Sama v. Hanniga

669 F.3d 585 (5th Cir. 2012)

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Nature of the Case

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Facts

P was an inmate when she was diagnosed with a form of cervical cancer known as endocervical adenocarcinoma in situ. She underwent a surgical procedure, which revealed a more extensive cancer than had initially been suspected. P was then thirty-six years of age desired to preserve the possibility of conceiving again. P was referred to the GYN Tumor Service, at which time Dr. Edward Hannigan (D) became involved in her case. It is undisputed that the appropriate treatment for her malignant tumor was a radical hysterectomy. P discussed the treatment and also reiterated her desire to conserve her remaining ovary for future fertility. P expressed understanding that the likelihood of preserving the ovary was low. Ds also stated in their affidavits that it was fully discussed with, and understood by, P that preservation of the ovary would be an intra-operative decision based on findings during surgery. P claims she made it clear 'with each and every one of the team of [physicians]' that she would not consent to the removal of her ovary. On the final consent form, she refused to initial certain items because she 'would not sign any permits that allowed the removal of my ovary.' Ds observed that the left ovary was grossly abnormal with multiple cysts, and it had adhered to surrounding structures in Sama's abdominal cavity. The surgeons were concerned with the risk of malignancy in the abnormal-appearing ovary and also determined that removal of the ovary was necessary 'to get to the lymph node basin and perform the parametrectomy (radical portion of the hysterectomy).' Ds concluded that the ovary was non-functional and that its removal was medically necessary and in P's best, long-term interest. The ovary was removed. The surgical pathology report revealed no evidence of persistent local disease or metastatic cancer. P sued, and Ds’ summary judgment motion based on qualified immunity was granted. P appealed.