autopsy

[gfro]

CA. My husband died 4 months ago of heart failure but the question was what caused it? He'd been going to Drs. and tests for months (heart Dr. says his heart was good)and I finally insisted one of his Drs. admit him. He died 5 days later. He had a DNR code. He was only 64 . Could I have insisted they perform resusitation? His attending Dr. kept saying "it's what he wanted" over and over (I asked if they could bring him back)as I was in shock.He'd been doing better that morning. Eventually I asked for an autopsy performed to find out what happened. I am getting so frustrated with the pathologist who seems in no hurry.I need answers . He says next week (a month ago) and I call today to find out he took off on vacation till july 29 just after I had talked to him. No he didn't do it or ask anyone else to do it. I am totally a mess from the death anyway and this situation is like it's happening over and over again. I guess the worse part- besides the obvious -is no one ever seems in a hurry. With all the tests and doctors he saw, there was never any hurry- 2 weeks for this and that , etc...and now this guy.What is the name of your state (only U.S. law)?CA.

 

[ecmst12]

If your husband had a legal DNR order on file, then no you couldn't over-ride it. That's why he had the order - so HIS wishes would be obeyed instead of the wishes of others.

 

[Proserpina]

CA. My husband died 4 months ago of heart failure but the question was what caused it? He'd been going to Drs. and tests for months (heart Dr. says his heart was good)and I finally insisted one of his Drs. admit him. He died 5 days later. He had a DNR code. He was only 64 . Could I have insisted they perform resusitation? His attending Dr. kept saying "it's what he wanted" over and over (I asked if they could bring him back)as I was in shock.He'd been doing better that morning. Eventually I asked for an autopsy performed to find out what happened. I am getting so frustrated with the pathologist who seems in no hurry.I need answers . He says next week (a month ago) and I call today to find out he took off on vacation till july 29 just after I had talked to him. No he didn't do it or ask anyone else to do it. I am totally a mess from the death anyway and this situation is like it's happening over and over again. I guess the worse part- besides the obvious -is no one ever seems in a hurry. With all the tests and doctors he saw, there was never any hurry- 2 weeks for this and that , etc...and now this guy.What is the name of your state (only U.S. law)?CA.

I'm sorry for your loss.

While I know you do need answers, please understand that it's highly unlikely that yours is the only case the pathologist is dealing with. Sometimes it does take time - toxicology by itself can take weeks (in some districts months) to come back and it can sometimes be months before the final results are known. While it's a little less-than-professional to mislead a family member about sensitive issues it does sometimes happen; and sometimes innocent mistakes or simple miscommunication occurs.

And please be prepared for the possibility that the autopsy will show no obvious reason why your husband died when he did.

There are many bereavement and grief support services available and they can be invaluable, particularly when a death was unexpected. Try and surround yourself with some of this support and please don't let this become the focus of your grief journey.

 

[lya]

In order to opine, I need clarification on the term, "heart failure". Was the husband a person who suffered from chronic congestive heart failure? Did he go into heart failure? or--is the term, "heart failure", being used to describe cardiac arrest?

A 64 year-old in average or good health is not granted a DNR order. If a living will declines heroic measures to keep the patient alive, it is NOT honored in a one-time sudden cardiac arrest situation.

DNR orders are for those patients for whom recovery is not feasible; the same goes for a living will that declines heroic measures. Neither applies to a one-time cardiac arrest situation in an otherwise healthy individual.

 

[You Are Guilty]

DNR orders are for those patients for whom recovery is not feasible; the same goes for a living will that declines heroic measures. Neither applies to a one-time cardiac arrest situation in an otherwise healthy individual.

Whoa! While that may be true in some jurisdictions, it is far from universal and there is plenty of case law about docs who knowingly chose to ignore an otherwise valid DNR.

 

[gfro]

my husband had been having heart failure symptoms for 3 months as we went from doctor to doctor and for tests. His heart stopped and they didn't revive him. Heart specialist said his heart was good the day before. I always thought a Dnr order was meant for comatose life support situations- not this.And why even offer this to a patient who has no definite cause yet? I was so confused and shocked- still am. I wish it hadn't been honored at least this time. As I said I am still waiting for a report and I am scared to death it will turn out to be something simple that could have been treated. In Calif. can a spouse override a DNR order?I need to know and I can't find any reference. If I couldn't , was the attending Dr. just trying to comfort me by saying it was what he wanted over and over? I first posted because I was so frustrated with the autopsy /pathologist being slow (4 months IS long). But I realize this is just more of what has been business as usual in my husbands case with these doctors and hospital (which by the way , is supposedly a very good one for heart problems).

 

[Proserpina]

Johns Hopkins: Healthy Living discusses DNR, living wills, healthcare proxy

Maybe this might offer some clarification about DNR versus a living will.

And this information is California-specific.

Emergency Medical Services Authority (EMSA):: DNR FAQs

And this one might offer some answers to other frequent questions:

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I do hope you can find some peace.

 

[LAWMED]

This is still making little sense.

Echoing Lya, can you please tell us specifically what symptoms he was having?
What tests were done? Did he have a cardiac echo? Stress test?
Where did this DNR order come from? Are you saying that when he was admitted he signed a DNR consent for himself? If so, who proposed the idea? Did you know about it? It would be a very odd occurrence for a seemingly healthy 64 year old to be approached by medical staff to consent to a DNR order....and equally odd for medical staff to agree to such an order if proposed by the patient. DNR orders are not pre-disease or emergency medical directives. They exist for use in a very limited set of circumstances where a terminally or critically ill patient should be granted the right to 'death with dignity' and an end to suffering should their heart stop, breathing stop, or become dangerously compromised.I have NEVER seen one for an individual who does not meet similar criteria.

What transpired in the 5 days he was in the hospital? What was his diagnosis? Did something occur which made a DNR a valid option? Your husband died 4 MONTHS AGO and the autopsy has not been done? Are you kidding????

I see a few possibilities: either this entire thing is made up and wasting our time, or the facts presented are not reflective of the actual events and diagnosis. If the later, terminology and medical knowledge may be a barrier to getting your point across...without accurate information we cannot help.

 

[lya]

Whoa! While that may be true in some jurisdictions, it is far from universal and there is plenty of case law about docs who knowingly chose to ignore an otherwise valid DNR.

Let me be specific--The intent of a DNR order is not to prevent a healthy 45 year-old man who suffers sudden cardiac arrest on the golf course from receiving every available method of restarting his heart. The intent of a DNR order is to prevent prolonging death through artificial means in a patient for whom little to no chance of recovery is possible.

Therefore--if the OP's husband had no prior cardiac condition and suffered an acute cardiac event, DNR is not in play. If he is a chronic cardiac patient, suffering severe ejection fraction deficit, chronic CHF, and has little to no chance of recovery/survival, DNR is in play.


jeez...

 

[ecmst12]

I'm thinking that OP did not tell us the whole story and if not a heart problem, then he must have had SOME other serious health condition (cancer? kidney failure?) and wasn't "otherwise healthy" and that is why he had the DNR in the first place.

 

[You Are Guilty]

Let me be specific--The intent of a DNR order is not to prevent a healthy 45 year-old man who suffers sudden cardiac arrest on the golf course from receiving every available method of restarting his heart. The intent of a DNR order is to prevent prolonging death through artificial means in a patient for whom little to no chance of recovery is possible.

Therefore--if the OP's husband had no prior cardiac condition and suffered an acute cardiac event, DNR is not in play. If he is a chronic cardiac patient, suffering severe ejection fraction deficit, chronic CHF, and has little to no chance of recovery/survival, DNR is in play.


jeez...

Lighten up. You know it's just a matter of time until someone else searching for DNR info saw your post and misunderstood what it meant.

That said, it still looks like this story is missing a piece or ten.

 

[gfro]

OK- He was in CHF but his heart was not the cause ( we were told). And he was in MILD renal failure but his kidneys was not the causing the problem. Every specialist said their specialty was not it.That morning they took a biopsy to see if amyloidosis was an answer- negative. He had been a firefighter in the past with very MILD smoke induced asthma but his pulmonary Dr. said that was not causing it. I read the DNR code link one of you provided and I now think I should have lied and said he'd meant to cancel it. Unfortunately I failed to think of this. I just don't think DNR should be offered if no one knows what's happening yet. And, after reading all the Drs. notes,I think it tainted every thing they might have tried to at least find out what was going on. Now I want to know what caused this and , as with everything else about this stinking mess , no one seems in a hurry. Also- he signed was offered the DNR order when he was admitted to a better hospital. From what I understand ( they took him by helicopter as I drove down ) he had gone into cardiac arrest and then they offered the DNR.

 

[ecmst12]

It is unfortunate that the doctors did not find out the cause of the CHF before it was too late. But it appears the DNR really is what he wanted. It is also unfortunate that the two of you didn't really talk about what he wanted if something like this were to happen before it happened. But the medical profession still doesn't know everything about the human body. You need to accept the fact that you may never get your answers, it may not be possible to figure it out. And even if they do, it won't change anything. I'm very sorry for your loss, and I hope you will seek grief counseling to help you deal with it.

 

[gfro]

I also want to say if a DNR is for the terminally ill , why offer it to someone if they don't even know what is happening? They only knew the symptoms. As I said- I am so scared the autopsy will show some minor problem that could have been corrected. The pathologist did tell me that there was no sign of cancer (that he could tell from just looking at the organs).

 

[Proserpina]

I also want to say if a DNR is for the terminally ill , why offer it to someone if they don't even know what is happening? They only knew the symptoms. As I said- I am so scared the autopsy will show some minor problem that could have been corrected. The pathologist did tell me that there was no sign of cancer (that he could tell from just looking at the organs).

CHF can be considered a terminal condition (realistically speaking without a heart transplant there is no cure for CHF, though it can be reversed in cases where the cause can also be reversed or terminated).

But all that aside, it quite apparent that in some cases (perhaps state specific), a DNR is not restricted to those with a terminal condition (though most DNRs do appear to relate to terminal conditions).

Still, I can't help but be concerned that the focus on the DNR status of your husband is perhaps not the best thing for your grief journey at the moment. Obviously I have neither the right nor the clinical qualification to decide that but I do have the "benefit" (which seems to be an inappropriate term on one level) of going through a very similar experience myself. The end result is still the same - you've undergone a tragic and heart-breaking loss, and though it's natural for you to want answers, sometimes the only time we can obtain any form of "closure" is by acknowledging that there are times where we just can't know - and even when we know, it doesn't change the end result.

Wishing you much peace, however you may find it.