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 Copyright © 2018 Albuquerque Journal 
 
 A new lawsuit filed on behalf of a local woman alleges that Santa Fe’s Christus St. Vincent Regional Medical was negligent twice while she was in the hospital in 2016. 
 
 The suit filed on behalf of Jamie Sams, a writer known for books on spirituality, says the hospital and a doctor who was treating her are to blame for Sams going into cardiac arrest. 
 
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 And the negligence was compounded when hospital personnel resuscitated her, the lawsuit suit states. 
 
 Reviving Sams violated her “do no resuscitate” directive, the lawsuit says. 
 
 Now Sams must live the rest of her life with pain and substantial medical bills, according to the suit filed in state District Court. 
 
 “As a result of being revived, Plaintiff continues to experience severe pain, disability and limitations and further, will incur extensive expenses throughout the remainder of her life,” the lawsuit against Christus and emergency room doctor Jamie Gagan states. 
 
 Sams is also suing because she was given the painkiller Dilaudid, which the lawsuit says she is allergic to. 
 
 Sams suffers from Dercum’s, a rare, painful disease that produces tumors all over the body. 
 
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 “This condition is extremely debilitating and painful and, moreover, requires frequent hospitalization and medication at great expense,” the lawsuit says. 
 
 Sams went to the Christus St. Vincent emergency room on Feb. 5, 2016, for pain control and was prescribed Dilaudid through an IV by Gagan, “despite the fact that she had advised emergency room staff that she was allergic to this medication.” 
 
 Sams had an allergic reaction to the Dilaudid and went into cardiac arrest. 
 
 She was revived by emergency room staff, even though she signed a “Double DNR (do not resuscitate)” form. 
 
 “Despite the fact that Plaintiff Sams had signed a double DNR indicating that she did not wish to be resuscitated or intubated, the emergency room staff provided such services,” the suit says. 
 
 “Plaintiff Sams was resuscitated, something she adamantly did not want.” 
 
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 “The DNR met all statutory requirements, and was valid and binding upon Plaintiff’s health care providers, including Defendants Gagan and Christus St. Vincent Regional Medical Center,” the suit also says. 
 
 “Defendants had notice of the existence that Plaintiff had signed the DNR. Plaintiff Sams was wearing a purple bracelet issued by the hospital and labeled ‘DNR.’ ” 
 
 Christus spokesman Arturo Delgado said Gagan works for HealthFront, which does emergency services work for the hospital. He said he could not comment on the lawsuit. 
 
 Sams is a Native American author who, among other titles on spirituality, co-wrote “Medicine Cards: The Discovery of Power Through the Ways of Animals.” 
 
 When the Catholic Christus Health System of Texas merged with what had been St. Vincent hospital in 2008, some concerns were expressed publicly about whether Catholic religious doctrine would impact patients’ end-of-life directives. 
 
 But there has been no public controversy at the Santa Fe hospital over the issue in the decade since and the Sams lawsuit makes no claim that any policy or religious doctrine had an impact on how Sams was treated. ||||| Doctors in Miami faced an unusual ethical dilemma when an unconscious, deteriorating patient was brought into the emergency room with the words “Do Not Resuscitate” across his chest. 
 
 The 70-year-old man was taken earlier this year to Jackson Memorial Hospital, where doctors made their startling discovery: a chest tattoo that seemed to convey the patient's end-of-life wishes. The word “Not” was underlined, and the tattoo included a signature. 
 
 It left the medical team grappling with myriad ethical and legal questions. 
 
 Was it an accurate representation of what the patient wanted? Was it legally sound? Should they honor it? 
 
 The case was detailed Thursday in the New England Journal of Medicine, in a report that laid out the medical team's struggle for answers. 
 
 “This patient’s tattooed DNR request produced more confusion than clarity, given concerns about its legality and likely unfounded beliefs that tattoos might represent permanent reminders of regretted decisions made while the person was intoxicated,” the paper's authors wrote. 
 
 Gregory Holt, a critical-care physician and lead author of the paper, said in an interview that “I think a lot of people in medicine have joked around about getting such a tattoo — and then when you finally see one, there's sort of this surprise and shock on your face. Then the shock hits you again because you actually have to think about it.” 
 
 [‘Damaged for the rest of my life’: Woman says surgeons mistakenly removed her breasts and uterus] 
 
 Holt said the patient, who had a history of pulmonary disease, lived at a nursing home but was found intoxicated and unconscious on the street and brought to Jackson Memorial. 
 
 He arrived with no identification, no family or friends, and no way to tell doctors whether he wanted to live or die. 
 
 Holt said the man had an infection that led to septic shock, which causes organ failure and extremely low blood pressure. 
 
 When his blood pressure started to drop, emergency room doctors called Holt, who specializes in pulmonary disease — and they first agreed not to honor the tattoo, “invoking the principle of not choosing an irreversible path when faced with uncertainty,” according to the case study. 
 
 They gave the man intravenous fluids, antibiotics and blood-pressure medication to buy themselves more time to make the life-or-death decision. 
 
 The medical team used a breathing mask on the man, Holt said, but struggled the most with the decision to hook him up to a machine that would breathe for him. 
 
 “We had a man I couldn't talk to,” Holt told The Washington Post, “and I really wanted to talk to him to see whether that tattoo truly reflected what he wanted for his end of life wishes.” 
 
 [Doctors thought a woman had cancer — but it was just a reaction to an old tattoo] 
 
 Doctors treating the elderly patient knew of “a cautionary tale” published in 2012 in the Journal of General Internal Medicine. That paper told of a 59-year-old patient who had a “D.N.R.” tattoo across his chest but said he wanted lifesaving measures to be taken, in the event that he needed them. 
 
 When the patient was asked why he had the tattoo, he told doctors he had “lost a bet playing poker,” according to the report. 
 
 When outside of hospitals, Florida requires do-not-resuscitate orders to be printed on yellow paper and signed by a physician and the patient, or a surrogate. But inside the hospitals, doctors can talk to a patient, or the patient's family and friends to determine what the end-of-life wishes are. 
 
 Since the patient was unconscious and doctors at Jackson Memorial had never seen a DNR tattoo, they called an ethics consultant to discuss the legal and ethical issues. 
 
 Holt said the consultant determined doctors could presume the tattoo was an accurate reflection of the patient's wishes. 
 
 According to the case study: 
 
 After reviewing the patient’s case, the ethics consultants advised us to honor the patient’s do not resuscitate (DNR) tattoo. They suggested that it was most reasonable to infer that the tattoo expressed an authentic preference, that what might be seen as caution could also be seen as standing on ceremony, and that the law is sometimes not nimble enough to support patient-centered care and respect for patients’ best interests. 
 
 In any case, social workers were later able to track down the man's proper DNR paperwork, leaving doctors relieved, Holt said. 
 
 The man, who was never publicly identified, died the next morning. 
 
 Arthur Caplan, a professor of bioethics and head of the division of medical ethics at the New York University School of Medicine, said there are no legal penalties for ignoring a tattoo that instructs medical personnel not to resuscitate. 
 
 On the other hand, he said, letting a patient die without the legal documents to back it up could pose a problem. 
 
 “The safer course is to do something,” he said. But, he added, he did not consider the doctors' decision risky because doctors routinely have to make difficult decisions in an instant. 
 
 Still, Caplan said a DNR tattoo is not a substitute for an advance health-care directive, or living will. 
 
 “A tattoo, I think, is best seen as a way to alert medical staff to your wishes or trigger an inquiry to family and friends and partners: ‘Is that what he meant?’” he said, adding that patients should keep the actual document in a pocket or wallet. “It’s useful to back up a living will or an advanced directive.” 
 
 Caplan said patients should also make sure their families and friends are aware of their wishes. If a family member or friend calls 911, he said, the emergency medical technicians are going to resuscitate the patient. 
 
 “If you trigger the emergency response system, I’m going to say it’s pretty darn likely you’re going to get resuscitated — I don’t care where your tattoo is,” Caplan said. 
 
 Holt, the doctor at Jackson Memorial, said his patient's tattoo seemed like a serious request, and doctors honored it. 
 
 “It also seemed that he didn't trust that his end-of-life wishes would be conveyed appropriately,” he said of the patient. “So, to me, it means we need a better system. 
 
 “We need a better system for people to be able to convey their wishes — if these are their wishes — so that we don't do things to them that they don't want, like in the throes of an emergency when a man like this comes into the emergency room unconscious.” 
 
 An earlier version of this story incorrectly suggested that Florida requires all do-not-resuscitate orders to be printed on yellow paper, both inside and outside of hospitals. The post has since been updated. 
 
 
 
 Read more: 
 
 Nurse removed from hospital after saying white boys ‘should be sacrificed to the wolves’ 
 
 The unforgettable moment a widow touched the face that once belonged to her husband
– Jamie Sams is alive, and she's suing over that fact. The Albuquerque Journal reports the New Mexico woman has sued Christus St. Vincent Regional Medical Center over what she alleges were two acts of negligence that occurred at the Santa Fe hospital in 2016. Per the suit, Sams went to the hospital's ER on Feb. 5 of that year to be treated for pain related to Dercum's disease, which she suffers from. Though she claims she advised the staff that she was allergic to the opioid Dilaudid, it was administered to her via IV in the first alleged act of negligence. Then came the second. Sams says she had an allergic reaction to the pain medication and went into cardiac arrest as a result. The staff resuscitated her even though she had signed a double Do Not Resuscitate form and "adamantly did not want" to be revived. (The Santa Fe New Mexican reports it's unclear what a "double DNR" refers to, but says it could indicate she had two directives in place, one via the hospital and one via her estate planner.) Further, "Plaintiff Sams was wearing a purple bracelet issued by the hospital and labeled 'DNR.'" The suit, which names Christus and an ER doctor as defendants, says she is forced to continue to live with "severe pain ... and limitations" and will bear significant medical costs for the rest of her life. (One man's DNR tattoo caused a great deal of confusion.)