In the early morning hours of January 20, 2023, emergency responders arrived at the Knoxville, Tennessee home of Dr. Ryan Shanks, an emergency room physician, to find his wife Sarah unconscious in their driveway. The 36-year-old mother of two, described as previously healthy, never regained consciousness and died nine days later. What transpired that night has become the subject of two competing lawsuits that paint starkly different pictures of Sarah’s final hours and the circumstances surrounding her tragic death.

The Husband’s Lawsuit: Alleging Medical Malpractice
Dr. Ryan Shanks filed suit against:
- American Medical Response (AMR) paramedics
- Knoxville Fire Department first responders
- Fort Sanders Regional Medical Center staff
- Covenant Health (parent company of Fort Sanders)
Key Allegations in Ryan’s Complaint:
- Failure to properly intubate Sarah’s airways
- Inadequate CPR administration during cardiac arrest
- Lack of urgency in transporting Sarah to the hospital
- Deviation from standard care protocols that allegedly led to her death
Notably absent from Ryan’s lawsuit:
- Any explanation of how Sarah became unconscious
- Mention of their marital separation
- Details about events preceding the 911 call
All defendants have denied wrongdoing in their legal responses.
The Parents’ Lawsuit: Pointing the Finger at Ryan
Sarah’s parents filed a separate wrongful death lawsuit alleging their son-in-law bears responsibility. Their complaint reveals:
Troubled Marriage Details:
- The couple was separated at the time of Sarah’s death
- Sarah had borrowed money to retain a divorce attorney
- Ryan allegedly told friends divorce would be “inconvenient” and “unaffordable”
- Ryan reportedly cloned Sarah’s phone to monitor her communications
Concerning Behavior Before the Incident:
- Ryan made separate calls to Sarah’s parents expressing suicidal thoughts
- He mentioned considering purchasing a gun that night
- The couple argued about these calls before Sarah’s medical emergency
Medical Findings Cited:
- Blood alcohol level of 0.1 (above legal driving limit)
- Abnormally low blood pH indicating oxygen deprivation
- Neck tissue damage and abnormal chest air pocket on imaging
- Global anoxic brain injury (severe oxygen deprivation)
The Conflicting Narratives of That Night
Ryan’s Version (Per Parents’ Lawsuit):
- Sarah drank wine and took sleeping pills
- She woke Ryan saying she fell in bathroom and hurt neck
- Later had panic attack, feared she would die
- Went outside to avoid waking children
- Ryan stepped inside briefly when paramedics arrived
Parents’ Concerns:
- Why was Sarah alone when help arrived?
- How did she sustain neck injuries?
- What caused the oxygen deprivation?
- Why did cardiac arrest occur 12 minutes after paramedics’ arrival?
Official Investigations Yield No Charges But Raise Questions
Knox County District Attorney Charme Allen declined to prosecute, calling the case “untenable” due to:
- Inconclusive autopsy results
- Lack of definitive physical evidence
- Complications from organ donation after death
However, Allen noted:
- The death was “highly suspicious”
- Ryan was the only adult present before Sarah was hurt
- There was evidence of marital instability
- Concerns about Ryan’s mental health beforehand
The medical examiner classified the cause of death as “could not be determined,” stating: “We could neither prove nor exclude foul play based on the lack of solid physical evidence of trauma.”
Legal Maneuvering and Public Statements
Ryan’s attorney, Gavin Shepherd, called the parents’ lawsuit:
- “False”
- “Defamatory”
- “Malicious”
Ryan has filed a motion to dismiss the parents’ case, maintaining that the medical responders bear responsibility. His attorney emphasized that Ryan has never been charged with any crime related to Sarah’s death.
Unanswered Questions and Ongoing Controversy
This tragic case continues to raise difficult questions:
- Medical Mystery: How did a healthy woman suddenly require emergency care?
- Marital Context: Did the pending divorce play any role?
- Response Timeline: Could different medical intervention have saved Sarah?
- Forensic Limitations: Why couldn’t modern medicine determine cause of death?
The Human Toll Behind the Legal Battles
Beyond the courtroom drama lies:
- Two children who lost their mother
- Parents mourning their daughter
- A husband maintaining his innocence
- Medical professionals defending their care
As both lawsuits progress through Knox County Circuit Court, they may reveal more about what truly happened during those fateful early morning hours when Sarah Shanks’ life took its tragic turn.