Texas hospital says state has spent $24M to keep infant alive, files appeal to end life support

A Texas Medicaid program has spent $24 million to keep a toddler alive at Fort Worth, Texas-based Cook Children's Medical Center, the hospital said in an April 16 appeal cited by The Fort Worth Star-Telegram.

Two-year-old Tinslee Lewis was born with a rare heart condition and has been at Cook Children's for most of her life. She has been kept alive with "extreme efforts," the hospital said in the appeal, in which it asked the court to quickly schedule a trial date to determine whether life support care can be removed.

"Although this case has never been about money — and Cook Children's has never considered finances when making an end-of-life decision," the appeal says, "the State of Texas (through its manager of a Medicaid care program) is now threatening to interject the issue into this dispute."

Trinity Lewis, Tinslee's mother, has argued that her daughter could get better and the hospital shouldn't be able to decide her fate. Tinslee breathes with a ventilator and is sedated but conscious, Ms. Lewis said in January 2020, and responds to touch and stimulation. However, the hospital says Tinslee can't feel anything except pain, with multiple physicians testifying that Tinslee has no chance of recovery.

"This child should not be forced to endure this fate for months on end while this matter continues its creep through the legal system," the new appeal said.

"Cook still appears intent on killing (Tinslee) at the first available opportunity with increasingly crass language and reasoning and hyperbolic, gross mischaracterizations and misrepresentations of her actual condition and prognosis," the mother's response to the new appeal reads.

A Texas Medicaid manager is reviewing whether tax dollars should be spent on Tinslee's care "when such care is medically futile, far beyond the applicable medical standard of care and cannot impact her underlying condition," according to the hospital.

In October 2019, Cook Children's Ethics Committee voted unanimously to end Tinslee's care, which is within the hospital's legal right if care is deemed futile. However, Ms. Lewis fought back, with her attorney filing an injunction against the hospital in November 2019.

In January 2020, a 48th District Court in Fort Worth judge ruled that the hospital could end life support, a decision that was later reversed by the Second Appellate District of Texas in Fort Worth. In October, the Texas Supreme Court denied the hospital's petition to take Tinslee off life support, and in January, the federal Supreme Court also rejected the hospital's plea. The case now returns to the lower court for a final ruling. 

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