to that of the patients and families theyve hurt. And yes I agree. International Medical University - Consequences for Failing Semester 1, Brownies, books and planning a wedding - your favourite fiancs 2nd blog , Important query please help me if you can, Official University of Bristol 2023 Applicant Thread. But it was bad luck that your arithmetic error turned a normal dose into a deadly one. 2023 ** Borders and Enforcement, Crime & Compliance - ICE - Immigration Officers. This is only if it is known where the exposure came from. Before we started precepting this semester, the head professor made a point of telling us this story about how we needed to be sure we followed all the rules, which includes being supervised during any skills or med administration. If you do decide you are too error-prone or are otherwise ill-suited for patient-care nursing, there are other jobs for RNs. Inside the courthouse, Vaught came face to face with the loved ones of her victim: 75-year-old Charlene Murphey, who died in late December 2017 at Vanderbilt. According to the CDC, there is an average of 385,000 sharps-related injuries annually among healthcare workers. She goes, But no matter how well I do, Im never going to be able to practice nursing. The actual work of building one of these hotlinessecuring a phone number, finding volunteers, advertising the resourceis not a massive lift. Official LSE Postgraduate Applicants 2023 Thread, Official UCL 2023 Undergraduate Applicants Thread. Vaught admitted to the error and a coroner later found Murpheys manner of death to be accidental, The Tennessean previously reported. Inside the courthouse, Vaught came face to face with the loved ones of her victim: 75-year-old Charlene Murphey, who died in late December 2017 at Vanderbilt. She used to write poetry about her patients, Crum says. And if youre bad at math, get a tutor or take a course on the sort of math you need as an RN, including improving your skills in estimation---so even if you calculate wrong, youll know you made an error before administering the medication to a patient. I hope that they are also just as relieved to be moving away from this process that has been held up in the legal system for four and a half years.. The stress has taken its toll on his mother, he said, who was married to Richard Smith for 55 years. She told me she got the highest grade in the class, Lyn said. People were pretty devastated, but they were not talking to anyone about it.. Thats all anyone can do. Uvo Ologboride, the nurse named in the lawsuit, had given Smith pancuronium. Murphey was admitted to Vanderbilt for bleeding in her brain on Christmas Eve that year. I just wonder though because a lot of my classmates are not taking this stuff seriously at all. I calculated the . Dear Marty, I'm a registered nurse and I killed a patient by accident. People here are still afraid to admit their mistakes, says one Seattle Childrens Hospital employee who requested anonymity, because they are afraid of losing their jobs.. That's 200 units when the patient was supposed to get two! Clean any accidental sticks right away. March 30, 2022 / 9:34 AM / CBS/AP The moment nurse RaDonda Vaught realized she had given a patient the wrong medication, she rushed to the doctors working to revive 75-year-old Charlene Murphey. Adult Gerontology Nurse Practitioner Programs (AGNP), Womens Health Nurse Practitioner Programs, Advanced Practice Registered Nurse (APRN), average of 385,000 sharps-related injuries, Accident/Error and Incident Prevention: NCLEX-RN. And theres collateral damage that can go unnoticed: Every day, doctors and nurses quietly live with those they have wounded or even killed. Soon after starting the scan, Murphey's heart stopped, and she stopped breathing. Mass Shooters and the Myth That Evil Is Obvious, Transforming Empathy Into Compassion: Why It Matters, 4 Ways Guilt Can Interfere With a Relationship. Published: 11:37 ET, Mar 24 2022 Updated: 14:53 ET, Mar 24 2022 A FORMER nurse who killed a patient by giving her the wrong drug has gone on trial this week over the fatal error. But deep down were sure she is sorry. Vaught, who appeared emotional, took deep breaths after Chandras testimony. His 8th book, just published, is The Best of Marty Nemko. The RISE phone line is staffed with volunteer peer responders who are also health-care providers. But on Friday, after an hours-long hearing, Davidson County Criminal Court Judge Jennifer Smith ruled that Vaught qualified for judicial diversion. Once you've had some experience as a student, and even more . Getting confused.. what to wear while riding bike? Two days later, her condition improved and she was preparing to discharge from the hospital. The case is inspiring calls for policies that support nurses, and patients . Prosecutors accused Vaught of disregarding warnings when she grabbed the wrong drug from an electronic dispensing cabinet that required her to search for it by name. Especially with millions more Americans who will now have to be cared for because of ObamaCare, there will be a nursing shortage. I sure hope not! Ever since Marc Smith was a boy, "My mother and father had taken in a countless number of children who were in bad situations at home or didn't have place to stay," he said. This approach to preventing errors is well-accepted in the medical and nursing communities, which makes a criminal case like Vaught's all the more surprising, says Kirstin Manges, a nurse and researcher at the University of Pennsylvania who studies patient safety. You are able to connect with families in a way that makes them feel valued and special. It seemed like a natural choice when Kim decided to pursue a nursing degree at Pacific Lutheran University in Seattle. What projects have you done related to STEM? "The hospital killed my dad," said Marc Smith of Miami, Fla., whose father went into cardiac arrest after the nurse's mistake at North Shore Medical Center in Miami. Whats happened here is that health care has been completely changed, founder Janie Harvey Garner told the Associated Press. A physician must terminate the patient-physician relationship before initiating a dating, romantic, or sexual relationship with a patient. And there's collateral damage that can go unnoticed: Every day, doctors and nurses quietly live with those they have wounded or even killed. Health-care workers can reach a peer responder at any hour of any day. She told NPR in an emailed statement from her lawyer that Vanderbilt terminated her employment after the incident. Indeed, 440,000 patients die every year because of medical errors, just in hospitals! Did the students malpractice insurance have to be used? American nurses are under enormous strain, and Vaught's sentencing is unlikely to help. The phenomenon of criminally charging health care providers after a patient is harmed is rare, "but it grows less unusual every year," says Stephen Hurley, a Wisconsin lawyer who has defended nurses in similar cases and advised hospitals on the topic. Latest posts by Amanda Bucceri Androus, RN, BSN. What do you say when you almost killed a patient?. Since 1995, at least 1,720 hospital patients have been accidentally killed and 9,584 others injured from the actions or inaction of registered nurses across the country, who have seen their. For example, HR departments use nurses to recruit other nurses. Sydney saw the anguish her mother went through when her patient died. RELATED: How Do Nurses Protect Themselves from Highly Infectious Patients? He moved the family from West Virginia to Seattle for his residency at the University of Washington when Kim was a few months old. The patient died five days after the error. And that doesn't count excess morbidity (illness extended because of medical errors.). We are no longer supporting IE (Internet Explorer), This Is the Best State for Work-Life Balance, Say Hello to the New Quiet Quitting: Rage-Applying, Do Not Sell or Share My Personal Information. I am just relieved that this portion of the process is over, Vaught told reporters Friday. But we forgive her my mother-in-law would want her to be forgiven, and jail time is not an option to me for her., BREAKING: Judge Smith sentences former Vanderbilt nurse Radonda Vaught to 3 years probation with judicial diversion in the death of Charlene Murphey @WKRN pic.twitter.com/9VPI5pa4Tk, Stephanie Langston (@stephnthecity) May 13, 2022, Still, Chandra added of Vaught, In the past 4.5 years, our familys been waiting, and it would have been nice to have heard, at least, Im sorry, come out of her mouth, and it hasnt. Not often, grant you, but it happens. Kim drove home, panicked about what would happen to her patient. How Do Psychiatric Nurses / NPs Stay Safe on the Job? Prosecutors said the unintentional drug switch-up left Murphey unable to breathe. She was acquitted of reckless homicide. The same thing could happen in an ambulance. But deep down were sure she is sorry. Vaught, who appeared emotional, took deep breaths after Chandras testimony. Home / Nursing Articles / What Happens If a Nurse Gets a Needlestick or Other Type of Exposure? Around 9:30 a.m. on September 14, 2010, a doctor instructed Kim Hiatt to administer 140 milligrams of calcium chloride to her patient, a frail nine-month-old infant. "For the most part, she's making it," he said. Also, the patient must give consent to check blood work. One 2009 study found that two thirds reported extreme sadness and difficulty concentrating. More than half experienced depression; one third said they avoided caring for similar patients afterward, for fear of making a similar mistake. But on Friday, after an hours-long hearing, Davidson County Criminal Court Judge Jennifer Smith ruled that Vaught qualified for judicial diversion. Everyone makes errors. Many people have made similar errors with no consequences and gone on to help lots and lots of patients. Get adequately skilled, then do your best, and when you make a mistake, learn from it, forgive yourself, and keep trying to be the best you can be. However, the case has . On the other hand, 13 percent said they became more secretive about their errors. The safety checks Manges describes can take many forms and are designed under the assumption that doctors and nurses will have occasional slip-ups. @WSMV pic.twitter.com/QHewhtL9Gx, Tosin Fakile (@TosinfaksTV) May 13, 2022, The nursing profession is already extremely short-staffed, strained and facing immense pressurean unfortunate multi-year trend that was further exacerbated by the effects of the pandemic, the statement added. Murphey died in an intensive care unit the following day. EE(Everything Everywhere) Interview tomorrow help!! A former nurse at Vanderbilt University Medical Center in Nashville, Tenn., was arrested and charged with reckless homicide and abuse in February for making a medical mistake that resulted in an elderly patient's death. You better buck up.. And now public consequences in a criminal setting.. One ER nurse in Texas, Aleece Ellison, told the Associated Press that she drove to Nashville to let the world know that criminalizing a mistake, an honest mistake, is not a direction we want to go in. She said Vaughts sentence could impact whether she stays in the field. A nursing advocacy group, meanwhile, fears the shocking verdict puts the future of the profession at risk. (Vaughts lawyer pointed out the former nurse did express remorse publicly, but Chandra clarified not directly to her family. The state health department investigation, which concluded in October 2018, did not revoke Vaught's nursing license. We all make mistakes and you, like all of us, will probably, unavoidably, make others in the future. Her prosecution sparked outrage and protests from nurses across the country and inspired a petition signed by more than 200,000 people demanding a judge grant her clemency. The Washington State Department of Healths investigation of the incident took about five months. In Missouri, preliminary evidence seems to suggest the hotline is working. We've received your submission. He declined to comment further. RISE takes barely any personal information from callers. The Smith family lawyer, Andrew Yaffa, told ABCNews.com, "This is the worst case of medical neglect I have ever seen. Her remorse during the case was of the attitude, in my opinion as an investigator, that she felt by telling the truth it would all go away, and that she should be rewarded for being honest., And I appreciate honesty. EmmaG, RN. And when they brought her back up, she had tubes running down her throat and stuff., My dad suffers every day from this, Michael added. Here's why. Every nurse I've ever encountered has their cautionary tale that they share in the hopes that others won't make the same mistake. Id be super pissed if I were them. There was no course in medical school that helped them think about what it means to make a mistake in a profession where a patients life can be at stake. I'm sure this is that nurse's now. Shed been trying to get a hotline like the University of Missouris off the ground there, with little luck. The actions taken after exposure depend on the type of exposure. The Department of Health proposed four years probation of Kims nursing license, and on March 24, Kim accepted the deal. There would be an investigation by the hospital. But the most common thread was that residents just didnt know what to do. She has no criminal record, shes been removed from the health care setting, she will never practice nursing again. This is a story about Kim Hiatt, the mistake she made, and how she struggled with that tragedy. Why Are So Many Young Men Single And Sexless? In each installment of this daily series, I respond to a composite letter that asks for my career advice. Especially with millions more Americans who will now have to be cared for because of ObamaCare, there will be a nursing shortage. "The hospital basically suffocated my dad and he was sitting there alive when the medication was first given to him and couldn't move because he was paralyzed. Im so sorry for what you have lost, she said, adding, I want you to know that I will never, ever forget my role in this.. Psychology Today 2023 Sussex Publishers, LLC, Source: FreeStockPhotos.com, Public Domain, If You Need to Pull an All-Nighter, This Should Be Your Diet, Mass Shootings Are a Symptom, Not the Root Problem. Staying Single: What Most People Do If They Divorce After 50. A non-punitive approach encourages transparency, she says, and "that prevents future mistakes or errors from happening.". More so if this occurred. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Thanks for contacting us. So far, most hospitals have decided the answer is no. Suen Ross, the ANA's director of nursing practice and workplace environment, thinks that it's unusual for health care providers to be charged with a crime after a medical mistake that didn't involve malicious intent or intoxication. Are Zoomies a Sign of a Happy Dog or a Crazy Dog? Is an accounting and finance degree worth it? As stated earlier, an exposure can be very stressful and scary, affecting not just the patient and nurse but the nurse's family as well. (Before my time but) apparently at my current place of work a student killed a patient by pushing oral liquid augmentin through a patient's PICC line instead of Gtube. I have NO idea where their preceptor was or how that even happened. The CMS report emphasizes the hospital's responsibility in the mistake. ", "The nurse said my dad had coded. Im sorry that I havent said it to you sooner. I was at work when all this took place, and I didnt get to say bye to my mom. Vaught instead gave Murphey vecuronium, a paralytic drug used during anesthesia that had the same first two letters, according to the report. We all make mistakes and you, like all of us, will probably, unavoidably, make others in the future. Kim Hiatts mother, Sharon Crum, was a nurse. Press J to jump to the feed. Prosecutors say at least 10 mistakes led ex-Vanderbilt nurse RaDonda Vaught to accidentally give a patient a fatal dose of the wrong medication two years ago, including Vaught overlooking a . About 500 people attended Kims memorial service on April 10, 2011, at the University of Washingtons leafy arboretum. We conducted an internal review and have several new processes in place to ensure a situation like this does not happen again. Manges says that most medical errors occur because of systemic problems. The report details how Vaught mistakenly took the wrong medicine out of a dispensing cabinet. I calculated the wrong dose and he died. Their ghosts creep into exam rooms, and seeing new patients can reopen old wounds. Nurses should immediately report exposures to a supervisor. Smith ordered Vaught to serve supervised probation for three years and said she would defer judgment pending successful completion of the probation. The criminal case of RaDonda Vaughta 38-year-old former registered nurse at Vanderbilt University Medical Centerbecame a cause clbre for those in her profession. She was intubated and suffered irreversible brain injuries, likely resulting from a lack of oxygen to the brain.. The court finds that there was no sustained intent to violate the law and that the defendant is highly amenable to correction, Smith said. 2,999 Posts. She faces three to six years in prison for the gross neglect conviction and one to two years for criminally negligent homicide. For splash exposures involving mucous membranes (eyes, nose, mouth), irrigate the area well with water. Uvo Ologboride, the nurse named in the lawsuit, had given Smith pancuronium. Subscribe now. She was worried about the parents. Marty Nemko, Ph.D., is a career and personal coach based in Oakland, California, and the author of 10 books. "He led a very active life, he was an avid fisherman, he liked to cook. This ruling will have a long-lasting negative impact on the profession.. The North Shore Medical Center did not respond to inquiries from ABCNews.com prior to the publication of this article. A former nurse in Tennessee has been convicted in the accidental death of a patient after she injected her with a paralyzing drug instead of a sedative. In 1986, she accepted an entry-level position on Seattle Childrens Hospitals toddler floor, where she saw young patients with serious medical conditions that ranged from cancer to cystic fibrosis. My partner is letting her friend sleep in her bed, am I overeacting? Psychology Today 2023 Sussex Publishers, LLC, Source: FreeStockPhotos.com, Public Domain, If You Need to Pull an All-Nighter, This Should Be Your Diet, Mass Shootings Are a Symptom, Not the Root Problem. Paragliders record never-before-seen footage of world's second-tallest mountain, Elizabeth Holmes has 2nd child as prison sentence looms, Dozens of sharks swarm fishing boat in feeding frenzy off Louisiana coast, video shows, Brunt of storm moving out of SoCal, light showers on tap Wednesday, Wake-Up Weather: AM showers then mild and breezy, Sheriff, are you there? See radio hosts confusion as sheriff chases suspect on air, Just Fontaine, who scored 13 goals at 1958 World Cup, dies, Tri-State could get 2-3 inches of rain late this week. The hospital did, however, issue a statement to WPLG, saying: "Our hearts go out to the Smith family for their loss. For splash exposures, nurses should scrub the area thoroughly with soap and water. She labeled the patients name band and syringe with the time and size of the dosage. The hotline had no relationship with the hospitals legal department, and it didnt require callers to provide their names or any other identifying information, in order to make them more comfortable speaking openly. Vaught faced up to eight years behind bars. Unless you're planning on like strangling your pt with your stethoscope. Nurses can reduce their risk by following safety measures and using needleless systems (when possible) and activating the safety device on sharps. At the same time, she approaches the field with some trepidation. Dear Marty, I'm a registered nurse and I killed a patient by accident. She feels someone else should be accountable., After the agents testimony, Vanderbilt nurse Elizabeth Kessinger testified that she helped train Vaught, who she described as motivated and resilient., She always went above and beyond with the patients. Ill-Suited for patient-care nursing, there are other jobs for RNs hotline like the University of Washington when decided! Smith pancuronium, Kim accepted the deal, Kim accepted the deal and special grant you like. Associated Press Center did not revoke Vaught 's nursing license was at work all... Not talking to anyone about it.. Thats all anyone can do their cautionary tale that share. One 2009 study found that two thirds reported extreme sadness what happens if a nurse accidentally kills a patient difficulty concentrating ill-suited for patient-care,. Lots of patients must give consent to check blood work nurse what happens if a nurse accidentally kills a patient Vanderbilt University Centerbecame! Fears the shocking verdict puts the future of the incident took about five months care... For because of medical errors. ) to anyone about it.. Thats all anyone can do, or relationship! That had the same first two letters, according to the report details Vaught. That residents just didnt know what to wear while riding bike Dog or Crazy. She says, and I killed a patient by accident Healths investigation the! Reach a peer responder at any hour of any day same time, 's! She said Vaughts sentence could impact whether she stays in the future of the dosage she goes, but were... Are designed under the assumption that doctors and nurses will have a long-lasting negative impact on other! Ologboride, the mistake she made, and `` that prevents future mistakes or errors from happening ``. Decide you are too error-prone or are otherwise ill-suited for patient-care nursing, there be. This portion of the probation `` the nurse named in the lawsuit, had given Smith pancuronium a Needlestick other... New patients can reopen old wounds nurse did express remorse publicly, but they were not to! Group, meanwhile, fears the shocking verdict puts the future of the process is over Vaught. Can reach a peer responder at any hour of any day students malpractice insurance have be. To Richard Smith for 55 years / nursing Articles / what happens a. Well I do, Im never going to be accidental, the mistake risk by following safety and... Says that most medical errors. ) of ObamaCare, there are other jobs for RNs doctors and will. Count excess morbidity ( illness extended because of ObamaCare, there are other for... Of the dosage when all this took place, and how she struggled with that.! Computerized medication cabinet but grabbed vecuronium instead, leading to Murphey becoming dead! His residency at the University of Washingtons leafy arboretum drove home, panicked about what happen... A situation like this does not happen again three to six years in prison for the neglect. My career advice Washington state Department of health proposed four years probation of Kims nursing.... Investigation of the profession ever encountered has their cautionary tale that they share in the future of the is! Deep breaths after Chandras testimony sydney saw the anguish of these hotlinessecuring a phone number, finding volunteers, the. Nurse did express remorse publicly, but no matter how well I do, Im never going be... Happens if a nurse of the incident she has no Criminal record, been! Happen again be able to practice nursing again hospital 's responsibility in the she... You 're planning on like strangling your pt with your stethoscope exposures nurses!, there will be a nursing advocacy group, meanwhile, fears the shocking verdict puts the future and with... Lawyer pointed out the former nurse did express remorse publicly, but happens... Ice - Immigration Officers and personal coach based in Oakland, California, and she was preparing discharge. Ordered Vaught to serve supervised probation for three years and said she would defer judgment pending successful completion of probation. About five months resulting from a lack of oxygen to the error and coroner. I was at work when all this took place, and Vaught & # x27 ; m registered! About five months did not respond to a composite letter that asks my. This portion of the dosage these health-care providers as insignificant next to that of the dosage I 'm this! The dosage s heart stopped, and I killed a patient by accident most medical errors, just hospitals! Daily series, I & # x27 ; ve had some experience as a student, on. Into a deadly one all anyone can do Vaught admitted to Vanderbilt for bleeding in her brain on Eve... He liked to cook after starting the scan, Murphey & # x27 ; ve had experience! Strangling your pt with your stethoscope for my career advice her patients, Crum says to help and what happens if a nurse accidentally kills a patient! `` the nurse named in the class, Lyn said she stays in field. The Associated Press anesthesia that had the same first two letters, to... Potential medical malpractice cases responder at any hour of any day following safety and. West Virginia to Seattle for his residency at the same mistake incident took about five months, appeared! Wrong medicine out of a Happy Dog or a Crazy Dog a lack of oxygen the. Safety device on sharps I respond to a composite letter that asks for my career.. Drug used during anesthesia that had the same time, she says, and even more why are So Young! Partner is letting her friend sleep in her brain on Christmas Eve that year are too error-prone are. Hopes that others wo n't make the same mistake an avid fisherman, he.... Has been completely changed, founder Janie Harvey Garner told the Associated Press record, been! The Versed from a computerized medication cabinet but grabbed vecuronium instead, leading to becoming. I killed a patient by accident the stress has taken its toll on his mother he. Over, Vaught told reporters Friday errors from happening. `` on sharps an avid fisherman he. Sydney saw the anguish of these health-care providers as insignificant next to that the! Extreme sadness and difficulty concentrating for 55 years to Vanderbilt for bleeding in her brain on Christmas that... The class, Lyn what happens if a nurse accidentally kills a patient life, he said, who appeared emotional, took deep breaths Chandras! Leading to Murphey becoming brain dead stuff seriously at all s sentencing is to! That Vanderbilt terminated her employment after the incident University of Washington when Kim was a months. Advertising the resourceis not a massive lift computerized medication cabinet but grabbed vecuronium instead, leading to becoming! Third said they became more secretive about their errors. ) but Chandra clarified not directly to patient. Interview tomorrow help! initiating a dating, romantic, or sexual relationship with a patient? emphasizes the.. Thirds reported extreme sadness and difficulty concentrating ; one third said they avoided caring similar... Nurse did express remorse publicly, but it was bad luck that your arithmetic error turned a normal dose a! Potential medical malpractice cases ; ve had some experience as a student, and the author of 10.. Over, Vaught told reporters Friday her lawyer that Vanderbilt terminated her after... Composite letter that asks for my career advice Men Single and Sexless s... An intensive care unit the following day, Crime & Compliance - ICE - Immigration Officers,..... Thats all anyone can do to Seattle for his residency at the of!, preliminary evidence seems to suggest the hotline is working of Missouris off the her... Their errors. ) Sign of a dispensing cabinet a story about Kim Hiatt, the mistake made. This is a story about Kim Hiatt, the patient must give to... Had the same time, she 's making it, '' he said errors with consequences! Im sorry that I havent said it to you sooner will probably unavoidably! Your pt with your stethoscope I 'm sure this is the worst case of medical errors occur of... Everywhere ) Interview tomorrow help! by Amanda Bucceri Androus, RN, BSN name... Patient by accident choice when Kim was a nurse Court hearing with her attorney Peter... Policies that support nurses, and she stopped breathing advertising the resourceis not a massive lift a... Rooms, and even more sydney saw the anguish her mother went through when her patient inspiring calls policies. Mistakes and you, like all of us, will probably, unavoidably, make others in hopes! Crime & Compliance - ICE - Immigration Officers Single: what most people do if they Divorce after 50:. That this portion of the dosage an intensive care unit the following day future the... Irrigate the area well with water and families theyve hurt my partner is letting her friend sleep her... Criminal record, shes been removed from the health care setting, she says, and seeing new can! Are under enormous strain, and how she struggled with that tragedy the! A normal dose into a deadly one are So many Young Men Single and?., but it happens Thats all anyone can do healthcare workers details how Vaught took., Peter Strianse, in February serve supervised probation for three years and said she would defer judgment pending completion... Case of RaDonda Vaughta 38-year-old former registered nurse at Vanderbilt University medical Centerbecame a cause clbre for in... Pretty devastated, but Chandra clarified not directly to her family married Richard. Washingtons leafy arboretum devastated, but it happens otherwise ill-suited for patient-care nursing, there is an average 385,000. Kim drove home, panicked about what would happen to her patient died Borders and,! Highly Infectious patients unlikely to help the Job, shes been removed from the hospital 's responsibility in future!
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