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Ramsey v. Coatney8/14/2002
Plaintiff, individually and as administrator of the estate of his mother, appeals from the district court ruling granting summary judgment in favor of defendants in the plaintiff's medical negligence action arising from the death of his mother. REVERSED AND REMANDED.
Plaintiff Boyd E. Ramsey, individually and as administrator of the estate of his mother Ethel Helen Reha Ramsey, appeals from the district court ruling granting summary judgment in favor of defendants, Drs. Richard Coatney and Elaine K. Berry, in the plaintiff's medical negligence action arising from the death of Ethel Ramsey. The plaintiff contends the court erred in granting summary judgment because genuine issues of material fact exist as to whether Ethel Ramsey was in a terminal condition when life-sustaining procedures were withdrawn or withheld. We reverse and remand.
I. BACKGROUND FACTS AND PROCEEDINGS
On July 3, 2000 Ethel Ramsey (Ethel) was admitted to the Cass County Memorial Hospital for treatment of pneumonia. Her treating physician was Dr. Richard Coatney, D.O. At the time Ethel was admitted she was ninety-two years old and had a long history of physical impairments and medical conditions. She had been the victim of a stroke leaving her with slight paralysis on one side (hemiparesis). She also suffered from progressive dementia and her swallowing mechanism was impaired. For the last year Ethel had only communicated by opening her eyes periodically and had no other self-movement beyond that. She could not feed herself and had to be fed by her son Boyd Ramsey (Boyd). The records of the nursing home where Ethel was living indicate she was refusing to eat until Boyd began feeding her. Due to her impaired swallowing ability Ethel often aspirated food causing recurrent aspiration pneumonias which had intensified in the last few years requiring her to be hospitalized for treatment because the pneumonia no longer responded to oral outpatient antibiotics.
Ethel had four adult children, the plaintiff Boyd Ramsey, Bill Ramsey, Joan Donnelly, and Carol Schoop. At the time of her admission to the hospital on July 3, 2000 Ethel had not prepared a declaration concerning life-sustaining procedures. On August 15, 2000 Dr. Coatney's progress notes on Ethel indicated that her lungs were "clear at this time." Boyd wanted intravenous (IV) hydrations continued and tubal feeding commenced at that time but Ethel's other three children wanted the IV stopped and no feeding tube to be introduced. Coatney's notes indicate he discontinued IV hydration on August 15, 2000 "at the request of Bill and his two sisters." Bill, Joan, and Carol all signed notarized statements on August 18, 2000, which were sent to the hospital and Coatney by their attorney. The letters stated, "We, as the majority of adult children of Ethel H. Ramsey, agree to the withholding of life-sustaining procedures, i.e., intravenous feedings or tube feedings, after consultation with the attending physician, Richard F. Coatney, D.O."
Dr. Coatney's progress notes dated August 22, 2000, indicate that faced with the continued disagreement on treatment between Bill, Carol, and Joan on one side and Boyd on the other Dr. Coatney had sought a second opinion from Dr. Elaine K. Berry, M.D. In these notes Coatney also discusses a phone call he received from Boyd's attorney who read him Iowa Code section 144A.7 (1999). Dr. Coatney's notes of August 22, seven days after IV hydration had been discontinued, include the following: "Who was the other doctor who stated she was terminal? I did not state Ethel was terminal. I did not state it. . . . This patient was never declared terminal by me."
Dr. Berry examined Ethel on August 21, 2000, a
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