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Smart Summary

Factual and Procedural Background

The decedent, a Muslim man, collapsed at work and was taken to the New York Hospital Medical Center of Queens where he was pronounced dead of cardiac arrest. The decedent's family was contacted around 2:00 A.M. and asked for information, including consent for an autopsy, but the consent questions on the hospital's "Notice of Death" form were left unanswered. The decedent's wife stated she informed hospital personnel of her husband's Muslim faith and her intention to take the body to a mosque, and was told to return at 8:00 A.M. However, when the family returned, the body was no longer at the hospital; the attending physician had notified the Office of the Chief Medical Examiner, which took possession of the body at about 7:00 A.M. and performed an autopsy at 2:00 P.M.

The decedent's wife and children filed suit against the hospital and attending physician alleging emotional distress from the wrongful autopsy and violation of the Public Health Law. The hospital and attending physician filed a third-party complaint against the Medical Examiner. The plaintiffs moved for summary judgment on liability, and the third-party defendants cross-moved to dismiss the third-party complaint. The Supreme Court granted both motions, but the Appellate Division reversed these decisions.

Legal Issues Presented

  1. Whether the hospital violated Public Health Law § 4214(1) by ordering or performing an autopsy without written consent within 48 hours of death.
  2. Whether written consent is required when an autopsy is performed by the Medical Examiner.
  3. Whether the hospital was negligent for failing to act upon knowledge or reason to believe that the autopsy would violate the decedent’s religious beliefs under Public Health Law § 4210-c.
  4. Whether the third-party defendants’ cross motion for summary judgment dismissing the third-party complaint was properly granted or premature.

Arguments of the Parties

The opinion does not contain a detailed account of the parties' legal arguments.

Table of Precedents Cited

Precedent Rule or Principle Cited For Application by the Court
Bambrick v. Booth Mem. Med. Ctr., 190 AD2d 646 Autopsy performed by Medical Examiner does not require hospital consent under Public Health Law § 4214(1). Supported the conclusion that the hospital did not order or perform the autopsy, so § 4214(1) did not apply.
Harris-Cunningham v. Medical Examiner of N.Y. County, 261 AD2d 285 Written consent not required for autopsy performed by Medical Examiner. Confirmed that consent requirement does not extend to Medical Examiner autopsies.
Liberman v. Riverside Mem. Chapel, 225 AD2d 283 Application of Public Health Law §§ 4210-a and 4210-b regarding lawful authority for dissection/autopsy. Supported the legal framework governing autopsies by the Medical Examiner.
Rotholz v. City of New York, 151 Misc 2d 613 Interpretation of Public Health Law provisions relating to autopsies and religious objections. Used to clarify the statutory authority and limitations on autopsies over religious objections.
Banks v. United Hosp., 275 AD2d 623 Negligence liability principles applicable to hospital personnel. Supported the existence of triable issues of fact concerning hospital negligence.
Haber v. Cross County Hosp., 37 NY2d 888 Evidence of negligence through failure to follow hospital protocol. Used to show that failure to complete the "Notice of Death" form could be evidence of negligence.
Kadyszewski v. Ellis Hosp. Assn., 192 AD2d 765 Hospital liability for negligence in handling decedent’s remains. Supported the argument that protocol violations may constitute negligence.
Hughson v. St. Francis Hosp., 96 AD2d 829 Hospital duty to respect decedent’s religious beliefs and family instructions. Reinforced the duty to consider religious objections to autopsy.
J A Vending v. J.A.M. Vending, 303 AD2d 370 Prematurity of summary judgment motions in the absence of compliance with discovery orders. Supported denial of third-party defendants’ cross motion as premature due to incomplete discovery.

Court's Reasoning and Analysis

The court analyzed the applicability of Public Health Law § 4214(1), which prohibits hospitals from ordering autopsies within 48 hours of death without written consent. It found this statute inapplicable because the autopsy was performed by the Medical Examiner, not the hospital. The court relied on precedents establishing that written consent is not required for Medical Examiner autopsies.

The court further considered Public Health Law §§ 4210-a and 4210-c, which prohibit dissection except by lawful authority and restrict autopsies over religious objections unless there is a compelling public necessity. Since there was no evidence of a specific objection to the autopsy, the plaintiffs’ motion for summary judgment on liability was inappropriate.

Additionally, triable issues of fact existed regarding whether hospital personnel were negligent by failing to act on information that the decedent was Muslim and that the family wished to take the body to a mosque, which could constitute a reason to believe an autopsy would violate religious beliefs. The incomplete "Notice of Death" form suggested possible protocol violations, which could support negligence claims.

Finally, the court determined that the third-party defendants’ motion for summary judgment was premature because discovery had not been completed, particularly regarding the period between the body’s release to the Medical Examiner and the autopsy.

Holding and Implications

The court reversed the Supreme Court’s orders:

  • The order granting the third-party defendants’ motion for summary judgment dismissing the third-party complaint was reversed and the motion denied as premature.
  • The order granting the plaintiffs’ motion for summary judgment on liability was reversed and the motion denied.
  • Costs were awarded to the appellants, payable separately by the plaintiffs-respondents and third-party defendants-respondents.

The decision means that the case must proceed to further discovery and potentially trial to resolve factual disputes concerning hospital negligence and the circumstances surrounding the autopsy. No new legal precedent was established; the court applied existing statutory and case law frameworks to the facts.

LIRIJE JUSEINOSKI et al., Respondents, v. NEW YORK HOSPITAL MEDICAL CENTER OF QUEENS et al., Defendants and Third-Party Plaintiffs-Appellants. OFFICE OF CHIEF MEDICAL EXAMINER OF CITY OF NEW YORK et al., Third-Party Defendants-Respondents.

Ordered that the order dated January 9, 2004, is reversed insofar as appealed from, on the law and as a matter of discretion, and the cross motion of the third-party defendants for summary judgment dismissing the third-party complaint is denied as premature; and it is further,

Ordered that the order dated May 13, 2004 is reversed, on the law, and the plaintiff's motion for summary judgment on the issue of liability is denied; and it is further,

Ordered that one bill of costs is awarded to the appellants, payable by the plaintiffs-respondents and the third-party defendants-respondents appearing separately and filing separate briefs.

The decedent, a Muslim, collapsed at work and was taken by ambulance to the defendant New York Hospital Medical Center of Queens (hereinafter the hospital), where he was pronounced dead of a cardiac arrest. Members of the decedent's family were called to the hospital around 2:00 A.M. and were asked for certain information. Although the hospital's "Notice of Death" form contained questions with respect to whether the family consented to an autopsy, the answers to those questions were left blank.

The decedent's wife claimed that she informed hospital personnel that her deceased husband was a Muslim and she wanted to take his body to a mosque, and was told to return at 8:00 A.M. to claim the body. Her daughter, who was also present, could only recall questions about insurance.

When the family returned to claim the body at around 8:00 A.M., the body was no longer at the hospital: the attending physician had notified the Office of the Chief Medical Examiner of the City of New York (hereinafter the Medical Examiner) of the decedent's death and the Medical Examiner decided to take possession of the body for autopsy. It appears that the Medical Examiner picked up the body at about 7:00 A.M. and performed the autopsy at 2:00 P.M.

The decedent's wife and children commenced this action against the hospital and the attending physician, alleging, inter alia, emotional distress arising from the performance of the wrongful autopsy and violation of the Public Health Law. The hospital and attending physician brought a third-party action against, among others, the Medical Examiner. The plaintiffs moved for summary judgment on the issue of liability and the third-party defendants cross-moved for summary judgment dismissing the third-party action. The Supreme Court granted the motion and the cross motion. We reverse.

The Supreme Court granted the plaintiffs' motion for summary judgment on the issue of liability based upon Public Health Law § 4214 (1) which prohibits a hospital from ordering the performance of an autopsy within 48 hours of death absent written consent of a person legally entitled to consent. However, Public Health Law § 4214 (1) does not apply in this case on the basis that the autopsy was not performed by hospital personnel and was not ordered by the hospital ( see Bambrick v. Booth Mem. Med. Ctr., 190 AD2d 646).

Where an autopsy is performed by the Medical Examiner, written consent is not required ( see Harris-Cunningham v. Medical Examiner of N.Y. County, 261 AD2d 285, 286). The applicable provisions are Public Health Law §§ 4210-a and 4210-b (1) ( see Liberman v. Riverside Mem. Chapel, 225 AD2d 283; Rotholz v. City of New York, 151 Misc 2d 613). Public Health Law § 4210-a renders it unlawful to make, or cause or procure to be made, any dissection of a human being "except by authority of law." Public Health Law § 4210-c (1) which provides that "in the absence of a compelling public necessity, no . . . autopsy shall be performed over the objection of a surviving relative or friend of the deceased that such procedure is contrary to the religious belief of the decedent, or, if there is otherwise reason to believe that a dissection or autopsy is contrary to the decedent's religious beliefs."

Since Public Health Law § 4214 (1) is not applicable, written consent was not required to perform an autopsy. We further note that there is no evidence in the record that there was a specific objection to an autopsy. In view of the foregoing, the plaintiffs' motion for summary judgment on the issue of liability should have been denied.

However, there are triable issues of fact as to the liability of the hospital based upon the alleged negligence of hospital personnel ( see Banks v. United Hosp., 275 AD2d 623, 624). If a jury believes that the decedent's wife informed the hospital that the decedent was a Muslim and further informed the hospital that she wanted to take the body to a mosque, there is an issue of fact as to whether that information was sufficient to give "reason to believe" that the autopsy was contrary to the decedent's religious beliefs (Public Health Law § 4210-c). Further the fact that the "Notice of Death" form prepared by the hospital contained questions as to whether the family consented to an autopsy which were left blank constitutes some evidence that there may have been a protocol to ask such questions. The violation of such a protocol would constitute some evidence of negligence ( see Haber v. Cross County Hosp., 37 NY2d 888; Kadyszewski v. Ellis Hosp. Assn., 192 AD2d 765; Hughson v. St. Francis Hosp., 96 AD2d 829).

The third-party defendants' cross motion for summary judgment should have been denied as premature on the ground that the third-party defendants failed to comply with discovery directed in the preliminary conference order ( see J A Vending v. J.A.M. Vending, 303 AD2d 370, 374). It appears that the body was released to the Medical Examiner at around 7:00 A.M. and the autopsy was not performed until 2:00 P.M. There are outstanding questions as to what occurred in those intervening hours which are uniquely within the knowledge of the Medical Examiner. [ See 3 Misc 3d 1106(A), 2004 NY Slip Op 50441(U) (2004).]

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JUSEINOSKI v. N.Y. HOSP. MED. CTR. OF QUEENS
(May 23, 2005)