Jury sides with Wisconsin hospital in controversial malpractice case—but major red flags remain

The death of Grace Schara, a 19-year-old with Down syndrome, in 2021 has made headlines across the nation again, stirring deep emotions in healthcare professionals and the public alike.

While the case was closely followed, the decision has sparked a larger conversation about how medical ethics, patient care, and legal liability intersect. What can doctors learn from this case? And how should we navigate these delicate situations in our own practice?

The patient's backstory

Schara was admitted to St. Elizabeth Hospital for COVID-19 and low blood oxygen levels in October 2021.

According to her family, her treatment quickly turned into a tragic sequence of events, culminating in her death after being placed on a ventilator, with her parents claiming that her death was due to malpractice.

Hospital staff gave Schara three drugs—Precedex, lorazepam and morphine—initially due to her “agitation” at a loud breathing machine.

They also claimed Schara was put on DNR status without consent of an advocate.

However, the story told by Randall Guse, the attorney for one of Schara's doctors Gavin Shokar, MD, went differently.

Guse said Dr. Shokar was responding to the Schara family’s wish to avoid putting their daughter on a ventilator, which would require a breathing tube.

“If you cannot address the underlying cause of the cardiac arrest—in this case respiratory failure, and that means address it with intubation—CPR, defibrillation, all that is futile,” Guse said.^[]

The legal battle

Schara's family accused the hospital of improperly administering medication, failing to adequately inform them about treatment options, and not offering alternative care methods.

They believed the hospital’s actions directly contributed to Schara's death, filing malpractice charges that put the hospital’s medical decisions under intense scrutiny.

There were no clear breaches of medical practice or procedures, the defense claimed, and the death was a tragic but unavoidable outcome.

What this means for physicians

This case highlights several critical lessons for medical professionals, especially those practicing in high-stress environments like intensive care or during a public health crisis:

1. Patient communication is key

One of the critical points raised in this case was the level of communication between the hospital and the Schara family.

Doctors should strive to maintain open, clear, and compassionate communication with family members, especially when dealing with complex or life-threatening situations. Offering alternatives, explaining decisions, and ensuring families feel heard can prevent legal disputes and foster trust.

2. Standard of care under scrutiny

The case serves as a reminder that the standard of care can be a contentious issue in malpractice lawsuits. Even when physicians follow established guidelines, the perception of the family can drive legal action.

3. Ethical considerations

The ethical debate in this case revolves around the question of whether certain treatments, especially life-sustaining interventions like ventilation, were appropriate given Schara's condition. It underscores the complexity of decision-making, particularly when it comes to vulnerable populations.

4. Legal awareness in medical practice

While this case ended in favor of the hospital, it’s a wake-up call for all medical professionals to be aware of the legal implications of their decisions. Malpractice claims are sometimes a matter of perception and can stem from misunderstandings or lack of clear communication.