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Texas High Court Rules for Hospital in Missing Heart Case

A Texas hospital is safe from a Houston-area widow's malpractice suit because her husband's autopsy falls under a sweeping protection law for health care providers.

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A Houston-area widow cannot recover damages from a Texas hospital where her husband died under unusual circumstances because his autopsy — the widow's only realistic hope of determining why he died — falls under a sweeping law that protects health care providers from malpractice lawsuits, the Texas Supreme Court has ruled.

The unanimous ruling comes more than a decade after Jerry Carswell’s unexplained death at the Christus St. Catherine Hospital in Katy sparked a prolonged legal battle involving allegations of malpractice, deception and theft of a human heart.

The state’s high court on Friday ruled on the narrow question of whether the Texas Medical Liability Act applied to Carswell’s autopsy. The medical malpractice tort reform law, approved by Texas voters in a 2003 election, made it more difficult to sue health care providers for malpractice. It limited damages, required that suits be filed within a strict two-year statute of limitations and required testimony from medical experts at trial to establish malpractice.

Because Carswell’s widow Linda first challenged the hospital in court more than three years after her husband’s autopsy, and because autopsies are part of the professional services related to the medical care hospitals provide, it was too late to sue for malpractice claims, the Supreme Court found.

There was a 'real possibility that the heart submitted was not human.'— Court documents in the Carswell case

The case traces back to the morning of Jan. 22, 2004, when Jerry Carswell, admitted to Christus with kidney stones, was found dead in his hospital bed. Linda Carswell wondered if his death was due to a narcotic the hospital had administered. Carswell has said she asked for an independent autopsy, but her husband's autopsy was performed by a separate hospital under the same ownership as Christus St. Catherine Hospital — a fact she said she did not know at the time. That autopsy, which was inconclusive, did not include a toxicology test, which Carswell said could have shed light on whether the narcotic had killed her husband.

Further complicating matters, the examiner who performed the autopsy also allegedly removed the dead man’s heart without Carswell’s consent. The hospital fought not to release the organ, saying it could be important evidence that would show Carswell's husband died of a heart attack.

After an appeals court ordered the hospital to release the heart to Carswell, a separate forensic biologist said it contained no human DNA — either because of the way it was preserved, or because there was a “real possibility that the heart submitted was not human,” according to court documents.

A trial court jury sided with Carswell, who says she was misled by Christus Health about the autopsy’s independence and scope, and awarded her a rare $2 million fraud judgment against the health care provider.

But the Supreme Court ruling overturns that judgment, in addition to dismissing the malpractice claims, finding that “the post-mortem fraud claim is a health care liability claim.”

In court briefings, lawyers representing Christus Health argued Carswell's case fell under the Texas Medical Liability Act, which defines the nebulous term “health care” broadly enough to include autopsies. Christus Health appealed the case to the Supreme Court, although it sold Christus St. Catherine Hospital to Houston Methodist in 2014.

The high court concurred that the law was broad enough to apply to the case.

According to the Texas Supreme Court’s summary of the case, the Carswells claimed that “because the injuries they suffered from the hospital’s fraud did not involve an act rendered ‘for, to, or on behalf of a patient during the patient’s medical care, treatment, or confinement.’”

“We disagree,” wrote Justice Phil Johnson in the court’s majority opinion. “The Act does not limit its reach to persons receiving or having received health or medical care—it applies to ‘claimants.’”

Disclosure: Christus Health has been a financial supporter of The Texas Tribune. A complete list of Tribune donors and sponsors can be viewed here.

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