Court battle over ventilator takes patient from Minnesota to Texas

Scott Quiner, operations manager at a Minnesota transportation company, fell ill with Covid-19 in October.

Mr Quiner, 55, who was not vaccinated, was hospitalized the following month and his case became so severe that he had to be placed on a ventilator, court records show. For weeks, he remained on a ventilator at Mercy Hospital in Coon Rapids, Minnesota, a town of 62,000 about 16 miles north of Minneapolis.

Then, on January 11, hospital officials told Mr. Quiner’s wife, Anne, that they would remove him from the ventilator in two days, despite his objections.

What followed was a court case that raised questions about who has the right to make harrowing life-and-death decisions when patients cannot speak for themselves. He also pointed to tensions between people who refuse the coronavirus vaccine and hospitals that have been filled with patients with the virus, the majority unvaccinated.

In court documents, Mercy Hospital did not provide specific reasons why it decided to remove Mr. Quiner from the ventilator. Allina Health, which oversees the hospital, declined to comment on Mr Quiner’s case, citing patient confidentiality. Ms. Quiner did not respond to messages seeking comment.

On January 12, Ms Quiner pleaded for the help of a lawyer on the ‘Stew Peters Show’, a podcast whose host falsely called coronavirus vaccines ‘toxic beatings’ and gave a platform pandemic conspiracy theories.

She said that other than her husband’s lungs, his organs were working and “there was nothing wrong with his brain”. Just days earlier, she said, her husband had opened his eyes “and was more alert.”

“I think, ‘Why are you killing him? ‘” Said Ms Quiner, whose husband made her his health worker in 2017. Under Minnesota lawthis means she has the power to make medical decisions on his behalf if he is unable on his own.

Credit…Marjorie J. Holsten

On the day of her podcast appearance, she found a lawyer, Marjorie Holsten, who immediately filed for a restraining order to stop the hospital from removing Mr. Quiner from the ventilator.

Judge Jennifer Stanfield of the Anoka County Tenth Judicial District Court granted the order. On Jan. 15, Mr. Quiner was airlifted to a Texas hospital, where, Ms. Holsten said, his condition had improved significantly. She declined to identify the hospital.

Ms Holsten said: ‘He was conscious until they gave him a ton of sedatives. That’s when he was put on a ventilator. In Texas, she said Wednesday, “the doctor said he waved his hand” and “nodded and blinked in response.”

Mr Quiner, who remains on a ventilator, had lost 30 pounds and was described as the “most malnourished patient” a Texas hospital doctor had ever seen, Ms Holsten said.

Allina Health said in a statement that it “has great confidence in the exceptional care provided to our patients, which is administered using evidence-based practices by our talented and compassionate medical teams.”

“Allina Health continues to wish the patient and his family well,” the statement read.

In court papers, lawyers at Mercy Hospital said Mr Quiner’s treatment was based “on the best science and medical authority available”. In a motion, the lawyers asked Judge Stanfield to issue an order stating that the hospital had the authority to remove the ventilator.

Specialists were consulted and the treatment was “consistent with Mercy’s policies and procedures regarding medically non-beneficial interventions,” the attorneys wrote.

Mr Quiner did not specify whether he wanted to be kept alive on machines in his advance directive, a legal document stating what treatments he does and does not want.

On the form, he specified his wishes only in a section that asked about spiritual and religious beliefs.

“Ask family and friends for prayer at the bedside,” he wrote.

Minnesota hospitals have been overwhelmed with a combination of Covid-19 patients and those with other conditions, particularly in the Minneapolis and St. Paul area, according to the Covid-19 hospitalization monitoring project to University of Minnesota.

Thusday, only 1% of adult beds in the intensive care unit were available, according to the Minnesota Department of Health.

Resource scarcity can be a factor in a hospital’s decision to withdraw care, but it’s rarely a major factor, said Thaddee Popeprofessor who teaches health law and bioethics at the Mitchell Hamline School of Law in St. Paul.

Under Minnesota law, healthcare providers who believe a health worker is not acting in a patient’s best interest must appear before a judge, he said.

“It’s a rare situation where you’re going to override what the officer is saying,” Prof Pope said. “The hospital does not make health care decisions. The patient does it, and if the patient doesn’t have the capacity, the health worker does it.

Before going to court, doctors should try to communicate effectively with a health worker, he said. If that fails, doctors should present their case to an ethics committee, which would ideally include members of the community in addition to health workers, to determine whether the authority of the health worker should be overridden, said Professor Pope.

The decision to remove life support machines is easier when doctors have determined that a patient meets the criteria for brain death, said Dr. Mary Groll, professor of health sciences at North Central College in Naperville, Illinois.

But if a patient’s brain function is intact and a meaningful life remains possible, decisions about medical care rest more squarely with the patient or their proxy, Dr. Groll said. Physicians should then have candid conversations about what kind of future a patient may face, she said.

Medical training has become more focused on prioritizing a patient’s medical wishes, Dr. Groll said.

“Ultimately, it all starts and ends with your patient,” Dr. Groll said. “Your care starts with that person and ends with that person, and they should be at the center of decision-making.”

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