Health Briefs

LANDMARK FLORIDA CASE MAY SETTLE WHAT “DO-NOT-RESUSCITATE” ORDERS REALLY MEAN

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A landmark malpractice case began unfolding in a Palm Beach County courtroom in southern Florida recently over interpretation by doctors and lawyers of the “do-not-resuscitate” (DNR) living will order of a 92-year-old Florida woman with advanced Alzheimer’s disease who died more than 10 years ago.

The case may help define and instruct future courts on just exactly what constitutes a DNR and when and how it should be followed, or not.

On Oct. 17, 1995, Madeline Neumann was found unconscious in her nursing home room. She had just eaten her evening meal, and attendants feared she could choke on her food. Her physician, who had cared for her for three years and was familiar with the woman’s DNR order, was telephoned. He ordered the staff to call 911 and have his patient taken to a local hospital for evaluation.

On the way, a paramedic placed a breathing tube in her throat and had to restrain the woman’s arms when she tried to tear the tube out. Neumann’s condition worsened, and she died at the hospital six days later, surrounded by her family.

Two years later, Neuman’s granddaughter filed a lawsuit against the nursing home and the physician because her aunt’s DNR order wasn’t followed. Now, after more than a decade of contentious litigation, the case is proceeding to trial.

The lawsuit alleges that the Joseph Morse Geriatric Center in West Palm Beach, FL, and Dr. Jaimy Bensimon, the facility’s chief physician, committed battery against Neumann when they failed to follow her DNR order. The lawsuit also seeks unspecified damages, and alleges breach of contract and negligence.

Meaning of DNR Different For Public and Professionals

The case holds future legal implications for efforts to hold hospitals, nursing homes and physicians accountable if they disregard living wills and advance directives.

The public often thinks the DNR means “do not treat me if I am suffering from a critical illness.” Professionals define living wills as “do not treat me if I am in a terminal condition or a persistent vegetative state.

The physician’s attorney, Jim Nosich, told the court that the doctor decided to send Neumann to the hospital rather than follow her DNR order because he was not at the nursing home at the time and he sought to have her condition evaluated first.

Nosich said that Dr. Bensimon had cared for Neumann for the three years she was at the Morse center, and treated her for heart problems, pneumonia and seizures, conditions that were potentially fatal, and no one ever complained.

A Florida State University professor who specializes in healthcare law and end-of-life issues said the public has the idea that all you need is an advance directive. But DNRs are clumsy and vague because they can’t predict all conditions.

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SOURCE: http://www.palmbeachpost.com/search/content/local_news/epaper/2007/02/27/m1a_neumann_0227.html