One example in which an individual's life sustaining directives were not adhered to is in the case of a 91 year old Florida woman. Marjorie Mangiaruca experienced cardiac arrest while living in a nursing home. She was transported to a local hospital, in which she was administered CPR. As a result Mangiaruca ended up on life support. Mangiaruca had designated her daughter as her medical proxy in the event of a life threatening event. Her daughter did appear at the hospital with medical power of attorney and signed DNR, which she presented to hospital staff. This case resulted in a malpractice lawsuit against the hospital and nursing home in which Mangiaruca resided. The nursing home failed to present signed DNR to paramedics upon arrival. This lawsuit included medical malpractice in evasive life sustaining treatment, prolonging the woman's life against her wishes, and emotional distress experienced by the family. Florida emergency personnel were not liable for life sustaining procedures because proper documentation was not disclosed at transport. As a result, the family was forced to make the decision at a later date to disconnect life support on the elderly woman, as she was unresponsive and dependent on life support measures, (Kase, 2013). This is just one case in which all documents were legitimate, but not presented to medical personnel.
There are other documented cases such as this one. Health care professionals should be up-to-date on DNR directives, and aware if each patient has a signed DNR on file. Many states have adopted the rule of having patients with DNR directives to wear a bracelet that is color coded orange. This color coded bracelet signals to health care providers that a DNR order has been initiated, (Michael, 2002). In many cases, hospitals have specific DNR forms that must be filled out and signed by the individual's physician to meet criteria necessary to initiate a DNR request.
