Boston Hospital Accused of Mistakenly Labeling Patient `Do Not Resuscitate`
Jan. 28--A 49-year-old Wakefield woman is accusing Melrose-Wakefield Hospital of labeling her elderly father a "Do Not Resuscitate" patient without permission shortly before he died last July -- and a hospital executive later called it all a "misunderstanding."
Sandra Furrier, who had been given the power to make medical decisions for her 85-year-old father, Arthur Fairfield, said she signed orders for him to receive life-preserving care about a month before his death.
She said she last saw her dad, a retired master carpenter and grandfather of five, when she left the hospital the evening of July 20 and asked staff to call her if there were any changes in his condition.
"I said, 'Daddy, I'll come back if I can. I love you. See you later,' " Furrier said. "I kissed him on the cheek and I left. And that was the last time I saw him."
Furrier said the hospital called after her father died that night after complications from infections and told her he was listed as DNR -- something she said she never authorized and was the opposite of her written directives.
"I can't even drive by that place without getting sick to my stomach. I'm completely appalled," Furrier told the Herald. "They didn't call me. They didn't ask me. They never mentioned DNR. It was never discussed with me at any time at all."
William Doherty, chief operating officer for Hallmark Health System, which runs the hospital, offered his "sincere apology for the misunderstanding surrounding your wishes regarding your father's resuscitation status," in a letter to Furrier dated Aug. 5.
"As a result, we are enhancing our procedures around communication and documentation of Medical Orders for Life-Sustaining Treatment (MOLST) and DNR status," he wrote.
Furrier said there was no misunderstanding.
She said the family gathered at a rehab facility on June 24 -- her father's birthday and about a month before his death -- and she filled out a MOLST form, which called for resuscitation and ventilation should her dad need it. The state's MOLST form instructs: "Any changes to this form requires the form to be voided and a new form to be signed."
A Hallmark Health System spokesman, however, said Furrier ordered the DNR, saying in a statement, "Her conversation and wishes are documented in the medical record. This conversation and documentation supersedes any previous discussion or documentation."
The hospital did not provide a copy of that DNR record and would not say whether a form was even signed. It also would not name the physician who authorized the DNR, or any witnesses to the DNR request the hospital said Furrier made. The hospital agreed to discuss the case only after Furrier signed a privacy waiver.
According to a copy of Hallmark Health System's policy provided by the state Department of Public Health, the hospital requires only a physician signature after "suitable consent and agreement" for a DNR order.
That's different from the state's DNR template form, which asks for a patient or health care proxy signature.
The hospital said its procedures are under review and the nurse practitioner involved in the case "is an employee in good standing." The state Board of Registration in Nursing, which licenses nurses, is investigating the incident.
George Annas, a Boston University health law expert, said, "The big issue is consent. You're supposed to do what the patient wants. Doctors can't put in a DNR without your permission. They need the consent of a patient or the health care proxy."
Malpractice lawyers told the Herald DNR lawsuits involving the elderly face an uphill battle because hospitals can argue the patients may have died even if they were resuscitated.
Furrier said her father had already been resuscitated once about two weeks earlier, but the day he died she said he was lucid and talking as they made plans to bring him home.
"I'm not delusional," said Furrier. "I'm not saying had they resuscitated him that he would have gotten off of it and come home and lived happily ever after for another five, 10 years, but we'll never know. I know he was sick, but that doesn't give anyone the right to go against his wishes and the family's wishes."
Doherty and the nurse practitioner did not return calls seeking comment.
DPH can't investigate individual DNR cases, a spokesman said, but Annas argued the agency has oversight of state hospitals.
"Of course they can investigate," he said. "But it sounds like they don't want to."
Furrier said she consoles herself caring for her father's dog, Malcolm, and insisted that all she wants is justice.
"I want regulations made and I want the people punished that did this," she said. "I don't want someone else to feel the horror that I've been feeling."
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