Fetus in Muñoz case is “distinctly abnormal,” attorneys say

01/22/2014 6:34 PM

11/12/2014 3:47 PM

Attorneys for the family of a pregnant Haltom City woman who has been on life support at John Peter Smith Hospital for eight weeks issued a statement late Wednesday that the fetus is “distinctly abnormal.”

The 22-week-old fetus’s lower extremities are deformed and it is impossible to determine its gender, the attorneys for the woman’s husband, Erick Muñoz, said in an emailed statement.

“The fetus suffers from hydrocephalus [water on the brain]. It also appears that there are further abnormalities, including a possible heart problem, that cannot be specifically determined due to the immobile nature of Mrs. Muñoz’s deceased body,” the statement said.

The fetus, which was deprived of oxygen for “an indeterminate length of time, is gestating within a dead and deteriorating body as the horrified family looks on,” the attorneys said.

Marlise Muñoz, 33, was 14 weeks pregnant when she collapsed Nov. 26. She was taken to JPS, where doctors told her husband that she was brain-dead. He and other relatives asked that life support be removed.

JPS officials refused, citing a state law requiring that a pregnant woman remain on life support until the fetus is viable, usually at 24 to 26 weeks.

Wednesday’s statement from attorneys Heather King and Jessica Janicek does not say whether the fetus is viable.

On Friday, state District Judge R.H. Wallace is scheduled to hear arguments about the law and whether to grant the family’s request.

Marlise Muñoz discussed with her family her wish not to have her life prolonged artificially, and she was competent when she made her wishes known, according to the lawsuit.

Few scientific studies

The case has made international headlines. But because of its controversial nature, experts at major medical institutions in the United States have declined to be interviewed about the prognosis for a fetus when the mother is brain-dead.

One of the few relevant studies was published in 2010 by a team of researchers in Heidelberg, Germany. In a survey of medical literature from 1982 to 2010, the team found 19 cases where a pregnant woman was declared brain-dead.

In 12 of those, a viable baby was delivered and survived the postnatal period. The gestational age at the time of brain death varied widely in the cases studied.

“Depending on maternal stability and fetal growth, the decision [to use life support for the mother] must be made on an individual basis,” the study said. “According to our findings, prolonged somatic support can lead to the delivery of a viable child.”

But, the study said, “the number of reported cases is too small to define the rate at which intensive care support of the brain dead mother can result in a healthy infant.”

Furthermore, “neurological, critical care, obstetric, neonatal transplant and ethical staff, along with the patient’s family, should collectively make a decision about future treatment steps.”

In the Fort Worth case, the Muñozes’ attorneys argue that the hospital is misconstruing the Texas Health and Safety Code by failing to read the relevant sections in conjunction with the entirety of the code. They argue that Marlise Muñoz would already be considered dead because there is “irreversible cessation” of spontaneous respiratory and circulatory functions.

The attorneys also argue that the Advance Directives Act does not extend to withholding or withdrawing life support to the unborn child.

The lawsuit further argues that the section of the code that says a person cannot withhold or withdraw life-sustaining treatment from a pregnant patient violates Marlise Muñoz’s 14th Amendment rights with regard to decisions about her own body and equal protection under the law.

Staff writer Tim Madigan contributed to this report.

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