Judge considers allowing Arkansas hospital to deny resuscitation to ill child

PULASKI COUNTY, Ark. — Arkansas Children’s Hospital (ACH) in Little Rock has filed a petition against two parents who will not consent to a Do Not Resuscitate (DNR) order for their terminally ill child.

In an emergency petition filed on March 31, 2025, ACH requested that the court override the parents’ wishes and issue a DNR, allowing the child to pass away the next time he requires resuscitation. 

Court filings say the child, born Jan. 1, 2023, and referred to in the emergency petition as DJC, was born premature and has been in the hospital his entire life with no current discharge date scheduled.

DJC was reportedly born with multiple complications, including lungs that were underdeveloped.

According to court documents, the child’s condition worsened in February 2025 after DJC required “a prolonged period of cardiopulmonary resuscitation resulting in global brain injury resulting in further complications.”

The hospital said that DJC is not expected to walk, talk, or “have meaningful interactions,” and is on constant sedation and pain-relieving medications.

ACH said that its Ethics Committee and the child’s parents, his mother, Paulina Casillas, and father, Dezeioun Crudup, have met multiple times to discuss that continued resuscitation efforts are “medically inappropriate.”

The petition said that despite these conversations, the parents have refused to consent to a DNR order.

“Parents failure to consent to the DNR requires the ACH Care Team to continue to provide medically inappropriate care and treatment to patient,” the filing says. “It is the opinion of the care team that continued resuscitative efforts are medically inappropriate and will only result in unnecessary pain and suffering to the patient.”

The petition was filed for “injunctive and declaratory relief ordering and directing a healthcare decision be rendered for the patient.”

“ACH moves this court for an order allowing ACH to institute a Do Not Resuscitate Order for this patient,” the filing says.

A judge explained in a court order that Arkansas code, commonly known as Simon’s Law, requires a medical institution not to issue a DNR to a minor without the consent of at least one parent or guardian.

However, a subsection of Simon’s Law says that healthcare institutions aren’t required to continue care they deem medically inappropriate.

The order explains that Arkansas law also allows courts “an avenue to consent to treatment on behalf of a minor” when an emergency exists, there is a protest or refusal to provide consent, or no person authorized to provide consent is available.

During an April 7 hearing in the case, ACH Chief of Critical Care Medicine Dr. Ronald C. Sanders provided testimony in support of the petition.

Sanders, a member of DJC’s care team, explained that the child suffers from broncho-pulmonary dysplasia and is unable to properly oxygenate. This condition has caused frequent events in which his heart stops and resuscitation is required.

“Slight movements and routine patient care have previously caused DJC to be agitated and desaturate, requiring resuscitation. As such, DJC requires heavy sedation to limit desaturation events,” court documents say. “DJC has experienced numerous code events within the last year.”

Dr. Sanders reportedly explained that while DJC is currently on sedation and pain meds, those will lose their effectiveness over time, and the agitation that sometimes causes his heart to stop is happening on a daily basis.

During the April 7 hearing, the court also heard from DJC’s mother, Casillas, on the issue.

“The court is moved by the emotions expressed and the love shown by DJC’s parents at this difficult juncture,” a court order says. “DJC’s parents have expressed a desire to review their son’s medical records closely before such an important decision about his care may be made. The court is sensitive to their needs.”

The order, filed after the April 7 hearing, requires that DJC’s parents make a determination on changing his code status by April 21 at 5 p.m. If a determination is not made, the court will allow ACH to change his code status to DNR.

5NEWS has reached out to both parties in this matter and has not yet heard back.

During DJC’s nearly two-and-a-half-year stay at ACH, the relationship between the child’s parents and the hospital has grown unsteady. A lawsuit seeking a restraining order filed by the hospital in August 2024 claimed that Casillas allegedly attacked an employee, and the couple reportedly made “repeated, unprovoked threats” toward hospital staff.

ACH says in the complaint that it was seeking a temporary restraining order against Crudup and Casillas to “protect the life, health, safety, and welfare of its employees.”

An incident report from the hospital’s security department said that on June 29, 2024, officers were dispatched to the Pediatric Intensive Care Unit (PICU) for threats allegedly being made by Crudup toward a physician due to a care disagreement. The parents were threatened with a trespassing arrest, eventually leaving on their own accord.

Crudup was reportedly restricted from ACH property while Casillas was allowed to visit the patient, until an incident on Aug. 27, when she allegedly attacked a nurse.

The suit says that leading up to this incident, ACH employees opened the door, turned the lights on, and opened the curtains to ensure the patient’s room was well lit after a resuscitation.

“Defendant Casillas disagreed with this decision made by ACH employees and began verbally assaulting [the nurse] and other ACH employees in the vicinity,” the complaint says. “Defendant Casillas then physically attacked [the nurse] by grabbing [her] by the hair, ramming her head into a door, ramming her head into a table, and forcibly shaking her.”

The lawsuit claims that it took multiple people to remove Casillas from the nurse, who reportedly had visible injuries on her face, neck, and back.

“I am concerned for the life, safety, and welfare of our employees,” ACH Executive Vice President and Chief Legal Office Brent Thompson said in court documents. “Both Crudup and Casillas have repeatedly jeopardized the life, health, safety, and welfare of ACH and its employees, and I believe them to both be a continued risk to ACH employees.”

According to a security report from the incident filed as evidence in the case, Casillas claimed that she had requested new nurses for her child but had been ignored, and that a disagreement ensued over the door being open.

Casillas was arrested and charged with second-degree battery and terroristic threatening, to which she pleaded not guilty.

While Casillas was expected to face a jury on April 23 this year, the judge overseeing the case ordered that a fitness to proceed examination be administered. She’ll be in court on July 7 for a status hearing.

Shortly after filing the suit, ACH moved for a permanent injunction, which would last longer than the previously requested temporary restraining order.

The court decided on Nov. 1 that Casillas was barred from entering ACH but allowed to engage with hospital employees by phone to discuss her child’s care. The filing says Crudup would continue to follow ACH’s policies.

On Feb. 25, 2025, after the child’s condition had “significantly deteriorated,” Casillas requested that the injunction be amended due to “time-sensitive decisions regarding his medical care that must be made by the family.”

Two days later, a judge amended the injunction, allowing Casillas to visit at least one time per month for no more than an hour in a room designated by ACH. She was also ordered to provide notice before a visit.