Death Panel Slips DNR Order Into 12-Year-Old’s Medical File

State   |   Rachel Bohannon   |   Aug 29, 2012   |   10:21AM   |   Austin, TX

Until last week, a 12-year-old gunshot victim’s life was endangered more by his doctor than his injury.

Zach McDaniel of Abilene was shot in the head on August 6 when he got caught in the crossfire of a drug deal gone bad. He was rushed into emergency surgery, and then transferred to Cook Children’s Medical Center in Fort Worth for more intensive care.

At the time of transfer, Zach was stable, despite being on a ventilator and in a drug-induced coma. But as soon as Zach was admitted to the intensive care unit at Cook, doctors painted a grim picture for his parents, claiming that he would not live for long, and that part of his brain had been removed during surgery. His parents were urged to “let him go” and sign an organ donation consent form.

His parents considered signing, but a brain scan later revealed that Zach’s brain was whole. Cook staff said that there must have been miscommunication between the two hospitals. Consequently, Zach’s parents refused to sign the donation form.

Just a week later, the hospital convened a death panel — called an “ethics committee” — to review Zach’s case. Under Texas law, if the panel members agree among themselves that a patient’s care would be “futile” in order to improve or save the patient’s life, then the hospital reserves the right to terminate all care — including food and water — after 10 days.

In the panel’s opinion, Zach’s case was futile. But because of procedural mistakes, the panel couldn’t issue a ruling. However, they made it clear that they no longer wished to treat Zach, even though the family wanted to give Zach a chance to recover.

Three days later, Zach was able to breathe on his own and his ventilator was removed.

That same day, a friend asked Zach’s parents why Zach was receiving “palliative care,” meaning no food or water — just morphine. That’s when Zach’s mom, Jessica, called Texas Right to Life.

Texas Right to Life told Jessica what questions to ask the nurses and doctors. She also looked through Zach’s chart and discovered, shockingly, that Zach’s doctor had slipped a “Do Not Resuscitate” order into Zach’s chart, without her knowledge or consent.

Texas Right to Life advised Jessica to confront the doctor immediately. Removing food and water without a death panel’s proper approval is criminal. And as Zach’s legal guardian and medical decision maker, it was Jessica’s right — and not the doctor’s — to direct her son’s care.

Secret “in-hospital” DNRs, however, are legal in Texas. Zach’s doctor neither needed the death panel’s nor Jessica’s consent to place one in Zach’s chart.

When confronted, the doctor reluctantly removed the DNR and reinstated Zach’s food and water, but again stressed to Zach’s parents that he no longer wished to treat their son.

Afterwards, the hospital threatened to reconvene the death panel — presumably following all the rules — and continued threatening Zach’s parents up until the day Zach was moved to a hospital closer to home.



On August 21, Zach was transferred by ground ambulance to Hendricks Medical Center in Abilene. Interestingly, Cook placed a DNR in Zach’s chart for the duration of the transfer. The family was able to remove it once he was safely at Hendricks.

Zach’s new neurologist at Hendricks is hopeful. So far, tests are positive, and it is the doctor’s opinion that Zach has a survivable injury. Zach will slowly be weaned off the sedatives until he comes out of his drug-induced coma.

These types of cases don’t always have happy endings. But for Zach, at least, it seems that the worst may be over. I will keep you updated on any further developments.

LifeNews Note: Rachel Bohannon is a spokeswoman for Texas Right to Life.