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"Hospitals routinely do that," Graham says. "In another case at Memorial Hermann, we were participating in an ethics committee process and the neurologist who had done brain surgery... he said that he put a DNR in the file. We asked, 'Did you consult with the patient's mother? Did you have any indication this is what the patient wanted?' And he said, "No, we do it all the time.' The doctor just decided to put a DNR on this patient. And I can think of two others right off the top of my head. And mind you, for all of this, these are only the ones who call us for help. There could be countless others."

Fine says that orders not to attempt resuscitation are almost always done in collaboration and with consent of the patient's family.

"I'd say it's that way 99.999 percent of the time," he says. However, "A doctor can write a [DNR] order on a patient if they feel that it is appropriate for the patient. No law prohibits that."

Fine concedes that because there is no database on the number of orders not to resuscitate that are entered or the number of times any one hospital convenes its ethics committee to decide whether to withdraw treatment, it's difficult to know which hospitals, if any, employ the laws more often than others.

"In most cases," he says, "because of the (privacy laws), we can't discuss them."

Graham says there is very little Texas residents can do to protect themselves if something goes wrong and they find their loved one's case in front of an ethics ­committee.

"The standard mantra has been to get the patient's wishes laid out in writing beforehand," she says. "But in Texas this means nothing because they can override it. It can be somewhat helpful, though, because if your wishes are spelled out, you have a stronger case if you have to go to court. What I would recommend is to call hospitals and ask what the hospital policies are."
_____________________

About a day after being told her daughter was in a coma, Lopez was sitting in the waiting room outside the intensive care unit when suddenly Lopez's stepmother came rushing over.

She told Lopez that she had been hanging around the hallway when a nurse came up and asked when Sabrina's funeral was going to be.

It took all the strength Lopez could muster not to break down and cry.

"I was so devastated and confused," says Lopez. "I didn't know if it was the truth or what. At this point, I didn't feel in good hands and I was starting to distrust the whole system completely."

This was only the beginning, Lopez and Murray say, of what became a horrifying pattern of hospital workers going behind their backs, talking to family members and trying to get them to yank the plug on Sabrina.

They claim that for days following Sabrina's second surgery, nurses and doctors were pulling extended family members aside, trying to encourage them to persuade Lopez and Murray to stop treatment, that it was the right thing to do.

"We ended up quarreling with family members who took the hospital's side," says Lopez. "It was chaos. Even now, it's still really hard and I don't talk to some of them anymore."

At one point, Lopez says, she called everyone who knew her daughter to tell them what was going on, including Lopez's former boyfriend living in Illinois. Daniel Martin, who showed up at the hospital, may be Sabrina's biological father, but Lopez and Painter say he has no legal rights and has had minimal involvement in Sabrina's life.

Painter says that doctors spoke with Daniel Martin, who sided with the physicians, but there was one glaring problem. As with all the other extended family members who agreed to withhold treatment, Daniel Martin had no say over the matter, and in fact, says Painter, it was a violation of federal privacy laws for anybody at Memorial Hermann to discuss the teen's medical condition with anyone other than Lopez and Murray, the legal guardians.

"I ended up writing a letter that I faxed to the hospital administration about the privacy law violations," says Painter. "And 20 minutes later, I got a call back and Daniel Martin was out of the picture. The hospital tried to split the family, and they do that quite frequently."

As Lopez and Murray would discover, however, that was just the start of the hospital's behind-the-curtain tactics.

Three days after Sabrina's second surgery, one of her doctors entered an order not to resuscitate her, says Painter. Lopez and Murray had no idea he had done so. They say they did not want the order put in. According to hospital records, the same day that the instruction was entered, a social worker documented that it "appeared (Lopez and Murray) did not agree with the recommendations for DNR as of yet."

Then, two days later, a different doctor issued a second order not to resuscitate Sabrina, the very day that hospital records show Lopez had requested a second opinion from another neurologist.

"I felt so violated," says Lopez. "I couldn't believe they would do this. I mean, we're talking about a hospital; they're supposed to have the patient's best interest, and this was way too soon to be giving up."

Lopez was further dumbfounded when doctors refused to insert a feeding pipe, called a G-Tube, or perform a simple tracheotomy, placing a breathing tube into Sabrina's neck, allowing her to leave the hospital so that Lopez could care for her daughter at home.

"They never proposed the G-Tube and trach," says Lopez. "I researched the options and said we wanted that. But Memorial Hermann wouldn't do it, saying she wouldn't have a high quality of life. And I was very disappointed because I was like, 'How do you define quality of life?' She doesn't need to play basketball as long as she can understand what we're saying."

Painter says he was appalled to learn how the hospital's ethics committee conducted itself. He alleges that the hospital's then-chief ethicist, who is no longer with Memorial Hermann, took an informal poll of committee members before convening the panel. However, the votes were not there, so the group never officially met.

"It's shocking how they did this," says Painter. "Instead of being neutral, the ethicist was acting like a floor whip in Congress. The one saving grace was that one doctor said he saw brain activity and that Sabrina may survive."

Painter and his clients believe that all these alleged attempts to end Sabrina's life were an effort to cover up the mistakes that led to her condition.

Write Your Comment show comments (11)

  1. As a practicing physician I can assure you that convening an ethics board (containing physicians, nurses and laypeople)to review every aspect of a case in great detail is the last thing a physician who had made a mistake would want to do.
    The laws in Texas are a blessing and exist so that physicians and nurses have the right to NOT continue painful and unnessesary treatments even if the family wants to continue. This is to protect the patient from unrealistic family members and the staff from doing things they find morally and profesionally wrong. They must continue full treatment until an independent group makes a decision.
    A DNR order is usually approved by the family, but is a decision made by a physician that advanced recusitation on a patient would not be benificial and would cause suffering for no reason.

    Comment by Robert — April 30, 2008 @ 12:31PM

  2. A physician is making my decisions or the decisions of my family? No way!

    Any person who calls themselves a physician and is in the business of killing should have their license revoked forever.

    This poor girl would have been dead if the doctors who promise to do no harm had their way. Now, she's in a loving home and has a loving friend and laughs at her jokes. The decision to kill her is not anyone's decision.

    These "independent" boards that help doctors cover up their mistakes is a joke.

    Comment by Astralis — April 30, 2008 @ 02:00PM

  3. I hate sue happy people, but in this case....SUE, SUE, SUE.

    Blessings to the family, I'm so sorry this happened to your little girl.

    I know there are two sides of this story and only one side was presented, but from what is being reported this never should have happened.

    Comment by Barb — May 1, 2008 @ 06:17AM

  4. hey, im one of sabrina's ex boyfriends....i have been close to this family for a long time, even before all this started....to get straight to the point...those doctors DID NOT treat sabrina with care...what so ever..they can deny it all they want, but if they would have just did their job, we would not be in the situation right now. Those doctors CRUSHED Sabrina's dreams and future...i would be at the hospital EVERY DAY to check on sabrina...and everytime i would go, it seems like she got worse and worse...sitting in her room, and her monitors would start beeping, and doctors would not come in and check on here...they seriously NEGLECTED her.she's had seisures, strokes, HER HEART STOPPED!! 2 years later and she's making a little progress, slowly but surely...don't take your child to memorial herman children's hospital!!!!!!

    Comment by joey thomas — May 2, 2008 @ 03:15PM

  5. hey, im one of sabrina's ex boyfriends....i have been close to this family for a long time, even before all this started....to get straight to the point...those doctors DID NOT treat sabrina with care...what so ever..they can deny it all they want, but if they would have just did their job, we would not be in the situation right now. Those doctors CRUSHED Sabrina's dreams and future...i would be at the hospital EVERY DAY to check on sabrina...and everytime i would go, it seems like she got worse and worse...sitting in her room, and her monitors would start beeping, and doctors would not come in and check on here...they seriously NEGLECTED her.she's had seisures, strokes, HER HEART STOPPED!! 2 years later and she's making a little progress, slowly but surely...don't take your child to memorial herman children's hospital!!!!!!

    Comment by joey thomas — May 2, 2008 @ 03:15PM

  6. Many people are patients at Hermann hospital and never pay their bills. It is a huge place that handles most of the local trauma . Many lives are saved at Hermann. For the ones that will not make it, the DNR is a kind way to let nature take its place. The story of that child is a sad one but things happen that are out of the control of all parties concerned. A reality check is needed here. The child appears to be in a vegetative state and no doubt, if she were able to communicate she would prefer to be set free. Often times parents suffer from guilt, selfishness in terms of wanting to hold on to their children even though they should let go. In this case, these people are determined to get money to satisfy their point of view and greed. They are wrong for doing so. They will not win. Hospitals try their best and not all will end up satisfied. We have to face reality that all things do not end up the way we expect.

    Comment by alumette — May 3, 2008 @ 07:35AM

  7. Frankly, no one gives a shit if they need to save their own asses. Since when do doctors really care if you're in pain or if treatment is unnecessary. BULLSHIT. She has a right to life. THere are many stories of people who defy the odds, so whose to say that one day she will be at least 50% better. As you can see towards the end of the article, she isn't a 'vegetable'...the way i see it, the parents can afford the supposed "unnecessary treatment" then is it really HURTING the doctors to treat the patient?? Last I checked, the doctors didn't give birth to her, they're not her parents, they don't know the emotional devastation of what losing a kid does to you; so they should get off their biggity high horse and treat the patients..that's what they get paid for. I'm currently in med-school and I would NEVER see myself playing God with someone's life. I hope they get sued up the ass.

    Comment by becky — May 3, 2008 @ 08:54AM

  8. The first time I found this article I was mortified. I read it out loud to my wife and a friend of ours. At the time I was only able to read the first half of the article. I just finished it and though I'm very saddened by it, I am also very happy that Sabrina recovered even if not fully. I don't know what I would do if a member of my family was suddenly in this condition. I do know though that there would be some medical staff that would be suffering as much if not more than my family for that negligence. Good wishes and prayers to Sabrina and her Family and Friends.

    Comment by Shane — May 6, 2008 @ 03:57PM

  9. Though I'm sure that this unfortunate girl's money hungry family and obviously highly educated ex-boyfriend are providing a completely unbiased veiw of the situation, I wish that the Press would have included some of the physician's side or at least 'A' physicians side of the story. The reporting is a little sensationalistic and one sided.

    Comment by Micheal — May 7, 2008 @ 09:42AM

  10. Yeah, what's up with doctors on their "biggity high horse". Becky, who is obviously in medical school ;), seems to of stated a very non-emotional, well thought out point. (you can tell from all the exclamation points and profanity) It needs to be stated that doctors are the caretakers of the PATIENT, not the family. Many times, especially in pediatric cases, the family/random boyfriends etc fail or refuse to understand and exept the situation. In that case many helpless people are subjected to painful and unneccesary procedures (intubation, feeding tubes placed through the abdominal wall, etc) that only prolong the inevitable. My sister and I wanted everything done for my father, even though, in retrospect, he had no chance of survival. A very patient and caring physician at Hermann helped us understand the process and my father died naturally in peace with us at his side. The doctors at Hermann did us a great service and saved my father a lot of needless pain.

    Comment by Dakwan — May 7, 2008 @ 09:44AM

  11. Oh. This was an "article" in a "news" publication. I thought it was a pamphlet from the Right to Life folks. Were any medical ethicists consulted? Did the "reporter" review the medical records himself or just talk to the family and their attorney? Did the "reporter" research locked-in syndrome enough to understand that this poor child doesn't have that? Did the "reporter" talk about the cases in which families insist that their all-but-dead relatives keep received life-sustaining treatment even when it is excruciating to the patient?

    Right. It was a pamphlet.

    Comment by Elizabeth — May 15, 2008 @ 11:39AM

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