First Healthcare Corp. v. Rettinger

Lawrence Rettinger, who suffered from Parkinson’s disease, executed a living will stating that he did not want his life to be prolonged by extraordinary means if his condition was terminal and incurable. Lawrence was placed in the Winston-Salem Convalescent Center (center) (plaintiff), and a copy of Lawrence’s living will was put on file. Lawrence was transferred to a hospital, where doctors inserted a nasogastric tube to treat Lawrence for pneumonia. After Lawrence returned to the center, Lawrence’s wife, Nell Rettinger (defendant), was informed that Lawrence’s condition was irreversible and incurable. The center refused Nell’s request to remove the tube based on a policy of not removing a nasogastric tube if doing so would lead the patient to starve or dehydrate to death. On June 25, 1991, Lawrence’s attending physician, Dr. Frederic Romm, signed a form from Lawrence’s attorney affirming Romm’s determination that Lawrence’s condition was terminal and incurable and that Romm had ordered the removal of the tube (the form). On September 12, 1991, a judge, finding that a second doctor had confirmed Romm’s determinations regarding Lawrence’s condition, ordered the tube to be removed. The tube was removed on October 5, and Lawrence died on October 22. The center sued Nell for payment for services rendered to Lawrence from June 26, 1991, to October 22, 1991. Nell argued that had the nasogastric tube been removed on June 26, 1991, Lawrence would have died, so she should not be responsible to pay for services provided following that date. The center, arguing that Romm never told the center to remove the tube, submitted an affidavit by Romm stating that he never sent the form to the center and that his findings regarding Lawrence’s condition were never confirmed by another physician. The judge granted summary judgment for the center.