Medical staff accused of placing DNR on patient without family’s knowledge

InvestigateTV – Chuck Milne remembers his older sister, Leona.

“It was like a little girl trying to grow up and be an adult,” Milne said. “But you could still see the child, the angel part.”

Milne said Leona was born with a mental disorder and as an adult had the cognitive abilities of a 9 or 10 year old. She lived with Chuck and their mother in Canton, Georgia for over 20 years.

“She was very social, very outgoing, and loved people and was the center of attention,” Milne said.

In April 2018, Milne said Leona had an infection in one of her toes, requiring foot surgery and rehabilitation to be able to walk again. That’s when she arrived at the Roselane Health and Rehabilitation Center in Marietta, Georgia. She was supposed to be a temporary stay rather than a long-term recuperation.

But within days, nurses noticed something wrong with the 73-year-old man. Milne said a nurse called to let her know her sister was having trouble breathing. He asked the nursing staff to send Leona to a hospital less than a mile away from her. Milne says the nursing staff refused.

This is because Leona signed a DNR, or “do not reanimate” order. This prohibits medical staff from performing CPR or other life-saving procedures on someone whose heart has stopped.

“And I said, ‘You don’t understand, she doesn’t have the ability to sign the DNR,'” Milne said. “I said [the nurse] She didn’t have the mental capacity to sign. ”

Milne said the nurse hung up after saying her hands were tied. Leona died some time later.

A pending wrongful death lawsuit filed by Leona’s family in Clayton County, Georgia, alleges that the DNR order given to Leona was fraudulent.

Attorney Mike Prieto is representing the family in a lawsuit against Roselane’s former medical director, Dr. Sarah Samvandam, the doctor ultimately responsible for Leona’s treatment.

“When we first looked into this case, we only looked at whether Ms. Milne had the mental capacity to perform a DNR,” Prieto said. “It was only later that the rest of the story was revealed.”

The rest of the story was revealed during a 2021 deposition with a social worker who worked for Roselane.

According to Milne’s attorney, Georgia law stipulates that two doctors must evaluate the patient and sign the order before issuing a DNR order for a mentally ill person. It should then be submitted to an ethics committee for final decision. Most states require similar protocols.

A social worker said nothing of the sort happened when she worked for Roselane for 21 years. In Leona’s case, the DNR had already been photocopied with her two doctors’ signatures before the form was given to Leona.

“Well, the process back then was that we pre-signed DNR forms like this one. They were already pre-signed,” the social worker said in a videotaped deposition. “I had them in my notebook. I had them when I went to see the residents.”

In Roselane’s DNR order, the form includes a section indicating whether the patient has “a medical condition that can reasonably be expected to lead to the imminent death of the resident.”

The dismissed social worker said the social worker allowed the patient to make that decision without a doctor’s evaluation.There was another problem with Leona’s DNR form. According to court records, her one of the doctor’s signatures included a doctor who left her facility before Leona was admitted to the facility.

“In our case, she was missing for seven months before the DNR was executed,” Prieto said.

This is not the only practice allegedly held at Roselane. Prieto’s law firm has identified at least 194 other of his DNR orders that are part of pending lawsuits. These were allegedly photocopied with the physician’s signature before the patient was evaluated. The DNR order was signed and dated when Sambandham was the facility’s medical director. The identity of the patient is unknown, as Roselane personnel redacted the name for privacy rights.

“The scary thing is how many people are victims of this doctor who don’t know anything. It’s scary,” Prieto said.

Through her attorney, Samvandam declined an interview but denies wrongdoing in court. “They look like they have been copied,” said Sambandham.

The doctor also claimed he had no knowledge of such a practice in his four years as the facility’s medical director.

“It’s not logical to claim that a doctor saw a pre-printed form in 194 patient files and knew nothing about it,” said Prieto.

Milne has settled a civil lawsuit seeking an undisclosed amount with the facility’s former operator, SavaSeniorCare. Roselane is now owned and operated by Harborview Health Systems. Neither of them responded to interview requests.

Since 2017, the Georgia Department of Community Health has cited the facility 34 times for a variety of violations, including delivery of appropriate treatment plans, oversight, and medication errors.

SavaSeniorCare was once considered one of the largest long-term care providers in the county, but operates only a handful of facilities in the Southeast and Midwest. In a statement released to Skilled Nursing News, which covers the long-term care industry, Sava said the pandemic had made the decision to sell or close its facilities.

“The nursing home industry has experienced significant challenges over the past few years, mainly due to COVID-19.

As a result, Sava and its affiliates have decided to transfer their portfolio of nursing centers to regional operators. Sava’s operating affiliates currently operate five nursing centers. “We expect all transitions to be completed by the end of January 2023,” he reported the online news outlet in December.

In May 2021, the Justice Department reported that SavaSeniorCare agreed to pay $11.2 million to settle claims that it improperly billed Medicare and Medicaid programs.

Since 2019, at least 4,808 long-term care facilities nationwide have been named for violating their patients’ advance directives, according to records from the Centers for Medicare and Medicaid Services. The advance directive includes her DNR, but it is not known how many violations the DNR order was improperly included. Ordered without patient or legal guardian consent.

Grace Shara’s family believes her daughter is among them.

Grace’s father Scott, who was born with Down syndrome, said Grace’s disability never slowed her down.

“She was gifted. .

In October 2021, a 19-year-old girl contracted COVID and went to St. Elizabeth’s Hospital in Appleton, Wisconsin for treatment. Documents provided to her by her parents to InvestigateTV show they had a medical power of attorney.

Schara said Grace’s doctor asked medical staff if she would like repeated attempts to revive her daughter if things got worse, but never mentioned the DNR order. Grace’s parents also say they never asked for a DNR order.

“Absolutely not. Why would we ask for that? No point. We expected our daughter to come out of there. We don’t expect her to die.” said Schara in an interview with InvestigateTV last September.

Wisconsin’s Department of Safety Professional Services (DSPS) licenses physicians in the state. According to a letter sent to the agency on behalf of the doctor, the doctor spoke with Grace’s parents three times about the DNR, claiming that he had “obtained the explicit consent of the family for the patient to be DNR.”

The hospital claims doctors recorded the same conversation. But according to Wisconsin law, a DNR order must be signed by both the doctor and the patient or their legal guardian. Patients are required to wear a special bracelet on their wrist to notify staff that a DNR order is being placed.

Grace’s parents said nothing of the sort happened to their daughter. Grace said she died on October 13, 2021, and that her medical record listed her DNR order, which her parents did not approve of.

“And the nurses from the hallway won’t come into the room. They yell, ‘She’s DNR.’ And we yell back, “She’s not her DNR. She save our daughter.” they refused. They wouldn’t enter the room,” said Schara.

Ascension, which runs St. Elizabeth Hospital, has not responded to multiple requests for interviews over the past five months. A DSPS investigation found that the doctor did not break the law because of where he was working at the time.

“Wisconsin law does not apply to physicians working in hospitals other than in emergency situations,” a government agency spokeswoman said in an email to InvestigateTV. This means that if a doctor works outside the emergency department or out-of-hospital emergencies, her DNR order in writing may not be necessary.

That makes no sense to Grace’s dad. “How can I escape responsibility for killing someone?” He was accused of dishonesty in a DNR order Criminal charges against medical staff are rare, but they do happen.

In Florida, a Marion County Sheriff’s Deputy arrested a state-designated guardian for abuse in 2020 after a 75-year-old client died under her care.

In a press release on its website, the Florida Department of Law Enforcement said, “Surveys show that on several occasions, seniors said they didn’t want a stop resuscitation order (DNR) and wanted to live.

In September, a judge declared the case erroneous because the jury was unable to deliver a unanimous verdict.

Police in Plano, Texas, have arrested a nurse for allegedly falsifying a DNR form for a patient who died in 2022.

Scara believes law enforcement should investigate allegations of fraudulent DNR orders further, rather than relying on medical and licensing agencies. “We already have the law on the books. We don’t need more law. What we need is a strong opportunity to prosecute,” he said.

Research producer Bailey Williams contributed research for this report.

Copyright 2023 Gray Media Group, Inc. All rights reserved.