Radonda Vaught v. Tennessee Board of Nursing

This is an appeal arising from a decision by the Tennessee Board of Nursing (“the Board”)
to revoke a registered nurse’s license after she retrieved the wrong medication from an
automatic dispenser and administered it to a hospital patient, resulting in the patient’s
death. The Tennessee Department of Health (“the Department”) brought an initial
complaint against the nurse concerning the incident, which it first determined did not merit
further action but then later re-opened. Simultaneously, the nurse faced criminal
prosecution and was ultimately convicted of two criminal charges related to the incident.
Following a contested hearing in the administrative proceedings, the Board revoked the
nurse’s license. The nurse sought judicial review of this decision pursuant to Tennessee’s
Uniform Administrative Procedure Act. During the judicial review proceeding, the nurse
raised, for the first time, the doctrines of res judicata and collateral estoppel as affirmative
defenses to the Department’s complaint. In response, the Board argued that the nurse had
waived these affirmative defenses because she had failed to raise them during the
administrative proceedings. While the petition for judicial review remained pending, the
criminal case moved to the sentencing phase. A doctor, who had testified as an expert
witness in both the contested administrative proceeding and the criminal case, wrote a letter
of support for the nurse to the criminal court judge in preparation for her sentencing. When
the nurse learned of the doctor’s supportive letter, she moved the trial court to remand the
instant case to the Board so that the Board could consider the contents of the letter in its
decision. The trial court declined to remand the matter to the Board or to allow the nurse
to present the letter to the Board as additional evidence. The trial court subsequently
entered a final order, determining that the nurse had not waived the affirmative defenses of
res judicata or judicial estoppel but declining to reverse the Board’s decision on those
grounds. The trial court then affirmed the Board’s decision to revoke the nurse’s license.
The nurse has appealed. Upon review, we determine that the nurse waived the affirmative
defenses of res judicata and collateral estoppel because she failed to present those doctrines
during the administrative proceedings  Accordingly, we reverse the trial court’s
determination concerning waiver of those defenses. In all other respects, we affirm.