Local NewsJudge’s Decision Allows Cook Children’s Hospital to Take Tinslee Lewis Off Life Support

Justice Sandee B. Marion denied a temporary injunction filed on behalf of the Lewis family, effectively allowing Cook Children's to end treatment in accordance with the Texas 10-Day Rule.
January 2, 2020
Today, after granting an extension following a hearing on December 12, Justice Sandee B. Marion denied a temporary injunction filed on behalf of the Lewis family seeking to prevent Cook Children’s from removing baby Tinslee Lewis from life support in accordance with the Texas 10-Day Rule. 

“I am heartbroken over today’s decision because the judge basically said Tinslee’s life is not worth living,” Tinslee’s mother, Trinity, said following today’s ruling according to Texas Right to Life, a pro-life advocacy organization working with the Lewis family.

“I feel frustrated because anyone in that courtroom would want more time just like I do if Tinslee were their baby. I hope that we can keep fighting through an appeal to protect Tinslee. She deserves the right to live,” Trinity continued.

Representatives for the family say the Lewis’ intend to file an emergency motion to stay. 

If granted, the legal action will prevent Cook Children’s from ending treatment while the appeal is decided.

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Born prematurely in February 2019, Tinslee suffers from Ebstein’s anomaly — a rare congenital heart condition that makes her dependent on a ventilator along with other medical equipment for proper heart and lung functioning. 

Having treated Tinslee since her birth, Cook Children’s Ethics Committee, an entity  composed of both hospital employees and community members alike, informed the Lewis family that they would be removing Tinslee from life support, effectively ending treatment. 

Citing their belief that they have provided all the care they are capable of to the ailing infant, Cook Children’s informed the Lewis family that baby Tinslee would be removed from life support in accordance with the Texas 10-Day Rule under the Texas Advance Directive Act

Under this controversial statute, medical providers who determine that a path to recovery is not foreseeable for a patient in their care are legally authorized to withdraw treatment 10 days after the family is informed of their decision.

The mandated time frame is intended to give the family time to either find another medical facility willing to accept their loved one as a patient or seek legal recourse in the form of a court injunction.

On November 10, just hours before Tinslee was to be removed from life support under the 10-Day Rule, Tarrant County Judge Alex Kim issued a temporary restraining order effective through November 22, preventing the hospital from withdrawing treatment.

A mutual agreement was made between legal representatives for both the Lewis family and the hospital further extending the order through December 10, giving the family more time to find another facility willing to accept Tinslee. 

On November 15, however, Cook Children’s filed a motion for the recusal of Judge Kim from presiding over the case, citing concerns about the judge’s ability to remain impartial based on past associations with organizations known to advocate against the Texas 10-Day Rule. 

Additionally, the hospital contended that inappropriate methods were used in obtaining the original temporary restraining order.

Subsequently, the hospital’s motion was granted, leading to the recusal of Judge Kim and appointment of Justice Marion to oversee the case. A hearing was then set for December 12. 

During the hearing, Joe Nixon, attorney for the Lewis family, expressed opposition to the Texas 10-Day Rule and gratitude to Cook Children’s for the care they’ve provided despite their employment of the statute. 

“The culprit in this case is not Cooks…The culprit here is the statute,” Nixon said.

In arguing against the statute, Nixon contended that the Texas rule is a violation of due process under the Fourteenth Amendment that eliminates Trinity’s “right to decide” her daughter’s fate. 

On the other side, attorney for Cook Children’s, Geoffrey Harper, argued the constitutionality of the statute and expressed concern over Tinslee’s current condition expressing the hospital’s belief that further treatment would prolong the infant’s suffering. 

“The undisputed medical evidence is she’s in pain and she’s suffering, and more importantly, everything we are doing to her is causing that,” Harper said.

“The statute is not about what the patient is entitled to. The issue is what is this medical team required to do… the issue is – can you compel a doctor to provide a certain care to a patient?” he continued. 

After hearing arguments from both parties, Justice Marion issued an extension until January 2 to review both sides of the case before issuing a final decision.

Since the December 12 hearing, Rep. Tony Tinderholt (R-Arlington) along with other other members of the Texas Legislature sent a letter with bipartisan support to Governor Abbott requesting a special session to repeal the 10-Day Rule on behalf of Baby Tinslee. 

During the regular legislative session earlier this year, Tinderholt co-authored a bill with other legislators that would provide additional rights to patients while also providing for medical facilities and their ability to communicate treatment concerns. 

Tinderholt along with Rep. Tan Parker (R-Flower Mound) also previously gave their support to Tinslee and the Lewis family before and after the issuance of the original temporary restraining order on November 10.

“I believe our responsibility as legislators is to protect the basic rights of our citizens. This unjust law protects neither the right to life nor due process…We ask Governor Abbott to call a Special Session to prevent future parents from having to fight for the very lives of their children,” Tinderholt said when the letter was issued.

Referring to the rule as “draconian,” the letter describes the method of transfer mandated by the Texas Advanced Directives Act as “nearly impossible,” forcing families to race against the clock as they seek another facility willing to provide medical treatment for their loved ones.

“No other state has codified such gross deprivation of due process for the ailing and disabled, yet a dozen states have enacted a protective measure that fosters cooperation between the current facility and the family. The 10-Day Rule is a black mark on our state’s record on how we care for the ailing and disabled,” the letter continued. 

Tinslee’s case also generated support from Texas Attorney General Ken Paxton, who filed an amicus brief earlier this year advocating for the Lewis family and against the Texas 10-Day Rule. 

Proponents of the 10-Day Rule, however, have issued support for the controversial statute in the form of letters to Governor Abbott and amicus brief filings of their own. 

Catholic Health Association of Texas recently sent a letter to Governor Abbott supporting the hospital’s decision to employ the directive saying, “Cook Children’s has provided the best, most compassionate care to Tinslee. We stand by the medical team’s efforts to lessen her pain and the ultimate recommendation to end her ongoing suffering.”

Texas Alliance for Life, Texas Catholic Conference of Bishops, Texans for Life Coalition, Coalition of Texans with Disabilities, Texas Alliance for Patient Access, Texas Medical Association, Texas Osteopathic Medical Association, Texas Hospital Association, LeadingAge, and Tarrant County Medical Society also filed an amicus brief defending the 10-Day Rule against what they describe as a “constitutional attack.”

During the hearing on December 12, it was decided that if the judge did deny the temporary injunction, the hospital would continue to treat baby Tinslee for a period of 7 days after the decision was handed down in order to give the family a chance to appeal or file a motion for emergency relief. 

According to Texas Right to Life, Tinslee’s case is currently being reviewed by two medical facilities deciding whether or not to accept her as a patient.

An appellate court will now decide whether or not to grant Tinslee more time through an emergency stay.

Here’s a look at the timeline of baby Tinslee’s story so far:

February 2019: Tinslee Lewis is born prematurely and diagnosed with Ebstein’s anomaly.

October 30: The Lewis family is informed of a decision made by the Cook Children’s Ethics Committee to end Tinslee’s treatment.

October 31: A letter explaining the decision of the hospital’s ethics committee to discontinue treatment is delivered to Trinity, marking the beginning of the 10-day time frame under the Texas Advance Directives Act.

November 10: Tarrant County Judge Alex Kim issues a temporary restraining order effective through November 22, preventing Cook Children’s from ending treatment. 

November 19: The temporary restraining order is temporarily extended until December 10.

November 20: Cook Children’s files a motion to recuse Judge Kim from Tinslee’s case, citing concerns about the Tarrant County Judge’s ability to remain unbiased and violations in the way the original order was issued. 

December 4: Judge Kim is recused from Tinslee’s case.

December 9: The case is assigned to Chief Justice Sandee B. Marion of the Fourth Court of Appeals.

December 10: A hearing is scheduled for December 12. 

December 12: The temporary injunction hearing results in an extension until January 2.

January 2, 2020: Justice Marion denies the temporary injunction allowing Cook Children’s to remove Tinslee from life support. 


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Sarah McConnell, Reporter for The Texan

Sarah McConnell

Sarah McConnell is a reporter for The Texan. Previously, she worked as a Cyber Security Consultant after serving as a Pathways Intern at the Department of Homeland Security – Citizenship and Immigration Services. She received her Bachelor’s degree in Political Science from Texas A&M as well as her Master of Public Service and Administration degree from the Bush School of Government and Public Service at Texas A&M. In her free time, Sarah is an avid runner, jazz enthusiast, and lover of all things culinary.

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