A quadriplegic father of five, 46-year-old Michael Hickson, died last month after he was diagnosed with coronavirus and the Austin hospital treating him concluded he had little “quality of life” left and halted his treatment.
Hickson became a quadriplegic after he went into cardiac arrest in 2017 while he was driving his wife, Melissa Hickson, to work. He received CPR and suffered a brain injury due to loss of oxygen to his brain. Over the past three years, he has been in and out of hospitals and rehabilitation facilities as well as his home.
Hickson was residing at Brush Country, a nursing and rehabilitation center in Austin, when Mrs. Hickson was notified on May 15 that her husband had tested positive for coronavirus after being infected by a staff member at Brush Country but was asymptomatic. On May 25, she was informed he had tested negative.
However, two weeks later on June 2, Mrs. Hickson was informed that her husband was experiencing coughing, trouble breathing, and a low-grade fever and had been admitted to St. David’s South Austin Medical Center. The next day, Hickson was moved to the hospital’s intensive-care unit.
Several days later on June 5, Hickson’s wife was notified that he was not doing well, and she visited him in the hospital. She was not allowed into her husband’s room, but she was permitted to have a FaceTime call with him from hallway. During that call, Hickson was conscious and responsive, puckering his lips when his wife asked, “Can I get a kiss?” and nodding his head when she asked whether he wanted to pray with her.
That same day, the ICU doctor had a conversation with Mrs. Hickson in the hospital hallway that was recorded, during which he informed her that in his assessment, her husband did not have much quality of life left.
“So as of right now, his quality of life — he doesn’t have much of one,” the doctor said.
“What do you mean? Because he’s paralyzed with a brain injury, he doesn’t have quality of life?” Mrs. Hickson responded.
“Correct,” the doctor answered.
The next day, Saturday, June 6, Mrs. Hickson was notified that her husband had been moved out of the ICU in stable condition and breathing on his own and that hospice care would be in touch with her. The hospice representative told Mrs. Hickson that her husband would be resuscitated and would receive fluids and nutrition. However, the hospital nurse gave her conflicting information, saying that he would not receive nutrition, hydration, or resuscitation. By this point, Hickson had developed pneumonia.
“They withdrew food, fluid, and any type of medical treatment to him” for six days, Mrs. Hickson said in a video statement about her husband’s death, adding that during that period she pleaded with both the hospital and her husband’s temporary court-appointed guardian, Family Elder Care, to “please, please stop this,” but “they refused.”
The last day Mrs. Hickson saw her husband was that Saturday, and she spent the following days until his death on Thursday, June 11 attempting to regain her legal- guardianship rights and schedule FaceTime calls with her husband. She was not able to schedule another call with her husband due to apparent communication issues between her, Family Elder Care, and the hospital.
Hickson passed away shortly after 10 p.m. on June 11 and his wife said the hospital did not notify her until 11:30 a.m. the next morning, when hospice care called to ask if she wanted the information of the funeral home where his body had been transported.
Mrs. Hickson was originally appointed temporary guardian of her husband, but a probate-court investigator for Travis County asked Mr. Hickson’s sister, Renee Hickson, who is a physician, to file for guardianship rights as well, which she did. In the meantime, Probate Court judge Guy Herman appointed Family Eldercare as his temporary guardian. At first, Family Eldercare agreed to his wife’s request that he be placed in a brain- and spinal-cord-injury program, rather than a nursing home. Later in March, the facility moved Hickson to Brush Country but assured his wife that the search for a rehabilitation facility for Hickson was ongoing. Mrs. Hickson believes that the court took her guardianship rights away because she refused to place him in a nursing home.
After he was hospitalized for coronavirus, Family Elder Care and St. David’s “decided together the fate of my husband,” Mrs. Hickson said.
A statement from the hospital provided by a St. David’s spokesperson read:
The loss of life is tragic under any circumstances. In Mr. Hickson’s situation, his court-appointed guardian (who was granted decision-making authority in place of his spouse) made the decision in collaboration with the medical team to discontinue invasive care. This is always a difficult decision for all involved. We extend our deepest sympathies to Mr. Hickson’s family and loved ones and to all who are grieving his loss.
St. David’s chief medical officer, Dr. DeVry Anderson, denied that Hickson’s previous condition as a quadriplegic with a brain injury factored into the hospital’s decision to halt his treatment.
“We don’t use disability, or gender, or race, or religious background or anything like that to determine if we’re going to offer care to a patient,” Dr. Anderson told KVUE, Austin’s ABC affiliate. “And so in no way did his disability contribute to us not offering him care.”
In a statement, Family Elder Care offered condolences to Hickson’s family and appeared to contradict his wife’s account that her husband was denied nutrition for several days before his death. The facility said it “consulted with Mr. Hickson’s spouse, family, and the medical community on the medical complexity of his case.”
“Mr. Hickson’s spouse, family, and the medical community were in agreement with the decision not to intubate Mr. Hickson,” the facility said in the statement. “As Guardian, and in consultation with Mr. Hickson’s family and medical providers, we agreed to the recommendation for hospice care so that Mr. Hickson could receive end-of-life comfort, nutrition and medications, in a caring environment.”
Brittany Baize, director of Development and Communications at Family Elder Care told National Review that laws governing guardianship and confidentiality prevents the facility from responding directly beyond the public record.
Asked about whether Family Elder Care made the decision to remove Hickson’s nutrition and hydration in tandem with his doctor, she responded that “those are merely allegations.”
Since the facility’s temporary guardianship has ended, Family Elder Care is “in no way preventing” Hickson’s medical records from being released to his family, Baize added.
Regarding the apparent communication difficulties between Family Elder Care, the hospital, and Hickson’s wife when Mrs. Hickson was attempting to schedule FaceTime calls with her husband, Baize said, “I’m sure it’s being presented that way.”
Dr. Monica Verduzco-Gutierrez, a Houston-area brain injury and neurotrauma specialist and professor at the University of Texas Health Science Center, weighed in on the case on Twitter, saying she disagrees with the hospital’s decision.
“As a Brain Injury Medicine physician, I have fought for patients like this every day of my career in Physiatry,” Verduzco-Gutierrez wrote in a tweet about Hickson’s case. “Begging doctors who don’t know the outcome data or ‘wouldn’t want to live that way’ to give a chance at treatment, rehab, & life.”
Hickson may have had “more quality of life than any of us,” she said.
A video posted in April 2018 shows Hickson awake and interacting with his family, laughing as someone tells him a story, and singing “Happy Birthday.”
“I never had a chance to even say goodbye,” Mrs. Hickson said in her video message. “His voice, which was me, was ripped away from him. That’s not right.”
“He deserves so much more. And now today, I’m a widow, and my children fatherless because someone decided that his life wasn’t worth treating,” she said.