When medics arrived at Sarah and Ryan Shanks’ home shortly after 2:40 a.m. on January 20, 2023, the otherwise healthy mother of two was lying alone in the driveway, unconscious and struggling to breathe.
The situation worsened. Sarah lost consciousness and died nine days later.
What happened that night in Knoxville, Tennessee, has sparked much speculation. Everyone agrees Sarah should be alive, but that’s where their agreement ends.
Nearly a year after Sarah’s death, Ryan Shanks, an emergency room doctor, filed a lawsuit against the first responders and the hospital that treated her, alleging that their actions, or inactions, killed her.
Sarah’s parents filed their own lawsuit in January, alleging that Ryan intended to prevent Sarah from filing for divorce and was to blame for her death.
The lawsuits, both filed in Knox County Circuit Court, shed light on what occurred.
Ryan Shanks blames first responders and the hospital
Ryan’s lawsuit is brief and to the point: Everyone involved in Sarah’s care is responsible for her death. Sarah would still be alive if first responders from American Medical Response and the Knoxville Fire Department had provided her with better care. The same goes for the staff at Fort Sanders Regional Medical Center, he claims in the suit.
He claims that the staff failed to properly intubate Sarah’s airways, perform CPR, and transport her to the hospital in a timely manner. Overall, he claims, they did not follow acceptable care practices.
Ryan’s lawsuit contains few details about what occurred the night he called 911. It does not specify how Sarah developed shortness of breath or how her condition deteriorated. There is no mention of marital problems or that he and Sarah were separated.
Fort Sanders, Covenant Health (which owns the company), American Medical Response, and the city of Knoxville all denied wrongdoing in legal filings in response to Shanks’ lawsuit.
Sarah Shanks’ family: Ryan Shanks wanted to avoid divorce at all costs
Sarah had separated from Ryan and borrowed money to hire a divorce attorney in the months leading up to her death, her family claims in their lawsuit. According to the lawsuit, he told friends that getting divorced would be “inconvenient” and “unaffordable.”
The two argued about how to care for their two elementary-aged children, and Sarah’s family accused Ryan of controlling behavior. He cloned Sarah’s phone, creating a copy that he could view on a different phone, to get a “better picture of their marriage,” a family friend later told police.
Ryan Shanks’ attorney, Gavin Shepherd, told Knox News, part of the USA TODAY Network, that the family’s lawsuit was “false, defamatory, and malicious.” Ryan Shanks has moved to dismiss the family’s lawsuit.
“Dr. Shanks has never been charged with any crime associated with the death of his wife and he is confident that the true facts associated with her death will continue to be revealed in the pending lawsuit that he filed,” Shepherd explained to reporters.
The night medical care was summoned
According to Sarah’s family’s lawsuit, Ryan called her parents separately the night she was rushed to the hospital and told them he was thinking about buying a gun and having “suicidal thoughts.”
Later that night, Sarah and Ryan got into a fight over the calls. According to the family’s lawsuit, Ryan told police that Sarah had drank several glasses of wine and taken sleeping pills. (According to the family’s lawsuit, Sarah’s blood alcohol level was later reported to be 0.1, making her legally drunk.)
According to the family’s lawsuit, Sarah woke Ryan up around 1:30 a.m. to tell him she had fallen in the bathroom and hurt her neck, referring to comments Ryan had made to Sarah’s friend about the events of the night. She went back to bed, but got up again because she was having a panic attack. He told police Sarah told him she thought she was going to die, according to the family’s lawsuit.
Sarah eventually made her way outside to avoid waking the children. According to the family’s lawsuit, when paramedics arrived, she was alone on the driveway, unconscious. Ryan Shanks told cops he had stepped inside briefly when they arrived.
Sarah went into cardiac arrest 12 minutes after paramedics arrived, and they began chest compressions before transporting her to Fort Sanders.
Sarah Shanks’ family points out other details about her condition
- The family says an MRI showed Sarah suffered a “global anoxic injury,” which occurs when the brain is deprived of oxygen.
- Sarah’s blood gas pH level was alarmingly low, according to the lawsuit. That shows she was suffering from a severe lack of oxygen, the lawsuit says.
- The family says emergency room staff at Fort Sanders were concerned about foul play after a CAT scan revealed tissue damage around her neck and an “abnormal air pocket” in her chest.
DA didn’t charge Ryan Shanks but called Sarah’s death ‘highly suspicious’
The family’s lawsuit refers to a note from Knox County District Attorney Charme Allen to a Knoxville Police Department detective who was reviewing the case, which Knox News obtained via a public records request.
Allen stated that she intended to file no charges because Sarah’s autopsy was “inconclusive.” She described the case as “untenable.” Her hands were tied.
Allen described Sarah’s death as “highly suspicious,” and claimed Ryan was the only other adult she was with in the hours before she was injured. Allen cited “evidence of instability in their marriage” and concerns about Ryan Shanks’ mental health prior to his wife’s death.
Darinka Mileusnic-Polchan, Knox County’s Chief Medical Examiner, has also issued a statement regarding the Shanks case, which was reviewed in December.
Sarah’s lengthy hospital stay and the donation of her organs following her death made it difficult to determine what happened, according to the medical examiner. Sarah’s death certificate lists her cause of death as “could not be determined”.
“We could neither prove nor excluded foul play based on the lack of solid physical evidence of trauma,” Mileusnic-Polchan wrote.
When reached by phone, Sarah’s mother declined to comment. The family’s attorney, Don Bosch, did not respond to a note seeking comment.
