Potassium Injected Instead of Anesthetic: The Ascension Saint Thomas Midtown Drug Mix-Up and What Injured Patients Should Know

On Friday, August 14, 2026, four patients underwent elective joint-replacement surgery at Ascension Saint Thomas Hospital Midtown in Nashville, Tennessee. According to the Tennessee Health Facilities Commission inspection report, and as reported by NewsChannel 5 Investigates and Fox 17 in Nashville, the syringes prepared for their spinal injections were supposed to contain a local anesthetic but instead contained a concentrated potassium electrolyte, a medication that can be lethal when given the wrong way.

The wrong drug reached four patients. Investigators found that a fifth syringe filled with the same medication was prepared and caught before it was administered, which spared a fifth patient. The hospital's own president and chief executive, Dr. Shubhada Jagasia, said in a public statement that the hospital self-reported the event to state regulators on the day it happened and apologized "for the harm caused to our patients."

This is not a rumor or an unproven allegation about what went wrong in the pharmacy. The core facts come from a government inspection and from the hospital's own account. What remains to be sorted out through the legal process is who is legally responsible to each injured patient and what those patients are owed.

According to the state survey findings as reported by NewsChannel 5 and Fox 17, the syringes were labeled as the local anesthetic mepivacaine, sold under the brand name Polocaine, but were actually filled with potassium phosphate. Early accounts from patients' families described the drugs in slightly different terms, and some outlets reported the intended drug as bupivacaine and the wrong drug as potassium chloride. The common thread across every account is the same: a concentrated potassium product went into patients' spines where a local anesthetic belonged.

Concentrated potassium is one of the most dangerous drugs in a hospital. The Institute for Safe Medication Practices lists concentrated electrolytes, and potassium in particular, as high-alert medications, meaning drugs that carry a heightened risk of serious harm when they are used in error. Hospitals are expected to build specific safeguards around them: restricted storage away from other drugs, standardized concentrations, independent double-checks, and barcode verification before a dose is prepared or given. Our article on medication errors and who is responsible explains how these safeguards are supposed to work and why concentrated potassium sits at the top of the danger list.

Injected into the space around the spinal cord, potassium does not numb. It disrupts the electrical signaling that nerves and the heart depend on. That is consistent with the injuries the patients suffered.

The four patients who received the wrong drug suffered severe and, in several cases, catastrophic harm. According to the inspection report and Nashville news coverage, one patient went into cardiac arrest during surgery, and one remained on ECMO, a heart-and-lung life-support machine, as inspectors finished their work. Three of the four were left with major neurologic injury to the lower body, described as paralysis and loss of sensation from roughly the mid-torso down.

One of the patients has been publicly identified by her family. Glenda Dorton, a 72-year-old woman who came in for a knee replacement, is paralyzed from the chest down, her family told WSMV, and remained in intensive care as they waited to learn whether any of the damage could be reversed. The other patients have not been publicly named.

These are life-altering injuries. Paralysis of this kind generally means permanent changes to mobility, independence, and the need for lifelong care. Under Tennessee law, that severity also matters to how a claim is valued, a point we return to below.

The stakes for the hospital are unusually high. According to NewsChannel 5 Investigates, CMS notified the health system that the Medicare provider agreements for both Ascension Saint Thomas Midtown and the affiliated Ascension Saint Thomas West could be terminated as early as September 18, 2026, if an acceptable correction plan was not accepted. Losing Medicare certification would also cut most commercial insurance and, the station reported, could threaten the hospitals' ability to keep operating. This is a fast-moving regulatory situation, and its status may change after this article is published.

Separately, the reporting indicates the Tennessee Bureau of Investigation opened a criminal inquiry after a referral from the state health commission. As of the reporting available, no criminal charges had been filed. A criminal investigation and a patient's civil claim are different tracks with different rules and different burdens of proof, and one does not depend on the other.

The hospital, for its part, says it has taken corrective steps, including isolating high-alert medications, requiring independent dual verification for spinal medication workflows, and bringing in outside quality experts. Those are the hospital's descriptions of its response. Whether they satisfy regulators, and what they mean for patients already harmed, are separate questions.

A government inspection finding and a civil claim are not the same thing. An inspection deficiency is a regulator's conclusion that the hospital broke a care rule. A lawsuit is an injured patient's claim that specific conduct caused a specific injury, and it has to be proven with medical evidence and expert testimony. But the two are closely connected here. The inspection report, the pharmacy records, the barcode-scanning logs, and the hospital's own timeline become evidence when a patient pursues a claim, because they can show whether the failures were known, systemic, and preventable rather than a one-off accident.

When harm involves a high-alert medication, the legal question usually turns on whether the institution's required safeguards were followed. Here the public record already points to overridden barcode checks, missing pharmacist verification, and high-alert drugs stored where they should not have been. Medication-error cases also often involve more than one responsible party, which can include the hospital and health system, the pharmacy staff, and the clinicians who administered the injections. Sorting out who is responsible takes a careful review of the complete chart and, in most cases, expert review by a pharmacist and physicians.

If you or a loved one was a patient at Ascension Saint Thomas Midtown in this window and something went wrong during or after surgery, the documented findings do not by themselves prove your case. They do mean the questions are worth asking, and that the records exist to answer them.

Move early to preserve the paper and electronic trail. Federal law gives patients and their representatives the right to inspect and copy the medical record, so request the complete chart in writing: the anesthesia record, the medication administration record, pharmacy preparation and dispensing logs, the barcode-scanning history, operative and nursing notes, and any incident or event reports the hospital generated.

Much of what matters in a medication case lives in the electronic record's metadata rather than the printed pages. Timestamps showing when a drug was scanned, when an override happened, and who touched the order can be decisive. Our article on EMR audit trails and what electronic records actually reveal explains how that hidden layer works and why it is worth demanding.

Write down your own account while it is fresh: the date and time of the surgery, the names of the staff involved, what you were told and when, and how the injury unfolded. Keep any correspondence from the hospital. If a loved one died, do not assume the cause listed on the initial paperwork is the final word.