FOR BRIANNE. FOR EVERY PATIENT.
The Issue
A Call for Medical Transparency, Meaningful Informed Consent, Patient Safety & Hospital Accountability
To the leadership of Henry Ford Health and Corewell Health: We are asking for answers about Brianne’s care, an appropriately independent review of our family’s concerns, and meaningful improvements that may help protect other patients.
I write this not only as Brianne’s sister, but also on behalf of our mother and father.
Brianne Rae Carlson 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 receiving 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 at just 32 years old, following two heartbreaking days of critical illness and suffering.
Only afterward, when I downloaded and began reviewing the more complete records from her hospitalization, did our family discover that physicians had documented serious concerns about her prognosis and ability to tolerate aggressive treatment—information that could have mattered deeply to the choices she made about her care and remaining time.
What I found left our family asking a question no patient or family should ever have to ask:
WHY WEREN’T WE TOLD?
THESE WERE NOT NOTES WE SIMPLY SAW IN A PATIENT PORTAL
I want people to understand something important about how we discovered this information.
These were not simply notes that appeared on Brianne’s patient portal for us to read during her hospitalization.
It was only after Brianne died, when I downloaded and reviewed the records covering her entire hospital stay, that I discovered the physicians’ own documented assessments, concerns, recommendations, and opinions about her condition.
That was when I read that a physician had serious doubts about her ability to tolerate aggressive treatment.
That was when I discovered documentation describing her prognosis as poor.
That was when I learned that hospice had already been identified as another option.
These were not conclusions I invented after my sister’s death. They were statements documented by her own physicians in the records we obtained.
And they were not the information our family understood from the conversations we witnessed at her bedside.
There is an important difference between being able to open a patient portal and understanding what is documented throughout an entire hospitalization.
A patient may check their portal, read test results, review appointments, and follow treatment instructions without realizing that additional clinical documentation may exist.
What is visible through a portal can vary by healthcare system, record type, and applicable access rules. Some physician notes may appear directly; others may be found through a more complete medical-records request.
I am not claiming that every hospital withholds these notes or that every clinical document is hidden from patients.
I am explaining what happened to our family.
I did not discover my sister’s physicians’ serious concerns by checking the information we could see in her patient portal.
I discovered them after she died, when I downloaded and read the records from her hospitalization.
And even when a medical note is electronically available, that does not establish that its contents were meaningfully explained to the patient.
Patients deserve more than passive access to written information.
They deserve conversations that help them understand significant medical concerns while they can still make decisions about their lives.
ACCESS TO A PORTAL IS NOT THE SAME AS AN INFORMED CONVERSATION.
A NOTE IN A CHART IS NOT A CONVERSATION.
WHAT WE FOUND AFTER BRIANNE PASSED
During Brianne’s September 2025 hospitalization, physician notes documented serious concerns about her medical 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 discussed hospice as another option and recommended considering systemic treatment once Brianne became sufficiently stable.
These were significant concerns.
And they were not isolated.
Other physician documentation raised concerns 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 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 discovered these documented concerns only after Brianne passed away.
Our family spent extensive time at Brianne’s bedside throughout her hospitalization. We listened to discussions 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.
In the conversations we witnessed:
We did not hear the serious concerns about Brianne’s treatment tolerance meaningfully explained to her.
We did not hear anyone tell her that physicians had documented serious doubts about her ability to tolerate aggressive treatment.
We did not hear her prognosis of “poor” explained to her in a meaningful way.
We did not witness hospice being presented to her as an option.
We did not witness anyone ask Brianne whether she would consider hospice before a physician documented an expectation about what she and our father might accept.
Our family was there.
We were listening.
We would remember conversations of this magnitude.
We recognize that medical discussions may sometimes occur outside a particular family member’s presence or may not be fully reflected in the records we received.
That is precisely why we are asking for answers.
If these discussions occurred, when did they take place? Who participated? What was explained? What did Brianne understand? And where is that documented?
A statement written in a medical record is not the same as a conversation with a patient.
And a physician’s documented expectation about what a patient might accept should not replace an opportunity for that patient to understand and express her own wishes.
Brianne deserved meaningful information about her condition while she could still participate in decisions about her 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 her desire to attempt oral pain medication and outpatient chemotherapy and radiation.
Other documentation noted that an attempted transfer to St. John had not been accepted by oncology.
The September 12 discharge summary stated:
“patient requesting outpatient chemo plan”
It then documented a plan to transfer Brianne to Corewell Health 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’s understanding from the discussions we witnessed was that Brianne needed this inpatient chemotherapy treatment before she could return to the outpatient care she wanted.
That was the future she believed she was working toward.
But our family has important questions.
Why was this particular inpatient chemotherapy treatment necessary before Brianne could pursue outpatient care?
In the records provided to our family, we have not identified a clear explanation establishing why that treatment was required before the outpatient approach she wanted.
And where was the follow-up plan?
We found documentation of the proposed inpatient chemotherapy and Brianne’s request for outpatient treatment, but we have not identified a clear, coordinated plan explaining how or when she would return to outpatient treatment afterward.
The absence of such an explanation in the records we reviewed does not prove it was never discussed or documented elsewhere.
It means our family needs to know what the plan actually was.
These questions become especially important when considered alongside the physician notes describing Brianne’s poor prognosis and serious concerns about her treatment tolerance.
We are asking:
Was Brianne given a realistic explanation of the treatment’s purpose and what it might 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 informed that hospice had been identified as another possible option?
Were the risks, expected benefits, alternatives, and likely next steps explained in language she could understand?
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.
And even if she had been fully informed, she might still have chosen aggressive treatment.
But the right to keep fighting should include the right to understand what that fight may involve.
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 from Henry Ford Rochester Hospital to Corewell Health Troy for inpatient chemotherapy.
It was also the day she experienced a documented fall.
A physician’s examination afterward described her as sleepy and noted that she did not remember how she landed.
One part of the examination described her as pale, ill appearing, and sleepy but arousable. Another recorded her as fully oriented.
These observations may reflect different aspects or times of assessment. But our family wants to understand how her overall condition was evaluated.
The discharge summary was prepared by Dr. Kyle Gifford and verified by Dr. Mazen Afram.
It described Brianne as lethargic and cachectic—a medical term associated with significant physical wasting.
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.”
We understand that a patient can be seriously ill and still be considered sufficiently stable for a particular transfer.
We are not claiming that the word “stable” proves the transfer was inappropriate.
We are asking what clinical findings supported that assessment.
The discharge summary was verified at approximately 4:35 p.m.
Brianne departed at approximately 6:27 p.m.
In the records provided to our family, we have not identified documentation showing that Dr. Afram personally reassessed Brianne immediately before departure.
That does not prove no reassessment occurred.
But it raises important questions:
Who assessed Brianne after her fall and before her departure?
At what times were those assessments completed?
What findings supported the determination that she was stable enough for transfer?
How were her lethargy, fall, documented medical complications, and other safety concerns communicated to the receiving team?
How were concerns about prognosis and treatment tolerance communicated to Brianne before she left?
These are questions about patient safety, clinical communication, and informed decision-making.
They deserve specific 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 identified:
“Altered Mental Status”
“Decreased level of consciousness”
A requirement for cardiac monitoring during transport
The certification also listed a heparin infusion.
However, Henry Ford’s medication administration records appear to indicate that Brianne’s heparin infusion had been stopped on September 10—two days before her transfer.
Other transfer-related documents also contain differing anticoagulant information.
A medication order, an active medication list, a medication actually administered, and the time of its last dose are not necessarily the same thing.
That is why medication reconciliation is so important.
Following our family’s inquiry into the ambulance transport, we also obtained information that raised questions about whether the cardiac monitoring identified on the certification was actually performed.
We are requesting verification from the underlying transport records—not asking the public to assume the monitoring did or did not occur.
Our questions include:
Who verified Brianne’s current medications before departure?
What anticoagulants were ordered, actually administered, discontinued, or last given?
Why did the certification list a heparin infusion if the medication administration record showed it had been stopped?
Who determined the cardiac monitoring required during transport?
What monitoring was actually provided, and what records confirm it?
Who assessed Brianne’s mental status before departure?
What clinical information was communicated to the ambulance crew and receiving hospital?
The certification documents what was recorded as necessary for transport.
It does not, by itself, establish who personally examined Brianne, what monitoring occurred, or whether she was medically ready to receive chemotherapy.
Those determinations require review of the relevant clinical and transport records.
We are also asking Henry Ford Health to identify which records were prepared for transfer, which were actually transmitted or physically provided, and what documentation confirms that communication.
PATIENT SAFETY SHOULD NEVER GET LOST BETWEEN HOSPITALS.
QUESTIONS ABOUT MEDICAL RECORDS SHARED BETWEEN HOSPITALS
Another concern emerged as our family requested and reviewed Brianne’s records.
Our first records release from Corewell did not include a collection of Henry Ford documents reportedly prepared or sent in connection with Brianne’s transfer.
After our family questioned the omission, additional Henry Ford documents appeared in a later release.
We are not claiming that their absence from the first family records release proves Corewell’s treating clinicians did not have access to them on September 12.
Those are different questions.
What we want to establish is:
What documents did Henry Ford actually send, and when?
How were they transmitted or delivered?
What confirmations of transmission or delivery exist?
What information did Corewell receive?
When was that information available in its systems?
When, if at all, was it accessed or reviewed by the relevant clinicians?
Why were the documents absent from the initial family records release?
These questions matter because the safety of a hospital transfer depends on more than whether documents were printed.
Information must be accurately communicated and available to the people making treatment decisions.
QUESTIONS ABOUT PNEUMONIA, INFECTION, AND TREATMENT READINESS
Brianne’s respiratory symptoms and possible infection were documented before her transfer.
Her September 7–8 emergency department records listed pneumonia among her diagnoses.
They documented the administration of intravenous azithromycin on September 8.
Chest imaging described findings that could be associated with infection or cancer. Our family’s understanding of the imaging report is that certain airway findings raised concern for an infectious process.
The September 12 discharge summary continued to list pneumonia among Brianne’s diagnoses.
Her 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 requiring appropriate clinical interpretation.
What happened when Brianne arrived at Corewell Health Troy?
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, based on the medication histories our family has reviewed, the Rocephin treatment referenced in her records appears to date back to July, while azithromycin was administered during Brianne’s September 8 presentation.
This raises a question about whether actual medication administration dates were verified and whether historical treatment information was clearly distinguished from more recent treatment.
PA-C Dallo’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.
We recognize that clinicians may reasonably decide to monitor a patient without antibiotics or immediate repeat testing depending on the available findings.
But our family wants to understand the clinical reasoning and information available when those decisions were made.
In the records we have reviewed, we identified entries through September 14 indicating that certain outside records or imaging had not been reviewed or were unavailable for review.
Those entries do not establish that every relevant outside record was unavailable to every clinician.
We want to know precisely what information had been received, reviewed, and considered.
Our questions include:
What records and imaging from Henry Ford were available to Brianne’s receiving team?
Which findings had the relevant clinicians reviewed before making treatment decisions?
How were Brianne’s documented pneumonia, ongoing respiratory symptoms, and prior antibiotic treatment evaluated?
Who verified which antibiotics she had actually received and when?
What findings supported monitoring without antibiotics or repeat chest imaging at that time?
When did Dr. Kadakol personally examine Brianne, and what assessments informed the treatment plan?
How were Brianne’s laboratory abnormalities and overall condition reassessed before chemotherapy on September 15?
What clinical criteria supported the decision that she could tolerate the proposed treatment?
What risks, expected benefits, and alternatives were explained to Brianne?
A physician had previously documented that systemic treatment should be considered once Brianne was sufficiently stable.
What clinical findings supported the determination that she had reached that point?
September 15 and the deterioration that followed
Brianne received chemotherapy on September 15, 2025.
She subsequently deteriorated rapidly.
Later testing identified pneumonia and a serious MSSA bloodstream infection. Her final illness included septic shock and acute respiratory failure.
We recognize that the records we have reviewed do not establish precisely when the bloodstream infection began.
They also do not, by themselves, establish that chemotherapy or any particular treatment decision caused Brianne’s deterioration or death.
We are not asking the public to draw that conclusion.
But we cannot ignore that Brianne had documented respiratory symptoms and pneumonia-related concerns before chemotherapy, followed by a devastating decline.
We want to understand:
Was her pneumonia improving, worsening, or still unresolved when chemotherapy was administered?
What examinations, laboratory results, imaging, and other findings supported the decision to proceed?
What did Brianne understand about her medical condition and the risks of treatment?
These questions deserve a thorough clinical and patient-safety review—not speculation.
QUESTIONS ABOUT INFORMED CONSENT AND DECISION-MAKING CAPACITY
Brianne’s records documented neurological and cognitive concerns during this period.
The September 12 ambulance certification identified altered mental status and decreased level of consciousness.
Our family also witnessed episodes of confusion and hallucinations during her illness.
These observations do not automatically establish that Brianne lacked decision-making capacity.
A patient can experience symptoms that fluctuate. Capacity is decision-specific and requires consideration of whether the person can understand relevant information, appreciate how it applies to them, reason about options, and communicate a choice.
But documented concerns about mental status raise an important question when someone is being asked to make high-stakes medical decisions.
What safeguards were used to ensure Brianne could meaningfully understand and participate in decisions about her treatment?
Meaningful informed consent should be more than obtaining a signature.
Patients deserve understandable information about:
Significant treatment risks and expected benefits.
The purpose and goals of treatment.
Reasonable alternatives, including the consequences of declining or delaying treatment when relevant.
Serious clinical concerns that could affect whether treatment is appropriate.
Their prognosis when that information is relevant to the decision and consistent with their wishes regarding receiving information.
When a patient’s decision-making capacity is in question, appropriate assessment and safeguards should occur.
And when important concerns are documented, there should be a meaningful way to establish whether those concerns were communicated to the patient or, when appropriate, an 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 is not simply that hospice appeared in a physician’s note.
It is that an expectation about what Brianne and our father might accept had been documented.
Was that expectation based on a conversation with Brianne?
Our family spent extensive time with Brianne during her hospitalization. We did not witness hospice being presented to her as an option during the conversations we attended, and we did not hear it meaningfully discussed with our family at that time.
Hospice was one of Brianne’s greatest fears.
That made a compassionate, understandable conversation especially important.
Discussing hospice would not have required Brianne to choose it.
She could have asked questions.
She could have decided to continue pursuing treatment.
She could have explored what supportive care might offer while continuing treatment.
She could have considered what mattered most to her if time was becoming limited.
The choice should have been informed—and it should have belonged to Brianne whenever she was able to make it.
Palliative care and hospice are related, but they are not interchangeable. Palliative care can address pain, symptoms, and quality of life alongside treatments directed at an illness. Hospice generally focuses on comfort and support when care is approaching the end of life.
We believe patients deserve to understand clinically relevant options before a crisis whenever reasonably possible.
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 introduced to our family when Brianne was critically ill and dependent on breathing support. Hospice paperwork was completed.
We are asking why the earlier documented concern was not meaningfully communicated in the discussions we witnessed, and whether other conversations occurred that our family does not know about.
Brianne deserved an opportunity, while able to participate, to hear the information relevant to her choices and decide what she wanted.
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.
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 serious 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 return to outpatient treatment.
She was still thinking about her future.
She was making decisions based on the information she understood.
Maybe she would have chosen to continue aggressive treatment even after hearing every concern.
Maybe she would have asked for another opinion.
Maybe she would have wanted to spend her remaining time differently.
Maybe she would have wanted different conversations with the people she loved.
We will never know.
And we do not claim to know what she would have chosen.
That is why the questions about communication and informed consent matter so much.
The decisions were about her body, her treatment, her future, and her time.
Those choices belonged to Brianne.
EVERY PATIENT DESERVES THE RIGHT TO KNOW AND TO CHOOSE.
BRIANNE WAS STILL PLANNING FOR A FUTURE
This was not 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 that car.
Instead, it was parked outside her service.
These were plans Brianne was actively making during the same period when her physicians were documenting a poor prognosis, serious concerns about her ability to tolerate aggressive treatment, and hospice as a possible alternative.
Our family’s understanding was that she needed 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 does not exist only in a chart.
It can affect what patients believe about tomorrow.
It can affect what treatments they choose.
It can affect the conversations they have with people they love, how they spend their time, and the decisions they make about their own lives.
THE PATIENT SHOULD NEVER BE THE LAST TO KNOW.
WHY EVERY PATIENT SHOULD READ THEIR OWN MEDICAL RECORDS
I found these physician notes only because I downloaded Brianne’s records after she passed away and began reading the documentation from her hospitalization.
Our family never expected to find significant physician assessments that we did not remember hearing explained to her.
That experience changed the way I think about patient safety.
Patients should be encouraged to review their own medical records while they still have an opportunity to ask questions and make decisions.
Not because patients should be expected to practice medicine.
Not because every unfamiliar entry proves something is wrong.
And not because a medical record can replace a meaningful conversation with a healthcare professional.
Patients should read their records because those records contain important information about their lives.
They may include:
Diagnoses and significant clinical concerns.
Physician progress notes and specialist consultations.
Medication lists, orders, and administration histories.
Test results and imaging findings.
Prognosis and treatment goals.
Consent documentation.
Nursing notes and care plans.
Hospital transfer and discharge information.
Documentation describing discussions and medical decisions.
Sometimes patients may find information they do not understand.
Sometimes medications may remain on a list after they were stopped.
Sometimes different documents may describe different aspects of the same clinical situation.
Sometimes a note may contain an error or information that needs clarification.
And sometimes an entry may raise a serious question that deserves a careful answer.
A discrepancy is not automatic proof of wrongdoing. But it is a reason to ask questions.
Know the difference between your patient portal and your complete medical record
A patient portal is an important tool, but it may not display every document associated with your care.
If you have been hospitalized or received complex treatment, consider requesting the records for your entire hospital stay, including physician progress notes, specialist consultations, treatment plans, medication administration records, nursing documentation, discharge summaries, and transfer records, as applicable.
Do not assume that every document is included simply because you downloaded what was visible in your portal.
Ask the medical records department what your download contains, what additional records may be available, and how to request them.
Patients should be able to ask:
What does this diagnosis mean?
Was this medication ordered, or was it actually given?
What were my physicians documenting about my condition?
Why does this record describe a treatment as curative or palliative?
What does this note mean about my prognosis?
When was this information discussed with me?
What records followed me when I was transferred?
How can I request an amendment or have a disagreement appropriately documented?
Patients should have meaningful ways to request their records, understand unfamiliar information, and raise concerns about possible inaccuracies.
Most importantly, obtaining a copy of a medical record should never replace a healthcare professional’s responsibility to communicate information necessary for an informed medical decision.
Medical records should support communication and safe care—not become the first place someone discovers significant information after the opportunity to make a decision has passed.
YOUR MEDICAL RECORD IS ABOUT YOUR LIFE. YOU DESERVE TO UNDERSTAND WHAT IT SAYS.
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 received 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 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 explained.
The patient being transferred between hospitals.
The patient experiencing confusion while facing an important medical decision.
The patient considering palliative care or hospice.
The family trying to make decisions for someone who can no longer speak for themselves.
Whether someone is facing cancer, heart disease, infection, surgery, chronic illness, pregnancy, mental-health treatment, emergency care, or another 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 ARE ASKING HOSPITAL LEADERSHIP TO DO
We are calling on Henry Ford Health and Corewell Health leadership to meaningfully review our family’s concerns, provide substantive answers, and strengthen protections for patients whose medical decisions depend on accurate information and clear communication.
Each healthcare system should review the care, decisions, and communications within its own responsibility.
1. CONDUCT A THOROUGH AND APPROPRIATELY INDEPENDENT REVIEW OF BRIANNE’S CARE
We request a meaningful review of relevant medical decisions, informed-consent discussions, treatment planning, medication information, clinical assessments, transfer procedures, and communication between care teams.
Where practicable, reviewers should not have been directly responsible for the decisions being examined.
We are asking for an evidence-based review—not a predetermined finding of fault.
2. PROVIDE OUR FAMILY WITH SUBSTANTIVE WRITTEN ANSWERS
We request written responses addressing the specific concerns we have raised, including:
What significant clinical information was communicated to Brianne, by whom, and when?
How were her treatment goals, expected benefits, risks, prognosis, and reasonable alternatives explained?
What assessments supported major treatment and transfer decisions?
What information accompanied her September 12 transfer?
How were medications and required transport monitoring verified?
What clinical information was available and reviewed before chemotherapy?
How were concerns about infection, mental status, and treatment tolerance evaluated?
We ask for a designated leadership contact, an organized response to our questions, and a meeting with appropriate executive, clinical, and patient-safety representatives.
We understand that privacy laws and protections for certain internal review materials may limit what can be shared. We request the fullest meaningful explanation permitted.
3. STRENGTHEN INFORMED CONSENT BEYOND A SIGNED FORM
Patients should receive understandable explanations of significant treatment risks, expected benefits, reasonable alternatives, and the consequences of declining or delaying care when applicable.
When clinicians have serious concerns about whether a patient can tolerate treatment, those concerns should be part of the discussion whenever clinically appropriate and reasonably possible.
Important informed-consent conversations should be documented in a way that distinguishes clinical information recorded in a chart from information actually discussed with the patient or authorized decision-maker.
A SIGNATURE IS NOT A SUBSTITUTE FOR UNDERSTANDING.
4. PROTECT PATIENTS WHEN DECISION-MAKING CAPACITY MAY BE IMPAIRED
Significant confusion, changes in consciousness, or other substantial concerns about a patient’s ability to understand a decision should prompt appropriate assessment and safeguards before high-risk, non-emergency treatment decisions.
Capacity should not be assumed or denied solely because a patient is seriously ill, confused at one point, or described as alert and oriented at another.
Patients deserve appropriate, decision-specific evaluation and support.
5. IMPROVE COMMUNICATION ABOUT PROGNOSIS, TREATMENT GOALS, AND SUPPORTIVE CARE
Patients should receive honest, compassionate information about their condition and treatment goals, consistent with their preferences and clinical circumstances.
When palliative care or hospice becomes clinically relevant, patients should have a meaningful opportunity to understand those options before a crisis whenever reasonably possible.
No healthcare professional should assume what a patient will accept without an appropriate effort to understand that patient’s wishes.
6. STRENGTHEN MEDICAL-RECORD ACCURACY AND HOSPITAL TRANSFERS
We ask hospitals and transport providers to use reliable processes for communicating:
Current medications and discontinued medications.
Actual medication administration and known last doses.
Significant clinical findings and changes in condition.
Pending tests, important imaging, and unresolved concerns.
Required monitoring and safety needs during transport.
Treatment plans and information needed by the receiving team.
Records prepared for a transfer should be distinguished from records actually transmitted or provided.
When critical information is handed off, there should be a reliable way to document that communication.
7. ENSURE PATIENTS UNDERSTAND WHAT THEIR PORTAL DOES—AND DOES NOT—SHOW
Hospitals should clearly explain what types of records are available in patient portals and how patients can obtain additional documentation from an entire hospitalization or course of treatment.
Patients should not be left to assume that the information visible in a portal represents every note, consultation, assessment, or document associated with their care.
Healthcare institutions should make it straightforward to request more complete records, including clinician documentation and medication administration histories, subject to applicable access rules.
And significant medical information relevant to a patient’s decisions should be meaningfully communicated—not merely entered into a chart or made electronically available.
8. IMPROVE PATIENT ACCESS TO AND UNDERSTANDING OF MEDICAL RECORDS
Patients should be encouraged to review their own records and have accessible ways to ask questions about unfamiliar entries.
They should have clear processes for raising possible inaccuracies, requesting amendments when appropriate, and obtaining explanations of significant discrepancies.
Access to records should be timely and consistent with applicable law.
A patient’s ability to understand their care should not depend on discovering important information after a crisis.
9. ENSURE SERIOUS CLINICAL CHANGES RECEIVE APPROPRIATE EVALUATION
Important changes in a patient’s condition—including confusion, hallucinations, decreased consciousness, respiratory symptoms, and other significant deterioration—should receive appropriate assessment, communication, and escalation.
Before high-risk treatments, relevant symptoms, laboratory abnormalities, possible infection, and other serious concerns should be considered as part of the clinical decision.
We are not asking hospitals to guarantee outcomes.
We are asking them to use meaningful safety processes and explain the clinical reasoning when serious questions arise.
10. PRESERVE RELEVANT RECORDS AND EXPLAIN DOCUMENTATION DISCREPANCIES
We request preservation of relevant existing records, including medical and medication administration records, consent documents, treatment-planning materials, transfer paperwork, ambulance records, handoff communications, and available printing, scanning, transmission, document-history, and electronic audit records.
We also request clarification of identified discrepancies, including differences between planned care, ordered care, and care actually administered.
Where treatment intent is described differently across records—for example, as curative in one context and palliative in another—we ask for an explanation of the terminology, clinical goals, and what was communicated to the patient.
A difference in documentation does not automatically establish improper billing or intentional misrepresentation. It does warrant clarification.
11. DEMONSTRATE ACCOUNTABILITY THROUGH MEASURABLE IMPROVEMENTS
When a review identifies deficiencies, we ask for appropriate corrective action and a meaningful explanation of the improvements made, within applicable legal and privacy limits.
We want hospitals to have a transparent process for receiving serious family concerns, coordinating review, providing substantive responses, and identifying improvements that can help prevent similar problems.
We also ask for direct involvement by appropriate executive and patient-safety leadership, not solely a routine administrative acknowledgment.
Accountability should mean more than saying a concern was received.
It should mean taking the concern seriously, examining the evidence, providing meaningful answers, and improving safety when improvements are warranted.
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.
We are not asking healthcare professionals to predict the future with certainty.
And we are not asking the public to decide whether medical negligence, misconduct, or a particular cause of death has been established based solely on our family’s account.
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—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’s wishes should not be assumed without an appropriate opportunity to understand and discuss the options.
Serious concerns about treatment tolerance should not remain unexplained when they could affect a patient’s choice.
And when patients move between healthcare facilities, important information must be accurately communicated, changing conditions appropriately evaluated, and necessary safety measures addressed.
We are asking for transparency.
We are asking for meaningful written answers.
We are asking for an appropriately independent review.
We are asking for accountability where deficiencies are identified.
And we are asking for stronger protections that may help prevent other families from facing similar questions.
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.
Our mother and father cannot bring their daughter back.
And no answer will give our family the future we imagined with her.
But if sharing Brianne’s story helps another patient hear important information they otherwise might not have heard, ask a question they otherwise might not have asked, understand a medical record they otherwise might not have read, or make a decision that truly reflects their wishes, then her legacy can continue helping people.
She spent her life protecting others.
Now let her legacy help protect patients.
PLEASE SIGN AND SHARE
By signing this petition, you support the Carlson family’s request for meaningful answers about Brianne’s care and stronger patient-safety protections at Henry Ford Health, Corewell Health, and healthcare institutions more broadly.
Your signature does not mean you have determined that negligence or wrongdoing occurred.
It means you believe patients deserve honest communication, meaningful informed consent, accurate records, safe transitions of care, appropriate review of serious concerns, and a meaningful voice in decisions about their own healthcare.
Please sign.
Share Brianne’s story.
Talk about patient rights.
Ask questions.
Read your medical records—and understand that your patient portal may not contain every document from your care.
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.
ACCESS TO A PORTAL IS NOT THE SAME AS AN INFORMED CONVERSATION.
A NOTE IN A CHART IS NOT A CONVERSATION.
DOCUMENTED IS NOT THE SAME AS DISCLOSED.
THE PATIENT SHOULD NEVER BE THE LAST TO KNOW.
FOR BRIANNE. FOR EVERY PATIENT.
Written by Jennifer Marie Preston, sister of Brianne Rae Carlson, on behalf of the Carlson family.
Learn more here ⬇️
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The Issue
A Call for Medical Transparency, Meaningful Informed Consent, Patient Safety & Hospital Accountability
To the leadership of Henry Ford Health and Corewell Health: We are asking for answers about Brianne’s care, an appropriately independent review of our family’s concerns, and meaningful improvements that may help protect other patients.
I write this not only as Brianne’s sister, but also on behalf of our mother and father.
Brianne Rae Carlson 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 receiving 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 at just 32 years old, following two heartbreaking days of critical illness and suffering.
Only afterward, when I downloaded and began reviewing the more complete records from her hospitalization, did our family discover that physicians had documented serious concerns about her prognosis and ability to tolerate aggressive treatment—information that could have mattered deeply to the choices she made about her care and remaining time.
What I found left our family asking a question no patient or family should ever have to ask:
WHY WEREN’T WE TOLD?
THESE WERE NOT NOTES WE SIMPLY SAW IN A PATIENT PORTAL
I want people to understand something important about how we discovered this information.
These were not simply notes that appeared on Brianne’s patient portal for us to read during her hospitalization.
It was only after Brianne died, when I downloaded and reviewed the records covering her entire hospital stay, that I discovered the physicians’ own documented assessments, concerns, recommendations, and opinions about her condition.
That was when I read that a physician had serious doubts about her ability to tolerate aggressive treatment.
That was when I discovered documentation describing her prognosis as poor.
That was when I learned that hospice had already been identified as another option.
These were not conclusions I invented after my sister’s death. They were statements documented by her own physicians in the records we obtained.
And they were not the information our family understood from the conversations we witnessed at her bedside.
There is an important difference between being able to open a patient portal and understanding what is documented throughout an entire hospitalization.
A patient may check their portal, read test results, review appointments, and follow treatment instructions without realizing that additional clinical documentation may exist.
What is visible through a portal can vary by healthcare system, record type, and applicable access rules. Some physician notes may appear directly; others may be found through a more complete medical-records request.
I am not claiming that every hospital withholds these notes or that every clinical document is hidden from patients.
I am explaining what happened to our family.
I did not discover my sister’s physicians’ serious concerns by checking the information we could see in her patient portal.
I discovered them after she died, when I downloaded and read the records from her hospitalization.
And even when a medical note is electronically available, that does not establish that its contents were meaningfully explained to the patient.
Patients deserve more than passive access to written information.
They deserve conversations that help them understand significant medical concerns while they can still make decisions about their lives.
ACCESS TO A PORTAL IS NOT THE SAME AS AN INFORMED CONVERSATION.
A NOTE IN A CHART IS NOT A CONVERSATION.
WHAT WE FOUND AFTER BRIANNE PASSED
During Brianne’s September 2025 hospitalization, physician notes documented serious concerns about her medical 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 discussed hospice as another option and recommended considering systemic treatment once Brianne became sufficiently stable.
These were significant concerns.
And they were not isolated.
Other physician documentation raised concerns 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 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 discovered these documented concerns only after Brianne passed away.
Our family spent extensive time at Brianne’s bedside throughout her hospitalization. We listened to discussions 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.
In the conversations we witnessed:
We did not hear the serious concerns about Brianne’s treatment tolerance meaningfully explained to her.
We did not hear anyone tell her that physicians had documented serious doubts about her ability to tolerate aggressive treatment.
We did not hear her prognosis of “poor” explained to her in a meaningful way.
We did not witness hospice being presented to her as an option.
We did not witness anyone ask Brianne whether she would consider hospice before a physician documented an expectation about what she and our father might accept.
Our family was there.
We were listening.
We would remember conversations of this magnitude.
We recognize that medical discussions may sometimes occur outside a particular family member’s presence or may not be fully reflected in the records we received.
That is precisely why we are asking for answers.
If these discussions occurred, when did they take place? Who participated? What was explained? What did Brianne understand? And where is that documented?
A statement written in a medical record is not the same as a conversation with a patient.
And a physician’s documented expectation about what a patient might accept should not replace an opportunity for that patient to understand and express her own wishes.
Brianne deserved meaningful information about her condition while she could still participate in decisions about her 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 her desire to attempt oral pain medication and outpatient chemotherapy and radiation.
Other documentation noted that an attempted transfer to St. John had not been accepted by oncology.
The September 12 discharge summary stated:
“patient requesting outpatient chemo plan”
It then documented a plan to transfer Brianne to Corewell Health 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’s understanding from the discussions we witnessed was that Brianne needed this inpatient chemotherapy treatment before she could return to the outpatient care she wanted.
That was the future she believed she was working toward.
But our family has important questions.
Why was this particular inpatient chemotherapy treatment necessary before Brianne could pursue outpatient care?
In the records provided to our family, we have not identified a clear explanation establishing why that treatment was required before the outpatient approach she wanted.
And where was the follow-up plan?
We found documentation of the proposed inpatient chemotherapy and Brianne’s request for outpatient treatment, but we have not identified a clear, coordinated plan explaining how or when she would return to outpatient treatment afterward.
The absence of such an explanation in the records we reviewed does not prove it was never discussed or documented elsewhere.
It means our family needs to know what the plan actually was.
These questions become especially important when considered alongside the physician notes describing Brianne’s poor prognosis and serious concerns about her treatment tolerance.
We are asking:
Was Brianne given a realistic explanation of the treatment’s purpose and what it might 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 informed that hospice had been identified as another possible option?
Were the risks, expected benefits, alternatives, and likely next steps explained in language she could understand?
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.
And even if she had been fully informed, she might still have chosen aggressive treatment.
But the right to keep fighting should include the right to understand what that fight may involve.
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 from Henry Ford Rochester Hospital to Corewell Health Troy for inpatient chemotherapy.
It was also the day she experienced a documented fall.
A physician’s examination afterward described her as sleepy and noted that she did not remember how she landed.
One part of the examination described her as pale, ill appearing, and sleepy but arousable. Another recorded her as fully oriented.
These observations may reflect different aspects or times of assessment. But our family wants to understand how her overall condition was evaluated.
The discharge summary was prepared by Dr. Kyle Gifford and verified by Dr. Mazen Afram.
It described Brianne as lethargic and cachectic—a medical term associated with significant physical wasting.
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.”
We understand that a patient can be seriously ill and still be considered sufficiently stable for a particular transfer.
We are not claiming that the word “stable” proves the transfer was inappropriate.
We are asking what clinical findings supported that assessment.
The discharge summary was verified at approximately 4:35 p.m.
Brianne departed at approximately 6:27 p.m.
In the records provided to our family, we have not identified documentation showing that Dr. Afram personally reassessed Brianne immediately before departure.
That does not prove no reassessment occurred.
But it raises important questions:
Who assessed Brianne after her fall and before her departure?
At what times were those assessments completed?
What findings supported the determination that she was stable enough for transfer?
How were her lethargy, fall, documented medical complications, and other safety concerns communicated to the receiving team?
How were concerns about prognosis and treatment tolerance communicated to Brianne before she left?
These are questions about patient safety, clinical communication, and informed decision-making.
They deserve specific 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 identified:
“Altered Mental Status”
“Decreased level of consciousness”
A requirement for cardiac monitoring during transport
The certification also listed a heparin infusion.
However, Henry Ford’s medication administration records appear to indicate that Brianne’s heparin infusion had been stopped on September 10—two days before her transfer.
Other transfer-related documents also contain differing anticoagulant information.
A medication order, an active medication list, a medication actually administered, and the time of its last dose are not necessarily the same thing.
That is why medication reconciliation is so important.
Following our family’s inquiry into the ambulance transport, we also obtained information that raised questions about whether the cardiac monitoring identified on the certification was actually performed.
We are requesting verification from the underlying transport records—not asking the public to assume the monitoring did or did not occur.
Our questions include:
Who verified Brianne’s current medications before departure?
What anticoagulants were ordered, actually administered, discontinued, or last given?
Why did the certification list a heparin infusion if the medication administration record showed it had been stopped?
Who determined the cardiac monitoring required during transport?
What monitoring was actually provided, and what records confirm it?
Who assessed Brianne’s mental status before departure?
What clinical information was communicated to the ambulance crew and receiving hospital?
The certification documents what was recorded as necessary for transport.
It does not, by itself, establish who personally examined Brianne, what monitoring occurred, or whether she was medically ready to receive chemotherapy.
Those determinations require review of the relevant clinical and transport records.
We are also asking Henry Ford Health to identify which records were prepared for transfer, which were actually transmitted or physically provided, and what documentation confirms that communication.
PATIENT SAFETY SHOULD NEVER GET LOST BETWEEN HOSPITALS.
QUESTIONS ABOUT MEDICAL RECORDS SHARED BETWEEN HOSPITALS
Another concern emerged as our family requested and reviewed Brianne’s records.
Our first records release from Corewell did not include a collection of Henry Ford documents reportedly prepared or sent in connection with Brianne’s transfer.
After our family questioned the omission, additional Henry Ford documents appeared in a later release.
We are not claiming that their absence from the first family records release proves Corewell’s treating clinicians did not have access to them on September 12.
Those are different questions.
What we want to establish is:
What documents did Henry Ford actually send, and when?
How were they transmitted or delivered?
What confirmations of transmission or delivery exist?
What information did Corewell receive?
When was that information available in its systems?
When, if at all, was it accessed or reviewed by the relevant clinicians?
Why were the documents absent from the initial family records release?
These questions matter because the safety of a hospital transfer depends on more than whether documents were printed.
Information must be accurately communicated and available to the people making treatment decisions.
QUESTIONS ABOUT PNEUMONIA, INFECTION, AND TREATMENT READINESS
Brianne’s respiratory symptoms and possible infection were documented before her transfer.
Her September 7–8 emergency department records listed pneumonia among her diagnoses.
They documented the administration of intravenous azithromycin on September 8.
Chest imaging described findings that could be associated with infection or cancer. Our family’s understanding of the imaging report is that certain airway findings raised concern for an infectious process.
The September 12 discharge summary continued to list pneumonia among Brianne’s diagnoses.
Her 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 requiring appropriate clinical interpretation.
What happened when Brianne arrived at Corewell Health Troy?
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, based on the medication histories our family has reviewed, the Rocephin treatment referenced in her records appears to date back to July, while azithromycin was administered during Brianne’s September 8 presentation.
This raises a question about whether actual medication administration dates were verified and whether historical treatment information was clearly distinguished from more recent treatment.
PA-C Dallo’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.
We recognize that clinicians may reasonably decide to monitor a patient without antibiotics or immediate repeat testing depending on the available findings.
But our family wants to understand the clinical reasoning and information available when those decisions were made.
In the records we have reviewed, we identified entries through September 14 indicating that certain outside records or imaging had not been reviewed or were unavailable for review.
Those entries do not establish that every relevant outside record was unavailable to every clinician.
We want to know precisely what information had been received, reviewed, and considered.
Our questions include:
What records and imaging from Henry Ford were available to Brianne’s receiving team?
Which findings had the relevant clinicians reviewed before making treatment decisions?
How were Brianne’s documented pneumonia, ongoing respiratory symptoms, and prior antibiotic treatment evaluated?
Who verified which antibiotics she had actually received and when?
What findings supported monitoring without antibiotics or repeat chest imaging at that time?
When did Dr. Kadakol personally examine Brianne, and what assessments informed the treatment plan?
How were Brianne’s laboratory abnormalities and overall condition reassessed before chemotherapy on September 15?
What clinical criteria supported the decision that she could tolerate the proposed treatment?
What risks, expected benefits, and alternatives were explained to Brianne?
A physician had previously documented that systemic treatment should be considered once Brianne was sufficiently stable.
What clinical findings supported the determination that she had reached that point?
September 15 and the deterioration that followed
Brianne received chemotherapy on September 15, 2025.
She subsequently deteriorated rapidly.
Later testing identified pneumonia and a serious MSSA bloodstream infection. Her final illness included septic shock and acute respiratory failure.
We recognize that the records we have reviewed do not establish precisely when the bloodstream infection began.
They also do not, by themselves, establish that chemotherapy or any particular treatment decision caused Brianne’s deterioration or death.
We are not asking the public to draw that conclusion.
But we cannot ignore that Brianne had documented respiratory symptoms and pneumonia-related concerns before chemotherapy, followed by a devastating decline.
We want to understand:
Was her pneumonia improving, worsening, or still unresolved when chemotherapy was administered?
What examinations, laboratory results, imaging, and other findings supported the decision to proceed?
What did Brianne understand about her medical condition and the risks of treatment?
These questions deserve a thorough clinical and patient-safety review—not speculation.
QUESTIONS ABOUT INFORMED CONSENT AND DECISION-MAKING CAPACITY
Brianne’s records documented neurological and cognitive concerns during this period.
The September 12 ambulance certification identified altered mental status and decreased level of consciousness.
Our family also witnessed episodes of confusion and hallucinations during her illness.
These observations do not automatically establish that Brianne lacked decision-making capacity.
A patient can experience symptoms that fluctuate. Capacity is decision-specific and requires consideration of whether the person can understand relevant information, appreciate how it applies to them, reason about options, and communicate a choice.
But documented concerns about mental status raise an important question when someone is being asked to make high-stakes medical decisions.
What safeguards were used to ensure Brianne could meaningfully understand and participate in decisions about her treatment?
Meaningful informed consent should be more than obtaining a signature.
Patients deserve understandable information about:
Significant treatment risks and expected benefits.
The purpose and goals of treatment.
Reasonable alternatives, including the consequences of declining or delaying treatment when relevant.
Serious clinical concerns that could affect whether treatment is appropriate.
Their prognosis when that information is relevant to the decision and consistent with their wishes regarding receiving information.
When a patient’s decision-making capacity is in question, appropriate assessment and safeguards should occur.
And when important concerns are documented, there should be a meaningful way to establish whether those concerns were communicated to the patient or, when appropriate, an 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 is not simply that hospice appeared in a physician’s note.
It is that an expectation about what Brianne and our father might accept had been documented.
Was that expectation based on a conversation with Brianne?
Our family spent extensive time with Brianne during her hospitalization. We did not witness hospice being presented to her as an option during the conversations we attended, and we did not hear it meaningfully discussed with our family at that time.
Hospice was one of Brianne’s greatest fears.
That made a compassionate, understandable conversation especially important.
Discussing hospice would not have required Brianne to choose it.
She could have asked questions.
She could have decided to continue pursuing treatment.
She could have explored what supportive care might offer while continuing treatment.
She could have considered what mattered most to her if time was becoming limited.
The choice should have been informed—and it should have belonged to Brianne whenever she was able to make it.
Palliative care and hospice are related, but they are not interchangeable. Palliative care can address pain, symptoms, and quality of life alongside treatments directed at an illness. Hospice generally focuses on comfort and support when care is approaching the end of life.
We believe patients deserve to understand clinically relevant options before a crisis whenever reasonably possible.
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 introduced to our family when Brianne was critically ill and dependent on breathing support. Hospice paperwork was completed.
We are asking why the earlier documented concern was not meaningfully communicated in the discussions we witnessed, and whether other conversations occurred that our family does not know about.
Brianne deserved an opportunity, while able to participate, to hear the information relevant to her choices and decide what she wanted.
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.
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 serious 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 return to outpatient treatment.
She was still thinking about her future.
She was making decisions based on the information she understood.
Maybe she would have chosen to continue aggressive treatment even after hearing every concern.
Maybe she would have asked for another opinion.
Maybe she would have wanted to spend her remaining time differently.
Maybe she would have wanted different conversations with the people she loved.
We will never know.
And we do not claim to know what she would have chosen.
That is why the questions about communication and informed consent matter so much.
The decisions were about her body, her treatment, her future, and her time.
Those choices belonged to Brianne.
EVERY PATIENT DESERVES THE RIGHT TO KNOW AND TO CHOOSE.
BRIANNE WAS STILL PLANNING FOR A FUTURE
This was not 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 that car.
Instead, it was parked outside her service.
These were plans Brianne was actively making during the same period when her physicians were documenting a poor prognosis, serious concerns about her ability to tolerate aggressive treatment, and hospice as a possible alternative.
Our family’s understanding was that she needed 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 does not exist only in a chart.
It can affect what patients believe about tomorrow.
It can affect what treatments they choose.
It can affect the conversations they have with people they love, how they spend their time, and the decisions they make about their own lives.
THE PATIENT SHOULD NEVER BE THE LAST TO KNOW.
WHY EVERY PATIENT SHOULD READ THEIR OWN MEDICAL RECORDS
I found these physician notes only because I downloaded Brianne’s records after she passed away and began reading the documentation from her hospitalization.
Our family never expected to find significant physician assessments that we did not remember hearing explained to her.
That experience changed the way I think about patient safety.
Patients should be encouraged to review their own medical records while they still have an opportunity to ask questions and make decisions.
Not because patients should be expected to practice medicine.
Not because every unfamiliar entry proves something is wrong.
And not because a medical record can replace a meaningful conversation with a healthcare professional.
Patients should read their records because those records contain important information about their lives.
They may include:
Diagnoses and significant clinical concerns.
Physician progress notes and specialist consultations.
Medication lists, orders, and administration histories.
Test results and imaging findings.
Prognosis and treatment goals.
Consent documentation.
Nursing notes and care plans.
Hospital transfer and discharge information.
Documentation describing discussions and medical decisions.
Sometimes patients may find information they do not understand.
Sometimes medications may remain on a list after they were stopped.
Sometimes different documents may describe different aspects of the same clinical situation.
Sometimes a note may contain an error or information that needs clarification.
And sometimes an entry may raise a serious question that deserves a careful answer.
A discrepancy is not automatic proof of wrongdoing. But it is a reason to ask questions.
Know the difference between your patient portal and your complete medical record
A patient portal is an important tool, but it may not display every document associated with your care.
If you have been hospitalized or received complex treatment, consider requesting the records for your entire hospital stay, including physician progress notes, specialist consultations, treatment plans, medication administration records, nursing documentation, discharge summaries, and transfer records, as applicable.
Do not assume that every document is included simply because you downloaded what was visible in your portal.
Ask the medical records department what your download contains, what additional records may be available, and how to request them.
Patients should be able to ask:
What does this diagnosis mean?
Was this medication ordered, or was it actually given?
What were my physicians documenting about my condition?
Why does this record describe a treatment as curative or palliative?
What does this note mean about my prognosis?
When was this information discussed with me?
What records followed me when I was transferred?
How can I request an amendment or have a disagreement appropriately documented?
Patients should have meaningful ways to request their records, understand unfamiliar information, and raise concerns about possible inaccuracies.
Most importantly, obtaining a copy of a medical record should never replace a healthcare professional’s responsibility to communicate information necessary for an informed medical decision.
Medical records should support communication and safe care—not become the first place someone discovers significant information after the opportunity to make a decision has passed.
YOUR MEDICAL RECORD IS ABOUT YOUR LIFE. YOU DESERVE TO UNDERSTAND WHAT IT SAYS.
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 received 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 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 explained.
The patient being transferred between hospitals.
The patient experiencing confusion while facing an important medical decision.
The patient considering palliative care or hospice.
The family trying to make decisions for someone who can no longer speak for themselves.
Whether someone is facing cancer, heart disease, infection, surgery, chronic illness, pregnancy, mental-health treatment, emergency care, or another 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 ARE ASKING HOSPITAL LEADERSHIP TO DO
We are calling on Henry Ford Health and Corewell Health leadership to meaningfully review our family’s concerns, provide substantive answers, and strengthen protections for patients whose medical decisions depend on accurate information and clear communication.
Each healthcare system should review the care, decisions, and communications within its own responsibility.
1. CONDUCT A THOROUGH AND APPROPRIATELY INDEPENDENT REVIEW OF BRIANNE’S CARE
We request a meaningful review of relevant medical decisions, informed-consent discussions, treatment planning, medication information, clinical assessments, transfer procedures, and communication between care teams.
Where practicable, reviewers should not have been directly responsible for the decisions being examined.
We are asking for an evidence-based review—not a predetermined finding of fault.
2. PROVIDE OUR FAMILY WITH SUBSTANTIVE WRITTEN ANSWERS
We request written responses addressing the specific concerns we have raised, including:
What significant clinical information was communicated to Brianne, by whom, and when?
How were her treatment goals, expected benefits, risks, prognosis, and reasonable alternatives explained?
What assessments supported major treatment and transfer decisions?
What information accompanied her September 12 transfer?
How were medications and required transport monitoring verified?
What clinical information was available and reviewed before chemotherapy?
How were concerns about infection, mental status, and treatment tolerance evaluated?
We ask for a designated leadership contact, an organized response to our questions, and a meeting with appropriate executive, clinical, and patient-safety representatives.
We understand that privacy laws and protections for certain internal review materials may limit what can be shared. We request the fullest meaningful explanation permitted.
3. STRENGTHEN INFORMED CONSENT BEYOND A SIGNED FORM
Patients should receive understandable explanations of significant treatment risks, expected benefits, reasonable alternatives, and the consequences of declining or delaying care when applicable.
When clinicians have serious concerns about whether a patient can tolerate treatment, those concerns should be part of the discussion whenever clinically appropriate and reasonably possible.
Important informed-consent conversations should be documented in a way that distinguishes clinical information recorded in a chart from information actually discussed with the patient or authorized decision-maker.
A SIGNATURE IS NOT A SUBSTITUTE FOR UNDERSTANDING.
4. PROTECT PATIENTS WHEN DECISION-MAKING CAPACITY MAY BE IMPAIRED
Significant confusion, changes in consciousness, or other substantial concerns about a patient’s ability to understand a decision should prompt appropriate assessment and safeguards before high-risk, non-emergency treatment decisions.
Capacity should not be assumed or denied solely because a patient is seriously ill, confused at one point, or described as alert and oriented at another.
Patients deserve appropriate, decision-specific evaluation and support.
5. IMPROVE COMMUNICATION ABOUT PROGNOSIS, TREATMENT GOALS, AND SUPPORTIVE CARE
Patients should receive honest, compassionate information about their condition and treatment goals, consistent with their preferences and clinical circumstances.
When palliative care or hospice becomes clinically relevant, patients should have a meaningful opportunity to understand those options before a crisis whenever reasonably possible.
No healthcare professional should assume what a patient will accept without an appropriate effort to understand that patient’s wishes.
6. STRENGTHEN MEDICAL-RECORD ACCURACY AND HOSPITAL TRANSFERS
We ask hospitals and transport providers to use reliable processes for communicating:
Current medications and discontinued medications.
Actual medication administration and known last doses.
Significant clinical findings and changes in condition.
Pending tests, important imaging, and unresolved concerns.
Required monitoring and safety needs during transport.
Treatment plans and information needed by the receiving team.
Records prepared for a transfer should be distinguished from records actually transmitted or provided.
When critical information is handed off, there should be a reliable way to document that communication.
7. ENSURE PATIENTS UNDERSTAND WHAT THEIR PORTAL DOES—AND DOES NOT—SHOW
Hospitals should clearly explain what types of records are available in patient portals and how patients can obtain additional documentation from an entire hospitalization or course of treatment.
Patients should not be left to assume that the information visible in a portal represents every note, consultation, assessment, or document associated with their care.
Healthcare institutions should make it straightforward to request more complete records, including clinician documentation and medication administration histories, subject to applicable access rules.
And significant medical information relevant to a patient’s decisions should be meaningfully communicated—not merely entered into a chart or made electronically available.
8. IMPROVE PATIENT ACCESS TO AND UNDERSTANDING OF MEDICAL RECORDS
Patients should be encouraged to review their own records and have accessible ways to ask questions about unfamiliar entries.
They should have clear processes for raising possible inaccuracies, requesting amendments when appropriate, and obtaining explanations of significant discrepancies.
Access to records should be timely and consistent with applicable law.
A patient’s ability to understand their care should not depend on discovering important information after a crisis.
9. ENSURE SERIOUS CLINICAL CHANGES RECEIVE APPROPRIATE EVALUATION
Important changes in a patient’s condition—including confusion, hallucinations, decreased consciousness, respiratory symptoms, and other significant deterioration—should receive appropriate assessment, communication, and escalation.
Before high-risk treatments, relevant symptoms, laboratory abnormalities, possible infection, and other serious concerns should be considered as part of the clinical decision.
We are not asking hospitals to guarantee outcomes.
We are asking them to use meaningful safety processes and explain the clinical reasoning when serious questions arise.
10. PRESERVE RELEVANT RECORDS AND EXPLAIN DOCUMENTATION DISCREPANCIES
We request preservation of relevant existing records, including medical and medication administration records, consent documents, treatment-planning materials, transfer paperwork, ambulance records, handoff communications, and available printing, scanning, transmission, document-history, and electronic audit records.
We also request clarification of identified discrepancies, including differences between planned care, ordered care, and care actually administered.
Where treatment intent is described differently across records—for example, as curative in one context and palliative in another—we ask for an explanation of the terminology, clinical goals, and what was communicated to the patient.
A difference in documentation does not automatically establish improper billing or intentional misrepresentation. It does warrant clarification.
11. DEMONSTRATE ACCOUNTABILITY THROUGH MEASURABLE IMPROVEMENTS
When a review identifies deficiencies, we ask for appropriate corrective action and a meaningful explanation of the improvements made, within applicable legal and privacy limits.
We want hospitals to have a transparent process for receiving serious family concerns, coordinating review, providing substantive responses, and identifying improvements that can help prevent similar problems.
We also ask for direct involvement by appropriate executive and patient-safety leadership, not solely a routine administrative acknowledgment.
Accountability should mean more than saying a concern was received.
It should mean taking the concern seriously, examining the evidence, providing meaningful answers, and improving safety when improvements are warranted.
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.
We are not asking healthcare professionals to predict the future with certainty.
And we are not asking the public to decide whether medical negligence, misconduct, or a particular cause of death has been established based solely on our family’s account.
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—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’s wishes should not be assumed without an appropriate opportunity to understand and discuss the options.
Serious concerns about treatment tolerance should not remain unexplained when they could affect a patient’s choice.
And when patients move between healthcare facilities, important information must be accurately communicated, changing conditions appropriately evaluated, and necessary safety measures addressed.
We are asking for transparency.
We are asking for meaningful written answers.
We are asking for an appropriately independent review.
We are asking for accountability where deficiencies are identified.
And we are asking for stronger protections that may help prevent other families from facing similar questions.
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.
Our mother and father cannot bring their daughter back.
And no answer will give our family the future we imagined with her.
But if sharing Brianne’s story helps another patient hear important information they otherwise might not have heard, ask a question they otherwise might not have asked, understand a medical record they otherwise might not have read, or make a decision that truly reflects their wishes, then her legacy can continue helping people.
She spent her life protecting others.
Now let her legacy help protect patients.
PLEASE SIGN AND SHARE
By signing this petition, you support the Carlson family’s request for meaningful answers about Brianne’s care and stronger patient-safety protections at Henry Ford Health, Corewell Health, and healthcare institutions more broadly.
Your signature does not mean you have determined that negligence or wrongdoing occurred.
It means you believe patients deserve honest communication, meaningful informed consent, accurate records, safe transitions of care, appropriate review of serious concerns, and a meaningful voice in decisions about their own healthcare.
Please sign.
Share Brianne’s story.
Talk about patient rights.
Ask questions.
Read your medical records—and understand that your patient portal may not contain every document from your care.
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.
ACCESS TO A PORTAL IS NOT THE SAME AS AN INFORMED CONVERSATION.
A NOTE IN A CHART IS NOT A CONVERSATION.
DOCUMENTED IS NOT THE SAME AS DISCLOSED.
THE PATIENT SHOULD NEVER BE THE LAST TO KNOW.
FOR BRIANNE. FOR EVERY PATIENT.
Written by Jennifer Marie Preston, sister of Brianne Rae Carlson, on behalf of the Carlson family.
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Petition created on December 13, 2025