Commonwealth v. Carlson

849 N.E.2d 790 (2006)

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Nature of the Case

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Facts

Carol and her husband, Robert, left their home to attend a cookout at their daughter's. They had just entered the intersection when their automobile was struck on the passenger side by an automobile operated by D. The force of impact pushed Carol's automobile a distance of approximately fifteen to twenty feet, across the road, over a sidewalk, and into a chain link fence. Traffic entering the intersection from D's direction was controlled by both a stop sign and blinking red light. A jury could infer that D had failed to stop (or yield the right of way) at the intersection and, thus, was negligent. Carol suffered multiple chest wall fractures. Several years prior to the accident Carol has suffered from chronic obstructive pulmonary disease (COPD). Carol required the use of an oxygen tank in her home to assist in her breathing. The additional trauma to her chest from the accident compromised her ability to breathe as she had before the accident, to the point where she could no longer oxygenate her blood by normal breathing. That night in the intensive care, Carol was intubated and placed on a ventilator. The next morning, the doctors removed her from the ventilator, and she was transferred to a medical floor in the hospital. Breathing difficulties increased. Three doctors advised to put her back on a ventilator in order to assist her breathing. Carol in the past had repeatedly told her daughter-in-law that she never wanted to be kept alive by a ventilator, and refused permission for the doctors to do so. Her family and friends convinced her to be reintubated, at least temporarily, in order to determine if her health would improve. Carol's kidneys began to fail and would require dialysis. She asked to be removed from the ventilator. Her doctors counseled against it, but she was adamant. Carol was taken off the ventilator, and the intubation tube was removed. She died a few hours later from respiratory failure. At D's trial, a doctor testified that the chest injuries suffered in the accident 'tipped the scales against Carol.' He also opined that Carol's decision not to be intubated 'likely played a role in her death.' Another doctor stated his opinion 'to a reasonable degree of medical certainty' that the victim would have survived her injuries if she had agreed to mechanical ventilatory support, and might even have returned to the state she was in before the accident, but conceded as well that the victim might have required 'chronic and continuous ventilatory support.' D's motions for a required finding of not guilty were denied. D asserts that the victim's death was a direct result of her independent decision not to undertake medical procedures that could be considered appropriate for a person in her condition and that would, in all probability, have allowed her to survive the accident. D argues that Carol's choice broke the chain of causation and relieved D of criminal responsibility for the death. D was found guilty of appealed.