Analysis

Baby Tinslee in Texas may get a second chance thanks to new doctor

life support, Texas, 10-day rule

A family battling to save their daughter’s life may have a new chance at hope. Last year, staff at Cook Children’s Medical Center in Fort Worth enacted Texas’ 10-day rule in the case of Tinslee Lewis, allowing the hospital to remove life-sustaining treatment, despite her parents’ wishes. Tinslee’s parents fought back. Now, a new doctor has stepped forward, saying he is willing to treat Tinslee, leading the family’s lawyers to file a new motion requiring Cook Children’s to grant emergency privileges to Dr. Glenn E. Green.

Tinslee, who celebrated her first birthday in February, was born premature, and was diagnosed with a rare heart defect called Ebstein’s anomaly, which causes her heart to press against her lungs. She has had to undergo multiple heart surgeries since July of 2019, and needs a ventilator to breathe. It was also in July that doctors began taking her off life support, which her family was firmly against. By September, doctors began a hospital ethics committee review, the first step towards invoking the state 10-day rule, giving the family 10 days to find another facility willing to treat her, or have Tinslee taken off of life support.

In a previous legal brief, Cook Children’s staff acknowledged that Tinslee is not brain-dead, and is kept sedated and paralyzed, using that as their excuse for removing life support. “She cannot move. She cannot cuddle. She is rarely, if ever, held,” the brief said. “The physician who has been treating her since birth has never seen her smile.” The brief also claims the treatment Tinslee receives is painful for her, will not improve her condition, and is therefore not fair for the staff.

Yet Dr. Green disagrees, and believes Tinslee’s condition has the potential to improve.

READ: The ’10-Day-Rule’ in Texas is an unethical and institutional power play

 

Green, a professor of otolaryngology at the University of Michigan, worked with Dr. Patrick Roughneen, a physician from Galveston, Texas, to evaluate Tinslee. Roughneen assessed her in person, and both Roughneen and Green agree there may be underlying airway issues leading to her “dying spells,” as described by Cook Children’s, and that these underlying issues could be treated, perhaps as easily as with a tracheostomy. Roughneen also said he found “no evidence” of pulmonary hypertension.

“Baby T.L. should be treated no differently than any other child who has been on a ventilator this long,” Dr. Roughneen said in a statement to Texas Right to Life. “Tracheotomies are routinely performed for patients after 14-days on a ventilator. Baby T.L. has been on a ventilator for over 10 months. It is not within the standard realm of care to leave a patient on a ventilator this long and refuse a tracheostomy. The benefits of a tracheostomy versus a ventilator are decreased work of breathing, reduction in airway dead space, avoidance of tracheo-innominate fistula [a lethal complication of an indwelling tracheostomy tube] and management of pulmonary secretions. Hence there are very specific patient benefits to performing this procedure.”

According to Texas Right to Life, which has been fighting for Tinslee and her family from the beginning, there are no doctors in Dr. Green’s specialty and subspecialty at Cook Children’s. The motion filed this week asks the court to require Cook Children’s to allow Green to treat Tinslee, while both Green and Roughneen signed declarations with the court stating their treatment is medically necessary.

It’s a welcome sign of hope for a family forced to fight for basic care for far too long.

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