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Posted on April 29, 2016 at 5:00 AM

Last August, I reported that the Court of Appeals of Indiana allowed a family to proceed with its medical malpractice action alleging that a hospital’s unilateral DNR order caused the patient’s death.

Today, the Indiana Supreme Court affirmed the intermediate appellate court’s decision.  Kathy L. Siner v. Kindred Hospital of Indianapolis.

Geraldine Siner was 83 and suffering from advanced dementia.  In October 2007, she was admitted to Kindred Hospital for treatment of aspiration pneumonia. The family asked her to be “full code” and use whatever means necessary to save her life.

But the medical staff thought that Siner’s condition was unlikely to improve and that the family had “unrealistic expectations and strong religious beliefs.”  The ethics committee overturned the “full code” designation and changed it to “no code” – even though it recognized “legal concerns with changing code status despite family opposition.”

By the time the family transferred the patient from Kindred to Methodist, she was irremediably injured from the lack of treatment at Kindred.  

No court has made a substantive ruling about the propriety of unilateral DNAR orders.  No court has made a substantive ruling about the propriety of providing less (non-CPR) treatment to a patient with a DNAR order.  The Supreme Court only decided that there is a genuine issue of material fact.  So, the family can take the case to a jury to hear and weigh the conflicting medical opinions on causation.

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