Miller v. Hca

118 S.W.3d 758 (2003)

Facts

Four months before her due date, P was admitted to the hospital in premature labor. The fetus had a gestational age of approximately twenty-three weeks. It was discovered that P had an infection that could endanger her life and require them to induce delivery. They informed P and her husband, that if they had to induce delivery, the infant had little chance of being born alive. The physicians also informed P that if the infant was born alive, it would most probably suffer severe impairments, including cerebral palsy, brain hemorrhaging, blindness, lung disease, pulmonary infections, and mental retardation. Ps informed Drs. Jacob and Kelley that they wanted no heroic measures performed on the infant and they wanted nature to take its course. The request was marked, and the nursing staff informed other Hospital personnel of the instruction that no neonatologist would be present in the delivery room when the infant was born. In subsequent meetings, it was determined that it would be necessary to wait to see the circumstances of the baby. They then decided to let the neonatologist make the call by looking directly at the baby at birth. Another physician who attended the meeting agreed, testifying that to deny any attempts at resuscitation without seeing the infant's condition would be inappropriate and below the standard of care. Hospital administrators asked P's husband to sign a consent form allowing resuscitation according to the Hospital's plan, but he refused. P's condition worsened, and her amniotic sac broke. P delivered a premature female infant weighing 615 grams. Sidney's actual gestational age was twenty-three and one-seventh weeks. She was born alive. Sidney, although blue in color and limp, gasped for air, spontaneously cried, and grimaced. Dr. Otero also noted that Sidney displayed no dysmorphic features other than being premature. He immediately 'bagged' and 'intubated' Sidney to oxygenate her blood; he then placed her on ventilation. Ps did not object to the treatment. Sidney improved but at some point during the first few days after birth; she suffered a brain hemorrhage -- a complication not uncommon in infants born so prematurely. Sidney suffered severe physical and mental impairments. At the time of trial, Sidney was seven years old and could not walk, talk, feed herself, or sit up on her own. She was legally blind, suffered from severe mental retardation, cerebral palsy, seizures, and spastic quadriparesis in her limbs. She could not be toilet-trained and required a shunt in her brain to drain fluids that accumulate there and needed care twenty-four hours a day. Her circumstances will not change. Ps sued Ds (HCA, Inc., HCA-Hospital Corporation of America, Hospital Corporation of America, and Columbia/HCA Healthcare Corporation, and the Hospital, a subsidiary of HCA.) Ps asserted battery and negligence claims. Ps claim that despite their instructions to the contrary, D not only resuscitated Sidney but performed experimental procedures and administered experimental drugs, without which, in all reasonable medical probability, Sidney would not have survived. The jury found that D, without the consent performed resuscitative treatment on Sidney. The jury concluded that Ds were grossly negligent and that D acted with malice. The trial court rendered judgment jointly and severally on the jury's verdict of $29,400,000 in actual damages for medical expenses, $17,503,066 in prejudgment interest, and $13,500,000 in exemplary damages. D appealed, and the appeals court reversed. Ps had no right to deny the medical treatment given to Sidney and that no court order was necessary to overcome their refusal to consent. Ps