A current lawsuit alleges that the hospital did not obtain proper consent from the family of the patient to designate her as a DNR patient.
The family claims that the hospital's actions resulted in a violation of the patient's rights. They argue that the removal of her father from the hospital and the denial of visitation to her sister left the patient without family or advocacy for significant periods.
On October 30, 2023, a judge in Outagamie County, WI, ruled in favor of a wrongful death lawsuit against Ascension Health, moving directly to a jury trial. The suit was filed by the family of Grace Schara, who was a patient at an Ascension Health–owned facility when she died in 2021. Schara, then 19, was admitted to St. Elizabeth’s Hospital in Appleton, WI, on October 7, 2021, with a diagnosis of COVID-19 and low oxygen saturation. Shara had Down syndrome, and her parents held legal, medical power of attorney status.
The suit alleges that hospital physicians had difficulties finding an appropriate mask to deliver oxygen to Schara and that she became agitated during treatment with a high-flow Vapotherm. Sedatives were then administered. Schara continued to receive sedatives throughout her admission, receiving several different medications at various doses. According to the complaint, members of the nursing staff had Schara’s father, Scott Schara, removed from the hospital at around 8 am on October 10, 2021. The complaint states that he was told he was removed, in part, because he had turned off “non-essential bedside alarms.” However, the complaint also states that a nurse had previously trained him to turn off those same alarms and did so because they disturbed his daughter’s sleep.
After Scott Schara was removed from the hospital, Schara’s sister attempted to go in his place. She was reportedly denied visitation, leaving Schara without family or advocacy for around 30 hours. After calls to patient services and discussions with St. Elizabeth’s legal department, the sister was permitted visitation with Schara beginning on October 11 at around 3:30 pm. However, she was told to leave a few hours later and was not allowed back into Schara’s room until 11 am the following day, leaving Schara without family or advocacy for an additional 17 hours.
On October 13, 2021, a physician called Schara’s parents. According to the complaint, they discussed the family’s wishes in the event that Schara’s medical condition took a downturn. Schara’s parents reportedly stated that they did not want her to be intubated but that they never discussed or consented to a DNR order. Despite this, a DNR order was allegedly placed on Schara’s’ chart immediately following the call.
Schara was reportedly still receiving high and repeated sedative doses. On the evening of October 13, 2021, Schara’s sister noticed her temperature dropping and repeatedly alerted nurses. The family claims that the nursing staff refused to assist. A few hours later, Schara’s heart and breathing slowed dramatically. Schara’s sister and parents, who had been contacted via FaceTime, repeatedly begged the staff to take action. They were told then that Schara was designated as a DNR patient. The complaint states that despite Schara’s parents refuting this designation multiple times, staff still took no action to resuscitate Schara. She died less than 10 minutes later.
The suit filed by the Schara family claims that medical staff at St. Elizabeth’s are liable for Schara’s death. They allege that the hospital did not obtain proper consent to designate Schara as a DNR patient and that their word over FaceTime should have caused staff to act. Additionally, they contend that the hours Schara was without family and advocacy were a violation of her rights and that the high amount of sedatives she received during her admission directly contributed to her death.
Ascension Health has refuted these allegations and asked for a dismissal of the case. In its defense statement, the organization denies any liability. The statement, as well as comments made to the press, claim that some of the suit’s allegations are based on regulations that do not apply to this case. For instance, the complaint cites a Wisconsin statute about using DNRs that only apply to care from first responders and in other emergency settings.
A January 2022 investigation into the Schara case conducted by the Wisconsin Department of Safety and Professional Services (DSPS) found no wrongdoing on the part of the hospital. Notably, the report states that the physician who spoke with the Scharas on October 13, 2021, believed that he had received “clear consent” from the family for the DNR order. In October 2022, DSPS investigated the incident for a second time and came to the same conclusion.
Ascension’s requests for dismissal have been denied.
DNR orders and Wisconsin law
The exact laws and requirements related to DNRs vary slightly from state to state. The fundamentals are the same across the country, and all states reciprocally honor DNRs. Federal regulations also govern the DNR requirements in some situations. However, there are also state-specific rules, including in Wisconsin.
Wisconsin residents who meet certain conditions have the option to wear a DNR bracelet at all times. Residents can choose from a free plastic version of the bracelets or a metal version that’s engraved with their name. Bracelets are meant to let emergency room staff, first responders, and other emergency medical providers know about someone’s wishes and are available to anyone over 18 who has a terminal medical condition or condition that would cause a resuscitation attempt to be unsuccessful or significantly painful. A physician must write an order for someone to receive a DNR bracelet.
A Wisconsin DNR bracelet is separate from a standard, federally required hospital DNR order. Federal rules regarding DNR orders during inpatient hospital stays require life-sustaining measures to be discussed with patients or their representatives during an admission. Any request for a DNR must be noted in a chart and last for the rest of a patient’s admission unless the patient or their representative revokes it.