After experiencing complications from a surgery performed by Dr. Christina Richards, Lillian Birt was diagnosed with pneumonia and sepsis and was placed on life support. She was later admitted to the ICU, where she was treated primarily by Dr. Wei Peng. Over the next several days, Ms. Birt remained on life support because she was still suffering from respiratory failure, septic shock, and decreased heart function.
Despite a negative prognosis and failed weaning trials, Ms. Birt was not terminal. Dr. Peng testified that she “had a very good chance to return to another care facility if we [had kept]going.” He estimated she had up to a twenty percent chance of mortality. In other words, there was likely over an eighty percent chance that she would have survived if care had been continued.
No one told the children that their mother could have a meaningful recovery and could potentially go home. And even though both Dr. Richards and Dr. Peng knew that Ms. Birt had a good chance of surviving, because they wanted to respect the family’s wishes, they did not attempt to dissuade the children from withdrawing care.
Reluctantly, the children agreed to withdraw Ms. Birt’s life support. After his conversation with the children, Dr. Peng gave Ms. Meeks a form to sign indicating that Ms. Birt’s condition was “terminal” and that “[t]o continue providing life-saving procedures would only serve to unnaturally prolong the moment of death and unnaturally postpone or prolong the dying process.” Dr. Richards, as the treating surgeon, also signed this consent form asserting that continuing Ms. Birt’s treatment would unnaturally prolong the dying process. Unbeknownst to the children, the statements on the form were untrue.
Ms. Birt was taken off the ventilator but remained on palliative care, including sedation and pain management. According to Ms. Meeks, her mother made no effort to breathe after care was withdrawn. She died eight hours after Ms. Meeks signed the form to withdraw life-sustaining care.
A Utah medical malpractice case arose from the withdrawal of life-sustaining treatment that resulted in the death of Lillian Birt, alleging that while Ms. Birt was in the intensive care unit (ICU), her children decided to discontinue life support based on their understanding of conversations they had with their mother’s treating doctors about her condition. They alleged that they believed that their mother’s condition was terminal and that the treatment was unnaturally prolonging her life but, in fact, their mother’s condition was not terminal; there was a high likelihood that she would have recovered if treatment had been continued. Ms. Meeks sought damages for two different types of harm—harm done to the heirs as a result of the death through a wrongful death action and harm done to Ms. Birt before her death through a survival action.
The Utah medical malpractice jury ultimately found that the doctors acted negligently in connection with the withdrawal of care and awarded damages to the heirs on the wrongful death claim and to the estate on the survival claim. The doctors moved for judgment as a matter of law on the estate’s survival claim, which was meant to compensate the estate for the harm done to Ms. Birt before her death due to the doctors’ negligence. The doctors argued, in part, that Ms. Meeks did not provide any evidence allowing a jury to reasonably infer that Ms. Birt had experienced pain and suffering in the hours before her death. The district court denied the motion, finding that the jury could use evidence of Ms. Birt’s experience before doctors withdrew life-sustaining care to infer that she experienced pain and suffering after that care was withdrawn.
The Supreme Court of the State of Utah (“Utah Supreme Court”) held in its opinion filed on February 15, 2024: “the district court correctly instructed the jury that Ms. Meeks had the burden of proving the standard of care to establish medical malpractice. But we hold that the court erred in denying the doctors’ motion for judgment as a matter of law on the survival claim. Ms. Meeks failed to provide evidence—medical or otherwise—that Ms. Birt experienced pain, suffering, or inconvenience during the period between the doctors’ negligence and her death.”
Peng v. Meeks, 2024 Utah 5.
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