Judge delays decision on removing Texas baby's life support

FORT WORTH, Texas (AP) — A judge newly assigned to decide if a Texas hospital can remove a 10-month-old girl from life support against her mother's wishes said Thursday she was allowing more time for a facility to be found that would take Tinslee Lewis, even as a doctor said the most basic activity “causes pain.”

Judge Sandee Bryan Marion of Texas' Fourth Court of Appeals said at the hearing in Fort Worth that she would decide by at least Jan. 2 if Cook Children's Medical Center could remove life support. Attorneys for the hospital and the girl's mother then agreed that if Marion denies the mother's request for a temporary injunction to stop the life support removal, the hospital won't take any action until seven days after the ruling.

Marion said she decided on the extension because she thought there was a reasonable chance a new facility could be found, and she needed more time to research the case. Marion was assigned to the case this week after a judge who'd granted a temporary restraining order last month was removed.

Doctors at the Fort Worth hospital had planned to remove Tinslee from life support Nov. 10 after invoking Texas’ “10-day rule,” which can be employed when a family disagrees with doctors who say life-sustaining treatment should be stopped. The law stipulates that if the hospital's ethics committee agrees with doctors, treatment can be withdrawn after 10 days if a new provider can’t be found to take the patient.

Hospital officials said they've reached out to more than 20 facilities to see if one would take Tinslee, but all agreed that further care is futile.

Tinslee has been at Cook Children's since she was born prematurely on Feb. 1, 2019. The hospital said she has a rare heart defect and suffers from chronic lung disease and severe chronic high blood pressure. She hasn't come off a ventilator since going into respiratory arrest in early July and requires full respiratory and cardiac support, deep sedation and to be medically paralyzed. The hospital said doctors believe she's suffering.

But Trinity Lewis, Tinslee's mother, testified Thursday that despite her daughter's sedation, she has a sense of the likes and dislikes of the daughter she describes as “sassy.” She said Tinslee likes getting her nails done, but doesn't like having her hair brushed. She says her daughter squeezes her hand, and enjoys the animated musical “Trolls,” crying when it ends.

“I want to be the one to make the decision for her,” Lewis said, about removing her daughter from life support.

Lewis said she can even tell her daughter's favorite nurses, saying she smiles at those she likes and stares at those she doesn't.

But nurse Kara Lane said she doesn't think Tinslee is able to recognize her. And she said that while Tinslee is capable of moving her arms, she doesn't believe it's purposeful. Lane said some nurses are so concerned about the pain the girl is in that they refuse to work shifts caring for her.

Dr. Jay Duncan, one of Tinslee’s physicians, described the girl's complex conditions and Cook Children’s efforts to treat her, which have included seven surgeries. The cardiac intensive care doctor said that for the first five months of Tinslee’s life doctors had hope she might one day at least be able to go home.

But Duncan said there came a point when doctors determined they had run out of surgical and clinical options, and that treatment was no longer benefiting Tinslee. The girl is not likely to survive six more months, and the hospital has made “extraordinary” efforts to find another facility for her, Duncan said.

“She is in pain. Changing a diaper causes pain. Suctioning her breathing tube causes pain. Being on the ventilator causes pain,” Duncan said.

Duncan said there had been “many, many” conversations with Tinslee’s family about her dire condition.

“We care a lot about Tinslee," Duncan said. "We care a lot about her family."

Tarrant County Juvenile Court Judge Alex Kim issued a temporary restraining order to stop the removal of life support on Nov. 10. But Kim was removed from the case last week after the hospital filed a motion questioning his impartiality and saying he had bypassed case-assignment rules to designate himself as the presiding judge.

After his removal, Marion was assigned to hear the request for an injunction. Trinity Lewis' attorney is also asking the judge to declare the “10-day rule” unconstitutional.

Cook Children's said hospital officials have been talking to Tinslee's family for months about concerns for her long-term survival. By August, the hospital said, everyone on the girl's care team agreed that further care was futile and by September they had begun talking to the family about withdrawing life support. With the doctors and her family still unable to resolve their differences, the ethics committee met Oct. 30 and unanimously decided further treatment was inappropriate.

Texas Right to Life, an anti-abortion group that opposes the “10-day rule," is among advocates for Tinslee that have been trying to find a facility to take her.

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