This complex case began more than a decade ago and raises the questions of whether an autopsy should be considered a medical procedure and whether suits stemming from it should fall under the state’s medical liability act. In 2004, Jerry Carswell was admitted to a Katy, Texas, hospital with kidney stones and a small mass on his right kidney. On the 4th day of his hospital stay, Mr. Carswell, who had been receiving pain medication, was found dead in his hospital bed. The hospital believed the cause of death was a heart attack.

Seeking answers about this unexplained outcome, his spouse, Linda Carswell, requested an independent autopsy. However, the autopsy was actually performed by a sister hospital in the Christus Health system. At the time, Mrs. Carswell was not aware of which organization performed the autopsy, but this was discovered later.

The autopsy results were inconclusive. Mrs. Carswell believed a toxicology test might have pointed to a medication error as the cause of death, but the autopsy did not include one. Further, the autopsy was performed by what the plaintiff argued was a non-neutral party – a sister hospital.

The medical examiner who performed the autopsy was believed to have removed the patient’s heart without the family’s consent. The heart was not returned to the body for burial. The hospital fought to avoid releasing the organ, arguing that it could be important evidence that would show Mr. Carswell died of a heart attack. But an appeals court ruled that the hospital must release the organ. When the hospital finally did, a forensic biologist examined the sample provided and found no human DNA.

Why? Court transcripts speculated that the tissue was not properly preserved, or perhaps it was not even a human heart. A jury agreed, and awarded Mrs. Carswell a $2 million fraud judgment.

On appeal, however, the hospital’s attorneys argued that Mrs. Carswell’s suit should have fallen under the Texas Medical Liability Act. That act, which some observers believe makes it impossible for many with legitimate malpractice cases to litigate, would have required the use of experts and other protocols that would have weakened Mrs. Carswell’s chances for prevailing in her current appeal.

A press release from the Christus St. Catherine Health Center stated that only a tissue sample from Mr. Carswell’s heart had been retained after an independent pathologist had performed an autopsy requested by the family. But attorneys for Mrs. Carswell insisted that the Harris County Medical Examiner’s Office was required by law to be alerted of a request to perform an autopsy. That office would have employed a forensic pathologist to confirm or deny whether medications played a role in the unexpected death.

References

  1. Casey R. Casey: When an autopsy is a medical procedure. Houston Chronicle. November 6, 2015. http://www.houstonchronicle.com/opinion/outlook/article/Casey-When-an-autopsy-is-a-medical-procedure-6616205.php. Accessed November 24, 2015.
  2. Statement on Carswell Case. CHRISTUS Health website. http://www.christushealth.org/body.cfm?id=17&action=detail&ref=32. Accessed November 24, 2015.
  3. Christus Health Gulf Coast vs. Linda G. Carswell. More Law Lexapedia website. http://www.morelaw.com/verdicts/case.asp?n=01-11-00292-CV&s=TX&d=62365. Published August 29, 2013. Accessed November 24, 2015.
  4. Allen M. Cardiac Arrest: Hospital Refuses to Give Widow her Husband’s Heart. ProPublica. July 12, 2012. http://www.propublica.org/article/cardiac-arrest-hospital-refuses-to-give-widow-her-husbands-heart. Accessed November 24, 2015.