## Facts

- Tara Hawkins, age 18 and pregnant, suffered head trauma and was taken by ambulance to a hospital emergency room unconscious and intubated.
- Tara never regained consciousness and remained on mechanical ventilation and other life-sustaining measures for months.
- Tara’s mother, Nonnie Hawkins, signed the hospital’s admission consent form on Tara’s behalf.
- A neurologist conducted an EEG shortly after admission and concluded Tara had severe global anoxic brain injury and imminent brain death; the neurologist discussed fetal termination to reduce oxygen demand, which Nonnie refused.
- Physicians repeatedly evaluated Tara over time and found no brain or brain-stem function.
- The pregnancy was continued to viability, and Tara delivered a live baby.
- The hospital had a written policy governing brain-based determination of death; clinicians conducted the brain-death work-up under that policy.
- Physicians performed apnea testing by temporarily discontinuing mechanical ventilation; Tara showed no spontaneous respirations. EEG testing showed absence of brain-wave activity.
- After a subsequent apnea test again showed no respiratory drive, Tara was pronounced dead; mechanical ventilation and other life support were not restarted.
- Nonnie disputed that Tara was brain dead and alleged the hospital caused Tara’s death by withdrawing life support without proper consent.

## Issues

1. Whether the timing and validity of a brain-death determination is a specialized medical question requiring expert testimony.
2. Whether the plaintiff produced evidence creating a genuine issue of material fact that Tara was not brain dead when ventilation was discontinued and not resumed.
3. Whether alleged lack of consent to apnea testing or withdrawal/non-resumption of ventilation could be a proximate cause of death where brain death was established by unrefuted medical evidence.
4. Whether breach-of-contract theories based on alleged lack of consent could proceed when the parallel tort causation showing failed.
5. Whether the estate could recover past and future lost wages as damages under the pleaded claims.

## Decision

- The Court of Appeals of Georgia affirmed in part and reversed in part.
- The court held defendants were entitled to summary judgment on the tort and contract claims because the plaintiff failed to present expert evidence disputing brain death or proving causation.
- The court concluded lay observations (e.g., reports that Tara appeared to “cry” weeks earlier) did not create a triable issue contradicting later, medically supported findings of brain death.
- The court held that even assuming defective consent, the plaintiff failed to show the alleged lack of consent proximately caused death because the evidence established Tara was already brain dead.
- The court affirmed partial summary judgment limiting damages, including disallowing recovery of Tara’s past and future lost wages on the record presented.

## Legal Principles

- Questions involving brain death and the timing of death based on neurological criteria are specialized medical matters that generally require competent expert testimony to create a genuine factual dispute.
- In wrongful-death claims alleging tortious withdrawal of life support, the plaintiff must present evidence—typically expert medical evidence—that the patient was not already legally dead and that defendants’ actions caused death.
- Alleged lack of consent does not establish liability absent proof of proximate causation; where uncontroverted evidence shows brain death, discontinuing ventilation is not treated as causing death.
- Contract claims premised on alleged failures to obtain consent and resulting death fail when they depend on the same causation theory rejected in tort.
- Damages for lost wages are subject to legal and evidentiary limits; summary judgment is proper where the claimed wage losses are not legally recoverable or are insufficiently supported.

## Conclusion

The court held that, without expert medical testimony disputing brain death and without evidence that any alleged consent defect caused death, the plaintiff could not maintain wrongful-death or related contract claims based on discontinuation and non-resumption of life support, and it upheld limits on lost-wage damages.


Hawkins v. DeKalb Med. Ctr., Inc., 313 Ga. App. 209, 721 S.E.2d 131 (2011)