Suing health care providers for wrongdoing just got harder in Texas, thanks to a Texas Supreme Court ruling on Friday that strengthens state limitations against medical malpractice lawsuits.
The Court found that even though a corpse is not a patient, examinations of a diseased body can still be subject to Texas’ strict rules regarding medical malpractice lawsuits, including a cap on damages and a two-year statute of limitations.There is a real possibility that the heart submitted was not human.
The case began 11 years ago, when Jerry Carswell died under mysterious circumstances at Christus St. Catherine Hospital. Anticipating a lawsuit, the medical examiner removed the dead man’s heart and retained it as evidence that the man died of a heart attack. The man’s wife, Linda Carswell, eventually sued, and a trial jury found that the hospital committed fraud when it removed Jerry Carswell’s heart without obtaining proper permission from Linda Carswell.
In a bizarre twist, the heart that was returned to Carswell contained no human DNA. A forensic biologist told the court that this could be either because of the way it was preserved, or because there was a “real possibility that the heart submitted was not human.”
The twist captivated public imagination, but had no effect on the state high court’s final ruling. Linda Carswell was blocked from receiving damages because she sued three years after the incident — outside the Texas Medical Liability Act’s (TMLA) statute of limitations for medical malpractice lawsuits.
The TMLA applied to this case because the fraud committed during Jerry Carswell’s autopsy was “directly related” to the hospital’s neglect in care while Jerry was alive. In the language of the Court, “the post-mortem actions of the defendants were taken for the purpose of concealing deficient pre-mortem health care.”
Critics say it’s the latest decision from conservative justices broadening state laws that makes it tougher to sue, while proponents point out the benefits of shielding doctors from lawsuits — including, even, attracting physicians to Texas in record numbers. Passed in 2003, the TMLA was the Texas Legislature’s response to the concern over rising health insurance premiums due to frivolous medical liability claims. They worried that a rising number of medical malpractice lawsuits promoted “defensive medicine”: physicians ordering expensive tests and procedures to protect themselves from liability in a medical malpractice case.
Researchers’ estimates about the cost of defensive medicine, however, vary widely.
For her part, Linda Carswell emphasizes the public cost of attacking the right to sue. “I’m doing everything I can right now to bring attention to the fact that we’re just one story of many stories,” she told The Texas Tribune. “If you get harmed in a hospital here in Texas, the doors to the courtroom are actually shut and barred.”
Many states have similar protections for doctors against medical malpractice suits. In California, for example, the Medical Injury Compensation Reform Act (MICRA) of 1975 imposes a cap of $250,000 on all damages in malpractice cases. The cap was set without indexing for inflation. If it had been inflation-indexed in 1975, the cap now would be $1.1 million, the LA Times points out.
Advocates of reforming California’s current law say the $250,000 cap on damages does more than discourage frivolous lawsuits; serious cases may receive little interest from lawyers, too.
“There’s no way they could make enough money to take the case on,” Eric Andrist, whose sister died at a hospital because doctors allegedly failed to diagnose a serious condition, told the LA Times in 2013. “MICRA made [my sister’s] life valueless.”
Restrictions on the right to sue can ‘save a modest amount for many by imposing devastating costs on a few.’ But the cap is popular in California, where voters appear concerned that malpractice lawsuits contribute to higher health insurance premiums. In 2014, Californians defeated Proposition 46, which would have raised the cap to $1.1 million and indexed it to inflation, by a significant margin — 67 percent against. At least six states impose a cap equal to the MICRA level of $250,000, according to the most recent database of reforms. In some states, however, the courts have intervened in favor of the right to sue. The Georgia Supreme Court overturned damages caps in 2010, and the Florida Supreme Court did the same in 2014.
The Florida Supreme Court actually accused the state legislature of manufacturing a “malpractice crisis” in order to push through severe restrictions on the right to sue — restrictions the Court said violate the state constitution’s equal protection clause. Florida’s cap of $500,000 or $1 million, depending on the circumstances, “has the effect of saving a modest amount for many by imposing devastating costs on a few,” a justice wrote in the 5-2 ruling.