The Case of the Missing Heart Comes to an End; More

Wayne J. Guglielmo, MA


June 16, 2016

In This Article

A Heart Being Examined for Autopsy May Not Have Been Human

In a ruling that effectively halted a challenge against a Houston hospital, the Texas Supreme Court last month found that the state's medical liability law—one of the toughest in the country—was broad enough to cover autopsies, according to a recent story posted on the website of the Texas Tribune.[1]

The ruling stems from a bizarre case involving the late husband of Houston resident Linda Carswell.

In January 2004, Jerry Carswell was admitted to Christus St Catherine Hospital, now owned by Houston Methodist, with kidney stones. Not long after, he was found dead in his hospital bed. Concerned that her husband's death might be related to a hospital-administered narcotic, Linda Carswell asked for an independent autopsy to be performed.

Instead, another hospital in the Christus Health system handled it, something Carswell didn't realize at the time. Although the autopsy proved inconclusive, it skipped over a toxicology test—a common exclusion in clinical autopsies,[2] but which, had it been performed, might have settled the narcotic issue one way or the other, Carswell said.

In a further twist, the examiner who performed the autopsy allegedly removed Jerry Carswell's heart without his widow's consent. After the hospital fought to retain the organ—arguing that it offered evidence that the patient had actually died of a heart attack—an appeals court ordered its release. At this point, Linda Carswell asked that an independent forensic biologist examine her husband's heart. The expert discovered something surprising: The heart contained no human DNA—either as a result of the way it was preserved, or because of the "real possibility that the heart submitted was not human."

Carswell filed her malpractice suit against the hospital more than 3 years after her husband's autopsy. She also sued for fraud, claiming that the hospital had misled her about the autopsy's "independence and scope." On the latter claim, a trial court jury agreed, slapping the defendant with a $2 million judgment.

But the high court's May ruling overturns that judgment, along with the plaintiff's malpractice claim.

Regarding the fraud judgment, the court decided that—contrary to the plaintiff's assertions—"the post-mortem fraud claim is a health care liability claim." As such, it is subject to the Texas Medical Liability Act, approved by voters in 2003; this act not only imposes a strict 2-year statute of limitations on medical liability-related claims but also requires testimony from experts at trial to establish malpractice.

The plaintiff, the court said, had failed to clear either hurdle. The court dismissed the plaintiff's malpractice claim for similar reasons, arguing that the Carswell autopsy was considered "healthcare" under the liability law and was therefore subject to the same restrictions and requirements.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.