FOR BRIANNE. FOR EVERY PATIENT.
The Issue
A Call for Medical Transparency, Meaningful Informed Consent & Patient Safety
I write this not only as Brianne's sister, but also on behalf of our mother and father. Brianne was their beloved daughter, my sister, and a Detroit police officer who devoted nine years of her life to serving and protecting others with courage and integrity.
When Brianne was diagnosed with metastatic cervical cancer, she fought with that same determination.
As walking became more difficult, she continued showing up for appointments. If she had to move, she did—even when that meant crawling.
Brianne trusted her healthcare team. She trusted that she was being given the information she needed to understand her condition, her treatment, and the choices in front of her.
She wanted to keep fighting. She wanted to return to outpatient treatment. She was still making plans for her future.
On September 18, 2025, Brianne passed away after two heartbreaking days of suffering. Only afterward did we discover that her physicians had documented serious warnings that might have changed the choices she made about her treatment and final days.
After her passing, I downloaded and reviewed her medical records.
What I found left our family asking a question no patient or family should ever have to ask:
WHY WEREN'T WE TOLD?
- WHAT WE FOUND AFTER BRIANNE PASSED
During Brianne's September hospitalization, physician notes documented serious concerns about her condition, prognosis, and ability to tolerate further aggressive treatment.
In a September 8, 2025, consultation, Dr. Douglas Pugmire documented that Brianne was "unlikely to tolerate" the proposed aggressive treatment "in its entirety."
He also wrote:
"Clearly this patient cannot be treated at this time and each day that passes will make hospice a more likely option."
The consultation identified hospice as another option and recommended considering systemic treatment once Brianne was stable enough.
These were significant concerns.
And they were not isolated.
Other physician documentation expressed concern about Brianne's ability to tolerate chemotherapy.
Her prognosis was described as "poor."
A progress note prepared by Dr. Kyle Gifford and electronically signed by Dr. Mazen Afram also documented that Brianne was "very lethargic," that an attempted transfer to another hospital had not been accepted by its oncology service, and that her prognosis was "poor."
We did not discover these documented concerns until after Brianne passed away, when I downloaded and reviewed her medical records.
We were continuously present with Brianne throughout her hospitalization. We listened to the conversations about her condition, treatment, and care. These were not minor details we would have forgotten. They were life-changing concerns about her prognosis, her ability to withstand treatment, and the choices available to her.
We did not hear these concerns meaningfully explained to Brianne.
We did not hear anyone tell her that physicians had documented serious doubts about her ability to tolerate aggressive treatment.
We did not hear anyone explain that her prognosis had been documented as poor.
We did not hear hospice presented to her as an option.
And we did not hear anyone ask Brianne whether she would consider hospice before a physician documented an expectation about what she and our father would accept.
Our family was there. We were listening. We would remember conversations of this magnitude.
If the medical records suggest these discussions occurred, we want to know precisely when they took place, who was present, what was explained, and how Brianne's understanding was established.
A statement written in a medical record is not the same as a conversation with a patient. And a physician's assumption about what a patient would accept is not a substitute for asking her.
Brianne deserved to know what her physicians were documenting about her condition while she was still able to participate in decisions about her own care.
A NOTE IN A CHART IS NOT A CONVERSATION.
- BRIANNE'S WISHES WERE DOCUMENTED. SO WAS HER POOR PROGNOSIS.
Brianne wanted to return to outpatient treatment.
This was not simply something she told our family. Her medical records documented that preference.
A September 12 progress note recorded Brianne's desire to attempt oral pain medication and outpatient chemotherapy and radiation.
Other documentation recorded that an attempted transfer to St. John was not accepted by oncology.
The September 12 discharge summary stated:
"patient requesting outpatient chemo plan"
It then documented a plan to transfer Brianne to Corewell Troy for one high-dose intravenous chemotherapy treatment with carboplatin and Taxol.
Brianne did not want to leave for another hospital. She wanted to return to outpatient treatment.
Our family was only told that Brianne needed to receive this one inpatient chemotherapy treatment before she could return to the outpatient care she wanted.
That was the future Brianne believed she was working toward.
But why was this inpatient chemotherapy necessary for her to return to outpatient treatment?
In the medical records we have reviewed, there is no clear explanation of why this particular inpatient treatment was required before Brianne could pursue the outpatient care she wanted. There is zero documentation.
And where was the follow-up plan?
We have identified documentation of the proposed inpatient chemotherapy and Brianne's request for outpatient care. There is no documented plan establishing how or when she would return to outpatient treatment afterward.
These questions become even more troubling alongside the concerns already documented about Brianne's treatment tolerance and poor prognosis. We did not hear those concerns meaningfully explained to her in the conversations we witnessed.
That leaves our family asking:
Was Brianne given a realistic explanation of what the proposed treatment could accomplish?
Was she told that her prognosis had been documented as poor?
Was she told that a physician had serious doubts about her ability to tolerate aggressive treatment?
Was she told that hospice was being considered as another option?
Was she given the opportunity to decide what mattered most to her with that information in hand?
Brianne wanted to fight.
That was her right.
But wanting to fight did not mean she should have been left unaware of significant information about her prognosis, treatment risks, and reasonable alternatives.
SHE HAD THE RIGHT TO FIGHT. SHE ALSO HAD THE RIGHT TO KNOW.
- THE SEPTEMBER 12 DISCHARGE RAISES QUESTIONS
September 12, 2025, was the day Brianne was transferred to another hospital for inpatient chemotherapy.
It was also the day she experienced a documented fall.
A physician's examination after that fall described her as sleepy and stated that she did not remember how she landed.
One part of the examination described her as pale, ill appearing, and sleepy but arousable, while another recorded her as fully oriented.
The discharge summary was prepared by Dr. Kyle Gifford and verified by Dr. Mazen Afram.
It described Brianne as lethargic and cachectic.
It listed pneumonia, pulmonary emboli, and thrombocytopenia among her discharge diagnoses.
Yet her discharge condition was recorded as "Stable."
A separate progress note electronically signed by Dr. Afram documented that Brianne was "very lethargic" and that her prognosis was "poor."
Sadly, a patient may be seriously ill yet considered stable enough for a particular transfer.
But these records raise questions about how Brianne's condition was assessed, particularly after her fall and before she left the hospital.
The discharge summary was verified at approximately 4:35 p.m.
Brianne departed at approximately 6:27 p.m.
In the records we have reviewed, there is no documentation showing that Dr. Afram personally reassessed Brianne immediately before her departure.
We are not claiming that the absence of a note proves no examination occurred.
We are asking:
Who assessed Brianne after her fall and before she left the hospital?
What findings supported the decision that she was stable enough for transfer?
How were her documented lethargy and other concerns communicated to the receiving team?
And how were the serious concerns about her prognosis and treatment tolerance explained to Brianne before she left?
These are questions about patient safety, communication, and informed decision-making.
They deserve answers.
- QUESTIONS ABOUT THE AMBULANCE TRANSFER
Brianne's September 12 ambulance Physician Certification Statement identified Dr. Mazen Afram as the attending physician.
The certification was completed by Sandra Schremser, RN, discharge planner.
The form documented weakness, lethargy, decreased core strength, and a need for ambulance transport.
It also checked:
- "Altered Mental Status"
- "Decreased level of consciousness"
- A requirement for cardiac monitoring during transport
The certification also listed a heparin infusion.
However, the sending hospital's medication administration records indicate that Brianne's heparin infusion had been stopped on September 10, two days before her transfer.
Following our family's inquiry into the ambulance transport, we also obtained information raising concerns about whether the cardiac monitoring identified on the certification was actually performed.
These discrepancies matter because accurate information and appropriate monitoring are essential when a seriously ill patient is transferred between hospitals.
We want to know:
Who verified Brianne's current medications before she left?
Who determined what monitoring she required during transport?
Was that monitoring provided?
Who assessed and documented her mental status before departure?
And what information was communicated to the receiving hospital?
The certification establishes what was recorded as necessary for ambulance transport.
IT DOES NOT, BY ITSELF, ESTABLISH WHO PERSONALLY EXAMINED BRIANNE OR WHETHER SHE WAS MEDICALLY READY FOR CHEMOTHERAPY.
That is why we are asking for a transparent review.
PATIENT SAFETY SHOULD NEVER GET LOST BETWEEN HOSPITALS.
- QUESTIONS ABOUT PNEUMONIA, INFECTION, AND TREATMENT READINESS
Brianne's respiratory symptoms and possible infection were not concerns that appeared only after her transfer.
Her September 7–8 emergency department record listed pneumonia among her diagnoses.
It documented administration of intravenous azithromycin for pneumonia on September 8.
Her chest imaging also described lung findings that could represent infection or cancer, including airway changes but it was more concerning for an infectious process.
The September 12 discharge summary continued to list pneumonia among her diagnoses.
Brianne's medical condition was complicated by other serious problems.
Her records documented pulmonary emboli, extensive blood clots, compression of major blood vessels by tumor-related disease, anemia, low platelet counts, weakness, and concerns about her ability to tolerate treatment.
Her records also contained abnormal laboratory findings that required appropriate clinical interpretation and management.
BUT WHAT HAPPENED WHEN BRIANNE ARRIVED AT THE RECEIVING HOSPITAL?
On September 12, PA-C Alexandra Dallo documented that Brianne reported a cough, nasal congestion, and sore throat.
Her note stated that Brianne had previously received Rocephin and azithromycin at the sending hospital.
However, according to the medication history our family has reviewed, the Rocephin treatment referenced in her records dated back to July, while azithromycin was administered in connection with her September 8 presentation.
That raises an important question: Were Brianne's actual medication administration dates verified, or was historical treatment information being carried forward without clarification?
Alexandra's note documented a discussion with Dr. Savitha Kadakol and a plan to monitor Brianne without antibiotics.
It also stated that a repeat chest X-ray or viral swab was not needed at that time.
A September 12 nursing note documented that Brianne arrived without orders in the system and that Dr. Kadakol was contacted by telephone, with orders received at approximately 10:15 p.m.
But our concerns go beyond the medication history.
In the medical records we have reviewed, we have identified multiple entries through September 14 indicating that outside records or imaging had not been reviewed or were unavailable for review.
We are asking exactly what information the receiving physicians had obtained and reviewed before deciding that Brianne was ready for chemotherapy.
If Brianne's previous records and imaging had not been fully reviewed, how was her documented pneumonia, prior antibiotic treatment, and overall medical condition evaluated?
How were the findings from the sending hospital communicated to the receiving team?
Who verified when her antibiotics had actually been administered?
What information supported the decision to monitor her without antibiotics or repeat chest imaging?
And when did Dr. Kadakol first personally examine Brianne before chemotherapy was administered on September 15?
A physician had previously recommended considering systemic treatment once Brianne became stable enough.
What changed between that assessment and the decision to proceed with aggressive treatment?
What criteria were used to determine that she could tolerate the proposed chemotherapy?
How were her respiratory symptoms, laboratory findings, and overall condition reassessed?
And what did Brianne understand about the risks?
AFTER HER TRANSFER, BRIANNE RECEIVED CHEMOTHERAPY ON SEPTEMBER 15 AND LATER DETERIORATED RAPIDLY.
Subsequent testing identified pneumonia and a serious MSSA bloodstream infection.
We recognize that the medical records alone do not establish exactly when Brianne's bloodstream infection began or whether a particular treatment decision caused her deterioration.
But what we cannot ignore is that Brianne left one hospital with pneumonia documented among her diagnoses, continued reporting respiratory symptoms after her transfer, and later suffered a devastating decline in which worsening pneumonia was among her serious medical complications.
Her respiratory symptoms and possible infection were documented before chemotherapy.
Was her pneumonia improving, worsening, or still unresolved when treatment was administered?
And what medical findings supported the decision that she was ready to proceed?
These are not questions our family should have to piece together from medical records after Brianne's death.
We are asking whether the receiving team had the information it needed, whether that information was accurately reviewed and verified, and whether Brianne's known medical concerns were appropriately evaluated before she received high-risk treatment.
Those questions deserve a thorough and transparent review.
- QUESTIONS ABOUT INFORMED CONSENT
Brianne's records documented neurological and cognitive concerns during this period.
The September 12 ambulance certification checked altered mental status and decreased level of consciousness.
Our family also witnessed episodes of confusion and hallucinations during her illness.
These findings do not automatically mean Brianne lacked the capacity to make her own decisions.
But they raise an important question:
What safeguards should exist when a patient is being asked to make a high-stakes medical decision while there are documented concerns about their ability to understand or fully participate in that decision?
Meaningful informed consent should be more than obtaining a signature.
Patients deserve understandable information about significant risks, expected benefits, reasonable alternatives, prognosis when relevant, and serious concerns that could affect their decision.
When a patient's ability to understand or participate is in question, appropriate assessment and safeguards should exist.
And when significant concerns are documented, there should be a meaningful way to establish whether those concerns were actually discussed with the patient or authorized decision-maker.
A SIGNATURE SHOULD NEVER REPLACE AN INFORMED CONVERSATION.
- WHEN HOSPICE ENTERED THE CONVERSATION
What our family later discovered in Brianne's medical records was devastating.
Dr. Pugmire's September 8 consultation identified hospice as another option and documented an expectation that Brianne and our father would be unlikely to accept that outcome.
What troubles us so deeply is not simply that hospice was mentioned.
It is that a physician documented an expectation about what Brianne and our father would accept.
Was that expectation based on a conversation with Brianne?
Our family was continuously present with her. We did not witness a conversation presenting hospice to Brianne as an option, and hospice was not discussed with our family during that hospitalization.
This is especially painful because hospice was one of Brianne's greatest fears.
She deserved the opportunity to know that it was being considered, to ask questions, to understand why, and to participate in decisions about what she wanted for her own care.
Discussing hospice would not have required Brianne to choose it.
She could have decided to continue pursuing treatment.
She could have asked for more information.
She could have considered what mattered most to her if time was becoming limited.
But those choices should have belonged to Brianne—not been assumed for her in a medical record.
Our family did not learn that hospice had already been documented as a consideration until after Brianne died and I reviewed her medical records.
Hospice was finally introduced to our family only when Brianne was critically ill and dependent on breathing support.
Hospice paperwork was completed.
Brianne should have had the opportunity to hear that information herself, ask questions, understand her options, and make her own informed choices.
- SEPTEMBER 18, 2025 — THE CHOICE BRIANNE DESERVED
No parents should have to hold their daughter's hand as the breathing support keeping her alive is removed. No sister should have to stand beside them and watch her take her final breaths.
But that was our reality. And it is a moment that will haunt our family forever.
Brianne was critically ill. Her records documented acute respiratory failure, septic shock, and an MSSA bloodstream infection, with serious lung disease and pneumonia among the concerns surrounding her deterioration.
I never imagined I would have to say goodbye to my sister that way.
What makes that day even more painful is what we learned only after she was gone.
Days earlier, physicians had documented concerns about her ability to tolerate aggressive treatment, described her prognosis as poor, and identified hospice as another option.
Yet Brianne was still trying to get back to outpatient treatment.
She was still thinking about her future.
She was making decisions based on the information she understood.
Brianne deserved to know the serious concerns documented by her physicians before deciding what came next.
Maybe she would have chosen to continue aggressive treatment.
Maybe she would have chosen to spend her remaining time differently.
Maybe she would have wanted different conversations with the people she loved.
We will never know.
That choice belonged to Brianne.
No family should have to discover after a loved one's death that information relevant to their treatment choices and remaining time had been documented but not meaningfully communicated.
EVERY PATIENT DESERVES THE RIGHT TO KNOW AND TO CHOOSE.
- BRIANNE WAS STILL PLANNING FOR A FUTURE
This wasn't an abstract medical decision to Brianne.
She was still thinking about tomorrow.
On September 10 and 11, 2025, while hospitalized, Brianne was ordering things from Amazon.
Some of those packages arrived after she died.
She was also planning a trip to Miami in April 2026.
After Brianne repeatedly encouraged our father to finally do something for himself, he bought a car.
They were supposed to drive it together after she finished treatment.
Brianne never got to see the car. Instead, it was parked outside her service.
These were plans Brianne was actively making while her physicians were documenting a poor prognosis, serious concerns about her ability to tolerate aggressive treatment, and hospice as a possible alternative.
Brianne was told that she needed to receive one inpatient chemotherapy treatment before returning to outpatient care. She was still planning her life around that understanding.
The Amazon packages that arrived after her death are a painful reminder of the future she was still expecting.
Medical information doesn't exist only in a chart.
It can affect what patients believe about tomorrow, what treatments they choose, what conversations they have with the people they love, how they spend their time, and what decisions they make about their own lives.
THE PATIENT SHOULD NEVER BE THE LAST TO KNOW.
- THIS IS WHERE BRIANNE'S STORY BECOMES EVERY PATIENT'S STORY
I cannot change what happened to my sister.
I cannot know what Brianne would have chosen if she had been given different information or had different conversations about her condition and options.
But I can ask what we should learn from her experience.
Because this is not only about cancer.
It is not only about chemotherapy.
It is not about one doctor, one hospital, one healthcare system, one diagnosis, or one medical specialty.
IT IS ABOUT EVERY PATIENT.
The patient considering surgery.
The patient starting a new medication.
The patient facing a serious diagnosis.
The patient deciding whether to continue aggressive treatment.
The patient weighing the risks and benefits of a procedure.
The patient whose condition is deteriorating.
The patient whose medical record contains information they have never heard.
The patient being transferred between healthcare facilities.
The patient considering palliative care or hospice.
The family trying to make decisions for someone who can no longer speak for themselves.
Whether the patient is facing cancer, heart disease, surgery, infection, chronic illness, pregnancy, mental-health treatment, emergency care, or any other medical condition, the principle is the same:
PATIENTS DESERVE THE INFORMATION THEY NEED TO MAKE INFORMED DECISIONS ABOUT THEIR OWN CARE.
Brianne is why this began. Every patient is why it matters.
- WHAT WE WANT TO CHANGE
We are calling for stronger patient protections centered on transparency, communication, meaningful informed consent, accurate medical records, safe transitions of care, and accountability.
We believe patients deserve:
1. SIGNIFICANT CLINICAL CONCERNS TO BE COMMUNICATED
When healthcare professionals have significant information that could materially affect a patient's decision about their care, that information should be meaningfully communicated to the patient before a decision is made, except when circumstances make such communication impossible.
2. INFORMED CONSENT THAT MEANS MORE THAN A SIGNATURE
Patients should receive understandable information about significant risks, expected benefits, reasonable alternatives, and the consequences of declining or delaying care when applicable.
3. SAFEGUARDS WHEN DECISION-MAKING CAPACITY IS IN QUESTION
When significant confusion, altered mental status, or other substantial concerns about a patient's ability to understand a decision are present, appropriate assessment and safeguards should occur before consent is obtained for high-risk, non-emergency treatment.
4. SERIOUS CONCERNS ABOUT A PATIENT'S ABILITY TO TOLERATE TREATMENT TO BE DISCUSSED
If a healthcare professional has serious concerns about whether a patient can tolerate a proposed medication, treatment, procedure, surgery, or other intervention, the patient should be part of that conversation whenever reasonably possible.
5. PROGNOSIS TO BE COMMUNICATED HONESTLY AND COMPASSIONATELY WHEN RELEVANT
Patients deserve information necessary to understand the seriousness of their condition and make decisions consistent with their own values and wishes.
6. REASONABLE ALTERNATIVES AND SUPPORTIVE-CARE OPTIONS TO BE DISCUSSED
Patients should be told about reasonable alternatives relevant to their decision.
When palliative care or hospice becomes clinically relevant, patients and families should have a meaningful opportunity to understand those options before a crisis whenever reasonably possible.
7. PATIENT-SAFETY CONCERNS TO BE APPROPRIATELY EVALUATED BEFORE HIGH-RISK TREATMENT
When significant symptoms, abnormal laboratory findings, or other medical concerns could affect the safety of a proposed treatment, patients deserve appropriate evaluation and understandable information about how those concerns could affect the risks of proceeding.
8. STRONGER CONTINUITY OF CARE BETWEEN HEALTHCARE FACILITIES
Important clinical concerns, significant recent findings, pending issues, current and discontinued medication information, relevant imaging, and other information necessary for safe continuity of care should follow patients when their care moves between hospitals, facilities, and healthcare systems.
9. TIMELY ACCESS TO IMPORTANT MEDICAL INFORMATION
Patients should have timely access to significant consultation notes, test results, treatment recommendations, and other information concerning their care, consistent with applicable laws and appropriate clinical processes.
10. IMPORTANT CONVERSATIONS TO BE DOCUMENTED
Healthcare institutions should distinguish, when appropriate, between information being documented in a medical record and significant information actually being communicated to the patient or authorized decision-maker.
11. SERIOUS CHANGES IN A PATIENT'S CONDITION TO RECEIVE APPROPRIATE ATTENTION
Significant deterioration—including acute confusion, hallucinations, changes in consciousness, breathing difficulties, or other serious changes—should receive appropriate evaluation and escalation.
12. PATIENTS AND FAMILIES TO HAVE A MEANINGFUL AVENUE FOR REVIEW
When patients or families believe critical information was not disclosed, informed consent was inadequate, transfer documentation was inaccurate, or serious patient-safety concerns were not appropriately addressed, they should have access to a transparent process for review and accountability.
- WHAT WE ARE REALLY ASKING FOR
We are not asking patients to become doctors.
We are not asking families to interpret every test result or understand every page of a medical record.
And we are not asking healthcare professionals to predict the future with certainty.
We are asking for something much more fundamental:
Tell patients what they reasonably need to know to participate meaningfully in decisions about their own bodies and lives.
A medical record should support communication with a patient—not become the place where a patient or family first discovers information that could have mattered to a life-changing decision.
A signature should not substitute for a conversation.
A patient should never have to discover afterward that significant concerns were documented but were not meaningfully communicated to them.
A patient's wishes should not be assumed without giving that patient an opportunity to understand and discuss the options.
And when patients move between healthcare facilities, their medical information should be accurate, their changing condition should receive appropriate attention, and necessary safety measures should not be overlooked.
We are not asking the public to determine medical or legal fault based solely on our family's account.
We are asking for transparency, meaningful answers, and stronger protections so that patients can make informed decisions about their own care.
DOCUMENTED IS NOT THE SAME AS DISCLOSED.
- BRIANNE'S LEGACY
Brianne spent nine years serving and protecting her community as a Detroit police officer.
She spent her career standing up for other people.
Our hope is that by telling her story, she can continue protecting others in a different way.
I cannot bring my sister back.
But if sharing her story helps another patient receive information they otherwise might not have heard, ask a question they otherwise might not have asked, or make a decision that truly reflects their wishes, then Brianne's legacy will continue protecting people.
She spent her life protecting others. Now let her legacy help protect patients.
- PLEASE SIGN AND SHARE
Please sign this petition if you believe patients deserve medical transparency, meaningful informed consent, honest communication, accurate medical records, safe transitions of care, and a meaningful voice in decisions about their own healthcare.
Share Brianne's story.
Talk about patient rights.
Ask questions.
Read your medical records.
Advocate for the people you love.
And help us make one principle impossible to ignore:
IF INFORMATION COULD CHANGE A PATIENT'S DECISION, THE PATIENT DESERVES TO KNOW.
THE PATIENT SHOULD NEVER BE THE LAST TO KNOW.
FOR BRIANNE. FOR EVERY PATIENT.
1,037
The Issue
A Call for Medical Transparency, Meaningful Informed Consent & Patient Safety
I write this not only as Brianne's sister, but also on behalf of our mother and father. Brianne was their beloved daughter, my sister, and a Detroit police officer who devoted nine years of her life to serving and protecting others with courage and integrity.
When Brianne was diagnosed with metastatic cervical cancer, she fought with that same determination.
As walking became more difficult, she continued showing up for appointments. If she had to move, she did—even when that meant crawling.
Brianne trusted her healthcare team. She trusted that she was being given the information she needed to understand her condition, her treatment, and the choices in front of her.
She wanted to keep fighting. She wanted to return to outpatient treatment. She was still making plans for her future.
On September 18, 2025, Brianne passed away after two heartbreaking days of suffering. Only afterward did we discover that her physicians had documented serious warnings that might have changed the choices she made about her treatment and final days.
After her passing, I downloaded and reviewed her medical records.
What I found left our family asking a question no patient or family should ever have to ask:
WHY WEREN'T WE TOLD?
- WHAT WE FOUND AFTER BRIANNE PASSED
During Brianne's September hospitalization, physician notes documented serious concerns about her condition, prognosis, and ability to tolerate further aggressive treatment.
In a September 8, 2025, consultation, Dr. Douglas Pugmire documented that Brianne was "unlikely to tolerate" the proposed aggressive treatment "in its entirety."
He also wrote:
"Clearly this patient cannot be treated at this time and each day that passes will make hospice a more likely option."
The consultation identified hospice as another option and recommended considering systemic treatment once Brianne was stable enough.
These were significant concerns.
And they were not isolated.
Other physician documentation expressed concern about Brianne's ability to tolerate chemotherapy.
Her prognosis was described as "poor."
A progress note prepared by Dr. Kyle Gifford and electronically signed by Dr. Mazen Afram also documented that Brianne was "very lethargic," that an attempted transfer to another hospital had not been accepted by its oncology service, and that her prognosis was "poor."
We did not discover these documented concerns until after Brianne passed away, when I downloaded and reviewed her medical records.
We were continuously present with Brianne throughout her hospitalization. We listened to the conversations about her condition, treatment, and care. These were not minor details we would have forgotten. They were life-changing concerns about her prognosis, her ability to withstand treatment, and the choices available to her.
We did not hear these concerns meaningfully explained to Brianne.
We did not hear anyone tell her that physicians had documented serious doubts about her ability to tolerate aggressive treatment.
We did not hear anyone explain that her prognosis had been documented as poor.
We did not hear hospice presented to her as an option.
And we did not hear anyone ask Brianne whether she would consider hospice before a physician documented an expectation about what she and our father would accept.
Our family was there. We were listening. We would remember conversations of this magnitude.
If the medical records suggest these discussions occurred, we want to know precisely when they took place, who was present, what was explained, and how Brianne's understanding was established.
A statement written in a medical record is not the same as a conversation with a patient. And a physician's assumption about what a patient would accept is not a substitute for asking her.
Brianne deserved to know what her physicians were documenting about her condition while she was still able to participate in decisions about her own care.
A NOTE IN A CHART IS NOT A CONVERSATION.
- BRIANNE'S WISHES WERE DOCUMENTED. SO WAS HER POOR PROGNOSIS.
Brianne wanted to return to outpatient treatment.
This was not simply something she told our family. Her medical records documented that preference.
A September 12 progress note recorded Brianne's desire to attempt oral pain medication and outpatient chemotherapy and radiation.
Other documentation recorded that an attempted transfer to St. John was not accepted by oncology.
The September 12 discharge summary stated:
"patient requesting outpatient chemo plan"
It then documented a plan to transfer Brianne to Corewell Troy for one high-dose intravenous chemotherapy treatment with carboplatin and Taxol.
Brianne did not want to leave for another hospital. She wanted to return to outpatient treatment.
Our family was only told that Brianne needed to receive this one inpatient chemotherapy treatment before she could return to the outpatient care she wanted.
That was the future Brianne believed she was working toward.
But why was this inpatient chemotherapy necessary for her to return to outpatient treatment?
In the medical records we have reviewed, there is no clear explanation of why this particular inpatient treatment was required before Brianne could pursue the outpatient care she wanted. There is zero documentation.
And where was the follow-up plan?
We have identified documentation of the proposed inpatient chemotherapy and Brianne's request for outpatient care. There is no documented plan establishing how or when she would return to outpatient treatment afterward.
These questions become even more troubling alongside the concerns already documented about Brianne's treatment tolerance and poor prognosis. We did not hear those concerns meaningfully explained to her in the conversations we witnessed.
That leaves our family asking:
Was Brianne given a realistic explanation of what the proposed treatment could accomplish?
Was she told that her prognosis had been documented as poor?
Was she told that a physician had serious doubts about her ability to tolerate aggressive treatment?
Was she told that hospice was being considered as another option?
Was she given the opportunity to decide what mattered most to her with that information in hand?
Brianne wanted to fight.
That was her right.
But wanting to fight did not mean she should have been left unaware of significant information about her prognosis, treatment risks, and reasonable alternatives.
SHE HAD THE RIGHT TO FIGHT. SHE ALSO HAD THE RIGHT TO KNOW.
- THE SEPTEMBER 12 DISCHARGE RAISES QUESTIONS
September 12, 2025, was the day Brianne was transferred to another hospital for inpatient chemotherapy.
It was also the day she experienced a documented fall.
A physician's examination after that fall described her as sleepy and stated that she did not remember how she landed.
One part of the examination described her as pale, ill appearing, and sleepy but arousable, while another recorded her as fully oriented.
The discharge summary was prepared by Dr. Kyle Gifford and verified by Dr. Mazen Afram.
It described Brianne as lethargic and cachectic.
It listed pneumonia, pulmonary emboli, and thrombocytopenia among her discharge diagnoses.
Yet her discharge condition was recorded as "Stable."
A separate progress note electronically signed by Dr. Afram documented that Brianne was "very lethargic" and that her prognosis was "poor."
Sadly, a patient may be seriously ill yet considered stable enough for a particular transfer.
But these records raise questions about how Brianne's condition was assessed, particularly after her fall and before she left the hospital.
The discharge summary was verified at approximately 4:35 p.m.
Brianne departed at approximately 6:27 p.m.
In the records we have reviewed, there is no documentation showing that Dr. Afram personally reassessed Brianne immediately before her departure.
We are not claiming that the absence of a note proves no examination occurred.
We are asking:
Who assessed Brianne after her fall and before she left the hospital?
What findings supported the decision that she was stable enough for transfer?
How were her documented lethargy and other concerns communicated to the receiving team?
And how were the serious concerns about her prognosis and treatment tolerance explained to Brianne before she left?
These are questions about patient safety, communication, and informed decision-making.
They deserve answers.
- QUESTIONS ABOUT THE AMBULANCE TRANSFER
Brianne's September 12 ambulance Physician Certification Statement identified Dr. Mazen Afram as the attending physician.
The certification was completed by Sandra Schremser, RN, discharge planner.
The form documented weakness, lethargy, decreased core strength, and a need for ambulance transport.
It also checked:
- "Altered Mental Status"
- "Decreased level of consciousness"
- A requirement for cardiac monitoring during transport
The certification also listed a heparin infusion.
However, the sending hospital's medication administration records indicate that Brianne's heparin infusion had been stopped on September 10, two days before her transfer.
Following our family's inquiry into the ambulance transport, we also obtained information raising concerns about whether the cardiac monitoring identified on the certification was actually performed.
These discrepancies matter because accurate information and appropriate monitoring are essential when a seriously ill patient is transferred between hospitals.
We want to know:
Who verified Brianne's current medications before she left?
Who determined what monitoring she required during transport?
Was that monitoring provided?
Who assessed and documented her mental status before departure?
And what information was communicated to the receiving hospital?
The certification establishes what was recorded as necessary for ambulance transport.
IT DOES NOT, BY ITSELF, ESTABLISH WHO PERSONALLY EXAMINED BRIANNE OR WHETHER SHE WAS MEDICALLY READY FOR CHEMOTHERAPY.
That is why we are asking for a transparent review.
PATIENT SAFETY SHOULD NEVER GET LOST BETWEEN HOSPITALS.
- QUESTIONS ABOUT PNEUMONIA, INFECTION, AND TREATMENT READINESS
Brianne's respiratory symptoms and possible infection were not concerns that appeared only after her transfer.
Her September 7–8 emergency department record listed pneumonia among her diagnoses.
It documented administration of intravenous azithromycin for pneumonia on September 8.
Her chest imaging also described lung findings that could represent infection or cancer, including airway changes but it was more concerning for an infectious process.
The September 12 discharge summary continued to list pneumonia among her diagnoses.
Brianne's medical condition was complicated by other serious problems.
Her records documented pulmonary emboli, extensive blood clots, compression of major blood vessels by tumor-related disease, anemia, low platelet counts, weakness, and concerns about her ability to tolerate treatment.
Her records also contained abnormal laboratory findings that required appropriate clinical interpretation and management.
BUT WHAT HAPPENED WHEN BRIANNE ARRIVED AT THE RECEIVING HOSPITAL?
On September 12, PA-C Alexandra Dallo documented that Brianne reported a cough, nasal congestion, and sore throat.
Her note stated that Brianne had previously received Rocephin and azithromycin at the sending hospital.
However, according to the medication history our family has reviewed, the Rocephin treatment referenced in her records dated back to July, while azithromycin was administered in connection with her September 8 presentation.
That raises an important question: Were Brianne's actual medication administration dates verified, or was historical treatment information being carried forward without clarification?
Alexandra's note documented a discussion with Dr. Savitha Kadakol and a plan to monitor Brianne without antibiotics.
It also stated that a repeat chest X-ray or viral swab was not needed at that time.
A September 12 nursing note documented that Brianne arrived without orders in the system and that Dr. Kadakol was contacted by telephone, with orders received at approximately 10:15 p.m.
But our concerns go beyond the medication history.
In the medical records we have reviewed, we have identified multiple entries through September 14 indicating that outside records or imaging had not been reviewed or were unavailable for review.
We are asking exactly what information the receiving physicians had obtained and reviewed before deciding that Brianne was ready for chemotherapy.
If Brianne's previous records and imaging had not been fully reviewed, how was her documented pneumonia, prior antibiotic treatment, and overall medical condition evaluated?
How were the findings from the sending hospital communicated to the receiving team?
Who verified when her antibiotics had actually been administered?
What information supported the decision to monitor her without antibiotics or repeat chest imaging?
And when did Dr. Kadakol first personally examine Brianne before chemotherapy was administered on September 15?
A physician had previously recommended considering systemic treatment once Brianne became stable enough.
What changed between that assessment and the decision to proceed with aggressive treatment?
What criteria were used to determine that she could tolerate the proposed chemotherapy?
How were her respiratory symptoms, laboratory findings, and overall condition reassessed?
And what did Brianne understand about the risks?
AFTER HER TRANSFER, BRIANNE RECEIVED CHEMOTHERAPY ON SEPTEMBER 15 AND LATER DETERIORATED RAPIDLY.
Subsequent testing identified pneumonia and a serious MSSA bloodstream infection.
We recognize that the medical records alone do not establish exactly when Brianne's bloodstream infection began or whether a particular treatment decision caused her deterioration.
But what we cannot ignore is that Brianne left one hospital with pneumonia documented among her diagnoses, continued reporting respiratory symptoms after her transfer, and later suffered a devastating decline in which worsening pneumonia was among her serious medical complications.
Her respiratory symptoms and possible infection were documented before chemotherapy.
Was her pneumonia improving, worsening, or still unresolved when treatment was administered?
And what medical findings supported the decision that she was ready to proceed?
These are not questions our family should have to piece together from medical records after Brianne's death.
We are asking whether the receiving team had the information it needed, whether that information was accurately reviewed and verified, and whether Brianne's known medical concerns were appropriately evaluated before she received high-risk treatment.
Those questions deserve a thorough and transparent review.
- QUESTIONS ABOUT INFORMED CONSENT
Brianne's records documented neurological and cognitive concerns during this period.
The September 12 ambulance certification checked altered mental status and decreased level of consciousness.
Our family also witnessed episodes of confusion and hallucinations during her illness.
These findings do not automatically mean Brianne lacked the capacity to make her own decisions.
But they raise an important question:
What safeguards should exist when a patient is being asked to make a high-stakes medical decision while there are documented concerns about their ability to understand or fully participate in that decision?
Meaningful informed consent should be more than obtaining a signature.
Patients deserve understandable information about significant risks, expected benefits, reasonable alternatives, prognosis when relevant, and serious concerns that could affect their decision.
When a patient's ability to understand or participate is in question, appropriate assessment and safeguards should exist.
And when significant concerns are documented, there should be a meaningful way to establish whether those concerns were actually discussed with the patient or authorized decision-maker.
A SIGNATURE SHOULD NEVER REPLACE AN INFORMED CONVERSATION.
- WHEN HOSPICE ENTERED THE CONVERSATION
What our family later discovered in Brianne's medical records was devastating.
Dr. Pugmire's September 8 consultation identified hospice as another option and documented an expectation that Brianne and our father would be unlikely to accept that outcome.
What troubles us so deeply is not simply that hospice was mentioned.
It is that a physician documented an expectation about what Brianne and our father would accept.
Was that expectation based on a conversation with Brianne?
Our family was continuously present with her. We did not witness a conversation presenting hospice to Brianne as an option, and hospice was not discussed with our family during that hospitalization.
This is especially painful because hospice was one of Brianne's greatest fears.
She deserved the opportunity to know that it was being considered, to ask questions, to understand why, and to participate in decisions about what she wanted for her own care.
Discussing hospice would not have required Brianne to choose it.
She could have decided to continue pursuing treatment.
She could have asked for more information.
She could have considered what mattered most to her if time was becoming limited.
But those choices should have belonged to Brianne—not been assumed for her in a medical record.
Our family did not learn that hospice had already been documented as a consideration until after Brianne died and I reviewed her medical records.
Hospice was finally introduced to our family only when Brianne was critically ill and dependent on breathing support.
Hospice paperwork was completed.
Brianne should have had the opportunity to hear that information herself, ask questions, understand her options, and make her own informed choices.
- SEPTEMBER 18, 2025 — THE CHOICE BRIANNE DESERVED
No parents should have to hold their daughter's hand as the breathing support keeping her alive is removed. No sister should have to stand beside them and watch her take her final breaths.
But that was our reality. And it is a moment that will haunt our family forever.
Brianne was critically ill. Her records documented acute respiratory failure, septic shock, and an MSSA bloodstream infection, with serious lung disease and pneumonia among the concerns surrounding her deterioration.
I never imagined I would have to say goodbye to my sister that way.
What makes that day even more painful is what we learned only after she was gone.
Days earlier, physicians had documented concerns about her ability to tolerate aggressive treatment, described her prognosis as poor, and identified hospice as another option.
Yet Brianne was still trying to get back to outpatient treatment.
She was still thinking about her future.
She was making decisions based on the information she understood.
Brianne deserved to know the serious concerns documented by her physicians before deciding what came next.
Maybe she would have chosen to continue aggressive treatment.
Maybe she would have chosen to spend her remaining time differently.
Maybe she would have wanted different conversations with the people she loved.
We will never know.
That choice belonged to Brianne.
No family should have to discover after a loved one's death that information relevant to their treatment choices and remaining time had been documented but not meaningfully communicated.
EVERY PATIENT DESERVES THE RIGHT TO KNOW AND TO CHOOSE.
- BRIANNE WAS STILL PLANNING FOR A FUTURE
This wasn't an abstract medical decision to Brianne.
She was still thinking about tomorrow.
On September 10 and 11, 2025, while hospitalized, Brianne was ordering things from Amazon.
Some of those packages arrived after she died.
She was also planning a trip to Miami in April 2026.
After Brianne repeatedly encouraged our father to finally do something for himself, he bought a car.
They were supposed to drive it together after she finished treatment.
Brianne never got to see the car. Instead, it was parked outside her service.
These were plans Brianne was actively making while her physicians were documenting a poor prognosis, serious concerns about her ability to tolerate aggressive treatment, and hospice as a possible alternative.
Brianne was told that she needed to receive one inpatient chemotherapy treatment before returning to outpatient care. She was still planning her life around that understanding.
The Amazon packages that arrived after her death are a painful reminder of the future she was still expecting.
Medical information doesn't exist only in a chart.
It can affect what patients believe about tomorrow, what treatments they choose, what conversations they have with the people they love, how they spend their time, and what decisions they make about their own lives.
THE PATIENT SHOULD NEVER BE THE LAST TO KNOW.
- THIS IS WHERE BRIANNE'S STORY BECOMES EVERY PATIENT'S STORY
I cannot change what happened to my sister.
I cannot know what Brianne would have chosen if she had been given different information or had different conversations about her condition and options.
But I can ask what we should learn from her experience.
Because this is not only about cancer.
It is not only about chemotherapy.
It is not about one doctor, one hospital, one healthcare system, one diagnosis, or one medical specialty.
IT IS ABOUT EVERY PATIENT.
The patient considering surgery.
The patient starting a new medication.
The patient facing a serious diagnosis.
The patient deciding whether to continue aggressive treatment.
The patient weighing the risks and benefits of a procedure.
The patient whose condition is deteriorating.
The patient whose medical record contains information they have never heard.
The patient being transferred between healthcare facilities.
The patient considering palliative care or hospice.
The family trying to make decisions for someone who can no longer speak for themselves.
Whether the patient is facing cancer, heart disease, surgery, infection, chronic illness, pregnancy, mental-health treatment, emergency care, or any other medical condition, the principle is the same:
PATIENTS DESERVE THE INFORMATION THEY NEED TO MAKE INFORMED DECISIONS ABOUT THEIR OWN CARE.
Brianne is why this began. Every patient is why it matters.
- WHAT WE WANT TO CHANGE
We are calling for stronger patient protections centered on transparency, communication, meaningful informed consent, accurate medical records, safe transitions of care, and accountability.
We believe patients deserve:
1. SIGNIFICANT CLINICAL CONCERNS TO BE COMMUNICATED
When healthcare professionals have significant information that could materially affect a patient's decision about their care, that information should be meaningfully communicated to the patient before a decision is made, except when circumstances make such communication impossible.
2. INFORMED CONSENT THAT MEANS MORE THAN A SIGNATURE
Patients should receive understandable information about significant risks, expected benefits, reasonable alternatives, and the consequences of declining or delaying care when applicable.
3. SAFEGUARDS WHEN DECISION-MAKING CAPACITY IS IN QUESTION
When significant confusion, altered mental status, or other substantial concerns about a patient's ability to understand a decision are present, appropriate assessment and safeguards should occur before consent is obtained for high-risk, non-emergency treatment.
4. SERIOUS CONCERNS ABOUT A PATIENT'S ABILITY TO TOLERATE TREATMENT TO BE DISCUSSED
If a healthcare professional has serious concerns about whether a patient can tolerate a proposed medication, treatment, procedure, surgery, or other intervention, the patient should be part of that conversation whenever reasonably possible.
5. PROGNOSIS TO BE COMMUNICATED HONESTLY AND COMPASSIONATELY WHEN RELEVANT
Patients deserve information necessary to understand the seriousness of their condition and make decisions consistent with their own values and wishes.
6. REASONABLE ALTERNATIVES AND SUPPORTIVE-CARE OPTIONS TO BE DISCUSSED
Patients should be told about reasonable alternatives relevant to their decision.
When palliative care or hospice becomes clinically relevant, patients and families should have a meaningful opportunity to understand those options before a crisis whenever reasonably possible.
7. PATIENT-SAFETY CONCERNS TO BE APPROPRIATELY EVALUATED BEFORE HIGH-RISK TREATMENT
When significant symptoms, abnormal laboratory findings, or other medical concerns could affect the safety of a proposed treatment, patients deserve appropriate evaluation and understandable information about how those concerns could affect the risks of proceeding.
8. STRONGER CONTINUITY OF CARE BETWEEN HEALTHCARE FACILITIES
Important clinical concerns, significant recent findings, pending issues, current and discontinued medication information, relevant imaging, and other information necessary for safe continuity of care should follow patients when their care moves between hospitals, facilities, and healthcare systems.
9. TIMELY ACCESS TO IMPORTANT MEDICAL INFORMATION
Patients should have timely access to significant consultation notes, test results, treatment recommendations, and other information concerning their care, consistent with applicable laws and appropriate clinical processes.
10. IMPORTANT CONVERSATIONS TO BE DOCUMENTED
Healthcare institutions should distinguish, when appropriate, between information being documented in a medical record and significant information actually being communicated to the patient or authorized decision-maker.
11. SERIOUS CHANGES IN A PATIENT'S CONDITION TO RECEIVE APPROPRIATE ATTENTION
Significant deterioration—including acute confusion, hallucinations, changes in consciousness, breathing difficulties, or other serious changes—should receive appropriate evaluation and escalation.
12. PATIENTS AND FAMILIES TO HAVE A MEANINGFUL AVENUE FOR REVIEW
When patients or families believe critical information was not disclosed, informed consent was inadequate, transfer documentation was inaccurate, or serious patient-safety concerns were not appropriately addressed, they should have access to a transparent process for review and accountability.
- WHAT WE ARE REALLY ASKING FOR
We are not asking patients to become doctors.
We are not asking families to interpret every test result or understand every page of a medical record.
And we are not asking healthcare professionals to predict the future with certainty.
We are asking for something much more fundamental:
Tell patients what they reasonably need to know to participate meaningfully in decisions about their own bodies and lives.
A medical record should support communication with a patient—not become the place where a patient or family first discovers information that could have mattered to a life-changing decision.
A signature should not substitute for a conversation.
A patient should never have to discover afterward that significant concerns were documented but were not meaningfully communicated to them.
A patient's wishes should not be assumed without giving that patient an opportunity to understand and discuss the options.
And when patients move between healthcare facilities, their medical information should be accurate, their changing condition should receive appropriate attention, and necessary safety measures should not be overlooked.
We are not asking the public to determine medical or legal fault based solely on our family's account.
We are asking for transparency, meaningful answers, and stronger protections so that patients can make informed decisions about their own care.
DOCUMENTED IS NOT THE SAME AS DISCLOSED.
- BRIANNE'S LEGACY
Brianne spent nine years serving and protecting her community as a Detroit police officer.
She spent her career standing up for other people.
Our hope is that by telling her story, she can continue protecting others in a different way.
I cannot bring my sister back.
But if sharing her story helps another patient receive information they otherwise might not have heard, ask a question they otherwise might not have asked, or make a decision that truly reflects their wishes, then Brianne's legacy will continue protecting people.
She spent her life protecting others. Now let her legacy help protect patients.
- PLEASE SIGN AND SHARE
Please sign this petition if you believe patients deserve medical transparency, meaningful informed consent, honest communication, accurate medical records, safe transitions of care, and a meaningful voice in decisions about their own healthcare.
Share Brianne's story.
Talk about patient rights.
Ask questions.
Read your medical records.
Advocate for the people you love.
And help us make one principle impossible to ignore:
IF INFORMATION COULD CHANGE A PATIENT'S DECISION, THE PATIENT DESERVES TO KNOW.
THE PATIENT SHOULD NEVER BE THE LAST TO KNOW.
FOR BRIANNE. FOR EVERY PATIENT.
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Petition created on December 13, 2025