Tinslee Lewis case under review by insurance investigative unit, Cook Children’s says

·4 min read

The hospital providing life-sustaining treatment for a 2-year-old girl continued to ask a Fort Worth court to schedule a swift trial date in order to determine whether or not physicians can end the toddler’s care.

Tinslee Lewis’ family has been fighting to keep her alive at Cook Children’s Medical Center while the hospital says her condition will never improve and treatment should end. Tinslee Lewis’ mother, Trinity Lewis, said Cook Children’s Medical Center has “grossly mischaracterized” Tinslee’s condition.

Cook Children’s asked the 48th District Court of Fort Worth to quickly schedule a trial date to decide whether Tinslee’s life support care should be removed. Lewis and her legal team argue that they need more time to find another hospital to transfer Tinslee to and prepare their case for a hearing. The hospital has asked for a July 26 trial date. Attorneys for Tinslee and her mother filed paperwork asking for a January 2022 date.

On May 11, Cook Children’s filed a response to Lewis’ motion in which she and her legal team said the expedited court proceedings the hospital asked for would create “an unreasonable timeline for everyone, including this Court.”

In her motion filed May 6, Lewis said Tinslee, who was born with a rare heart condition, continues to improve. She is undergoing occupational therapy and has been weaned off pain medication, the motion says. Lewis and her attorneys need more time to develop their case for the trial due to Tinslee’s lengthy medical records. They also continue to search for hospitals to try and transfer Tinslee to, and hope her improving condition will lead to a transfer.

“Tinslee’s life is a miracle and she proves that every day!” said Kim Schwartz, a spokeswoman with Texas Right to Life, in a Friday news release. “Look at this evidence and see for yourself how she is improving.”

Schwartz was referring to a recent video and photos of Tinslee showing the toddler awake.

Tinslee has been kept alive with medical care and “extreme efforts,” according to hospital officials, and the hospital disputes Lewis’ description of her daughter’s condition. Through court motions, Cook Children’s continues to say that Tinslee is not improving and is suffering due to her medical treatment. None of her treatments have improved her underlying illness, which Cook Children’s says is terminal.

“She is being kept alive only by extraordinary and aggressive measures, and she continues to suffer,” the hospital’s motion said.

The hospital said no other facilities will take over Tinslee’s care despite Lewis and Cook Children’s reaching out to other hospitals and physicians.

Cost of Tinslee’s care

Debate over the cost of Tinslee’s care also intensified when the hospital said in its appeal that Texas had spent $24 million in Medicaid funds to help keep Tinslee alive. The state of Texas, Cook Children’s said, is threatening to interject in the case due to the cost.

Lewis and her attorneys said they had heard nothing about a potential intervention into the case and could not confirm Cook Children’s claims. A Texas Health & Human Services Commission spokeswoman told the Star-Telegram the agency has not tried to intervene in the case.

However, in its most recent motion, Cook Children’s said a review of Tinslee’s case was initiated by third-party administrator Aetna’s Special Investigative Unit, which has requested all of Tinslee’s records. The Special Investigative Unit’s mandate under Medicaid regulations is to investigate“waste, abuse, and fraud,” the motion says.

“In Cook Children’s experience, such reviews are often precursors to efforts to deny payment or even claw back funds previously paid,” the motion said.

Tinslee has spent most of her life at Cook Children’s. The legal battle surrounding the toddler has made its way through every level of the court system, and now is working its way through the appeals process.

In October 2019, Cook Children’s Ethics Committee voted unanimously to end Tinslee’s treatment. Under the Texas Advance Directives Act, the hospital can end treatment for a patient if the care is deemed futile. The Act also protects a hospital from being sued in such a case.

However, Lewis fought back for her daughter’s life. She and her attorney filed an injunction against the hospital in November 2019.

Since then, the case went up through the courts, with each side appealing if the ruling was not in their favor. In January 2020, a judge ruled that Tinslee could be taken off life support after an emotional hearing in the 48th District Court in Fort Worth. In July 2020, the Second Appellate District of Texas in Fort Worth reversed that decision.

In October 2020, the Texas Supreme Court denied the hospital’s petition to take Tinslee off life support and in January, the federal Supreme Court rejected the hospital’s plea, as well.

The case now returns to the lower court for a final ruling. If the 48th District Court rules in favor of Tinslee’s mother, the hospital cannot end her treatment.