Miller v. HCA, Inc. *.

• Author: Bostrom, Barry A.
• Position: Nota Bene

HELD: Premature infant could not be fully evaluated for medical treatment until birth. Once the infant was born, the physician attending the birth was faced with emergent circumstances. These circumstances preclude a claim for battery, that is, for treating a child without parental consent, an exception to the general rule requiting consent to treatment.

The circumstances of this case began in August 1990, when approximately four months before her due date, Karla Miller was admitted to Woman's Hospital of Texas (the "Hospital") in premature labor. Karla's physicians discovered that Karla had an infection that could endanger her life and required them to induce delivery. Her obstetrician and neonatologist informed Karla and her husband that the infant had little chance of being born alive. They also informed them that if the infant was born alive, it would most probably suffer impairments including cerebral palsy, brain hemorrhaging, blindness, lung disease, pulmonary infections, and mental retardation.

After a discussion, the doctors asked the Millers whether they should treat the infant if it was born alive. The Millers informed the doctors that they wanted no heroic measures performed and they wanted nature to take its course. A medical note of the non-treatment decision was made and the medical staff was notified that no neonatologist would be needed. Mr. Miller left the Hospital to make funeral arrangements for the infant.

Later, Hospital administrators and doctors met and decided that denial of any attempt at resuscitation without seeing the infant's condition would be inappropriate and below the standard of care. The neonatologist present at the birth testified that there was no way to determine viability of a premature infant prior to assessment at the time of delivery. The Millers refused to sign a consent for resuscitation.

That evening Sidney Miller, a female, was born alive at twenty-three weeks gestation. The neonatologist provided treatment and placed her on ventilation because he decided that the baby had a reasonable chance of living, and was not necessarily going to have problems later on. The Millers did not object to this treatment. After a few days, Sidney had a brain hemorrhage, a complication not uncommon in premature infants. The hemorrhage caused physical and mental impairments.

At the time of trial, Sidney was seven years old and could not walk, talk, feed herself, or sit up on her own. She was legally blind, had...