What evidence is required to prove a survival claim in Utah medical malpractice cases? Meeks v. Peng Explained

The Utah Supreme Court’s decision in Meeks v. Peng provides important guidance on both jury instruction requirements and evidentiary standards for survival claims in medical malpractice cases.

Background and Facts

Lillian Birt was on life support in the ICU when her children decided to withdraw care based on conversations with her treating doctors. The children understood their mother’s condition was terminal and that continued treatment would unnaturally prolong her life. However, Ms. Birt actually had over an 80% chance of survival if treatment continued. After Ms. Birt died eight hours after care was withdrawn, her daughter sued the doctors for medical malpractice, bringing both a wrongful death claim on behalf of the heirs and a survival claim on behalf of the estate.

Key Legal Issues

The court addressed two primary issues: (1) whether jury instruction 23, which required proof of “breach of the standard of care” without explicitly stating the plaintiff’s burden to prove the standard itself, was legally sufficient; and (2) whether sufficient evidence supported the survival claim damages for pain and suffering during the eight hours between care withdrawal and death.

Court’s Analysis and Holding

Regarding jury instructions, the court held that requiring proof of “breach of the standard of care” implicitly requires the jury to determine both the applicable standard of care and whether that standard was breached. The instruction correctly conveyed the plaintiff’s burden without needing to separately list each subsidiary element.

However, the court reversed on the survival claim. While the plaintiff argued the jury could infer pain and suffering from earlier “weaning trials” when Ms. Birt appeared distressed after being taken off sedation, the court found this insufficient evidence for the relevant time period. During the actual care withdrawal, Ms. Birt remained on palliative care including sedation and pain management, and showed no signs of distress—she made no effort to breathe when the ventilator was removed for the final time.

Practice Implications

This decision clarifies that survival claims require evidence specific to the time period between the negligent act and death. General evidence from different circumstances, even if superficially similar, cannot support reasonable inferences about the decedent’s experience during the relevant timeframe. Practitioners should ensure they have direct evidence—whether medical testimony or lay observations—of the specific harm suffered during the precise period at issue in the survival claim.