Written by: Donna MacKenzie, Michigan Medical Malpractice and Wrongful Death Lawyer
A patient in septic shock lies in an intensive care unit. The ICU doctors suspect an infection at her recent surgical site. Her surgeon disagrees. Days pass while the disagreement goes unresolved, and by the time she reaches the operating room, it is too late.
A Michigan jury held the hospital directly responsible for letting that happen, and on October 23, 2026, the Michigan Court of Appeals affirmed. In Estate of Allen v. Dixit, the Court upheld a verdict against Henry Ford Macomb Hospital for failing to implement and enforce its own chain-of-command policy. It also rejected the hospital’s attempt to erase a $4.3 million damages award under the Michigan Supreme Court’s 2024 decision in Daher.
The decision matters to any Michigan family that has lost a loved one to hospital negligence, and especially to families who lost a parent who supported them.
What Did the Court Hold in Estate of Allen v Calo?
- A hospital can be directly liable for administrative negligence when it fails to implement and enforce patient-safety policies, separate from any doctor’s malpractice.
- After Daher, a decedent’s lost earning capacity is not recoverable on its own under Michigan’s Wrongful Death Act. Loss of financial support to the family still is.
- A jury may infer negligence from a hospital’s violation of Public Health Code provisions that protect patients.
- A hospital that produced its chain-of-command policy more than a year after a court order was held in contempt and ordered to pay sanctions.
- A corporation’s designated witness speaks for the corporation. A hospital could not swap in a new designee to change damaging answers.
What Happened to Cathleen Allen?
Cathleen Allen was a 41-year-old single mother of two. On May 26, 2017, a plastic surgeon performed an abdominoplasty. About a week later, after the surgeon removed a drain, she went to the Henry Ford Macomb Hospital emergency room with chills, pain, weakness, fatigue, and confusion. She was in renal failure and septic shock.
She was moved to the ICU. Her ICU attending suspected the source was an abdominal infection from the surgery and raised it with the surgeon. He disagreed and told the ICU team to look elsewhere. Physicians agreed at trial that source control, meaning finding and removing the source of the infection, is the cornerstone of treating septic shock.
The surgery did not happen until June 6, after another ICU physician called a surgeon at a different Henry Ford campus for a second opinion. Ms. Allen did not survive. Plaintiff’s experts testified that she had necrotizing fasciitis and that surgery in the first days of her admission would likely have saved her life.
Why the Hospital Was Liable: Chain of Command
Most hospitals have a chain-of-command policy. It tells staff how to escalate a disagreement about a patient’s care, or a dangerous delay, to someone with authority to resolve it. Henry Ford Macomb had one. The question at trial was whether anyone knew it existed or used it.
The evidence was striking. The hospital’s chief of surgery, testifying as its corporate designee, said he was not sure chain of command applied in health care and was more familiar with it in a military setting. He later admitted he first read the policy after his deposition. Both ICU attendings said they first read it in the weeks before their second depositions.
Plaintiff’s hospital administration experts testified that an unenforced policy is meaningless, that a deadlock between physicians over source control was a classic reason to invoke it, and that the failure to do so caused the delay that led to Ms. Allen’s death. After an 11-day trial, the jury found the surgeon professionally negligent and the hospital administratively negligent. The jury based the hospital’s liability on its own conduct, not on vicarious liability for the surgeon.
Ruling 1: Loss of Financial Support Survives Daher
In 2024, the Michigan Supreme Court held in Daher v. Prime Healthcare Services-Garden City that Michigan’s Wrongful Death Act does not allow recovery of a decedent’s lost future earnings unless a beneficiary is entitled to them as financial support. The Allen trial took place in 2023, before Daher, and the jury awarded $4,336,988 for lost earning capacity.
The hospital argued the entire award had to be thrown out. The Court of Appeals disagreed. It agreed that lost earning capacity is no longer recoverable for its own sake, but held that loss of financial support remains recoverable under MCL 600.2922(6). The record showed the family had sought exactly that:
- Allen was the only parent supporting her two children, ages 19 and 15.
- Witnesses testified that she provided substantial financial support and intended to continue.
- Counsel addressed the children’s financial losses in opening and closing.
- The jury was instructed that damages could include loss of financial support to Ms. Allen’s beneficiaries.
The Court also held that the hospital waived the argument by not raising it in the trial court. It added that the amount of damages is for the jury to decide.
For families, the lesson is practical. After Daher, a wrongful death claim should be built around who depended on the person who died, and how much. That means documenting income, household contributions, and the support the decedent provided to children, a spouse, or others.
Ruling 2: Public Health Code Violations Can Support an Inference of Negligence
The Court of Appeals had held earlier in the case that the Public Health Code does not create a private right to sue. The trial court still instructed the jury, under M Civ JI 12.01, that it could infer negligence if the hospital violated two Code provisions:
- MCL 333.21513, which makes a hospital’s owner responsible for staff licensure, training, review of professional practices, and adherence to protocols.
- MCL 333.20201(1)(e), part of the patient bill of rights, which entitles a patient to adequate and appropriate care.
The Court upheld the instruction. Under Klanseck v. Anderson Sales & Service, it applies when the statute is meant to protect against the harm, the patient is within the protected class, and the evidence supports proximate cause. All three were met. The Court also rejected the argument that the instruction expanded the patient’s remedies. The jury was told only that a violation permitted an inference of negligence.
Ruling 3: Hiding the Policy Had Consequences
The family alleged that for more than two years the hospital represented that no chain-of-command policy existed. The trial court had ordered production of policies on safe, timely care and supervision in July 2021. Defense counsel finally emailed the policy in August 2022.
The hospital argued the requests were too vague to cover it. The Court of Appeals disagreed. The deposition notice under MCR 2.306(B)(3) referred to the complaint, which specifically alleged a failure to implement and enforce chain-of-command policies, and the document request was limited to the five days of Ms. Allen’s admission. The request clearly encompassed the policy.
The trial court found the hospital in contempt, reopened discovery, and awarded attorney fees for the repeat depositions. It found the delay was not intentional and declined to enter a default. The Court of Appeals held those sanctions were within the trial court’s discretion.
Ruling 4: A Corporate Witness Speaks for the Corporation
After its designee’s damaging testimony, the hospital asked to replace him with its former chief medical officer. The trial court refused, though it allowed her to testify as a fact witness. The hospital did not call her.
The Court of Appeals affirmed. Relying on federal decisions, it explained that a designee’s testimony represents the corporation’s knowledge, that the corporation must prepare its designee, and that a “we don’t know” answer can bind it at trial. Allowing a new designee to give new answers would permit the kind of “sandbagging” the rule is meant to prevent.
Why This Matters Beyond Hospitals
According to the CDC, about 1.7 million American adults develop sepsis each year, and at least 350,000 die during their hospitalization or are discharged to hospice. When treatment depends on timing, a disagreement left unresolved can be as dangerous as a wrong decision.
Nursing homes, rehabilitation centers, and assisted living facilities have their own policies for escalating a resident’s change in condition to a nurse, a physician, or a director. In our nursing home neglect cases, a facility’s written policies are often only the starting point. What matters is whether staff knew them and followed them. Our firm’s four in-house registered nurses review records in every medical malpractice and nursing home case to find where care broke down.
What Should Families Do After a Hospital Death?
- Request the complete medical records, including ICU flowsheets, consult notes, and nursing notes.
- Write down what you were told and by whom, especially about disagreements among doctors or delays in surgery or testing.
- Gather proof of financial support. Collect tax returns, pay stubs, and records showing how your loved one supported children, a spouse, or other family members.
- Ask about an autopsy if the cause of death is unclear.
- Do not wait. Michigan medical malpractice claims have short deadlines and a required notice of intent before suit.
- Talk with an experienced lawyer before signing anything from the hospital or an insurer.
Frequently Asked Questions
Can I sue a hospital in Michigan for its own negligence, not just a doctor’s?
Yes. In Allen, the jury found the hospital directly liable for administrative negligence in failing to implement and enforce its chain-of-command policy.
What is a hospital chain-of-command policy?
It is a procedure for escalating a disagreement or safety concern about a patient’s care to someone with authority to resolve it, such as a department chief or medical director.
Can my family recover my loved one’s lost income after Daher?
Not as lost earning capacity on its own. Family members who depended on the decedent can recover their loss of financial support. Damages can also include medical, funeral, and burial expenses, conscious pain and suffering, and loss of society and companionship. Our guide to Michigan wrongful death claims explains more.
Does a Public Health Code violation prove the hospital was negligent?
No. When the requirements are met, a jury may infer negligence from the violation, and the hospital can offer evidence to rebut it.
Are there limits on damages in Michigan medical malpractice cases?
Yes. Michigan caps noneconomic damages in medical malpractice cases under MCL 600.1483. For 2026, the general cap is $596,400, with a higher cap of $1,065,000 for certain injuries listed in the statute. Economic damages, such as loss of financial support, are not subject to that cap.
Is Estate of Allen v. Dixit binding on other courts?
No. It is an unpublished Court of Appeals opinion, so it is not binding precedent under MCR 7.215(C)(1), though courts may consider it persuasive. Daher is a binding Michigan Supreme Court decision.
Talk to a Michigan Wrongful Death Lawyer
If your loved one died after a delay in hospital care, you deserve answers about what happened and who is responsible. The attorneys and nurses at Olsman MacKenzie Peacock have spent decades holding hospitals, physicians, and care facilities accountable across Michigan, from . Our medical malpractice results and wrongful death results show the kinds of cases we handle.
Contact us today or call 1-800-366-8653 for a free, confidential consultation. There is no fee unless we recover for you.
Source: Read the full Michigan Court of Appeals opinion in Estate of Allen v. Dixit
This post is for general information and is not legal advice. Every case turns on its own facts. To discuss your specific situation, contact a licensed Michigan attorney.
About the Author
Donna MacKenzie is a partner at Olsman MacKenzie Peacock and a past president of the Michigan Association for Justice. She has recovered millions of dollars for Michigan families in medical malpractice, nursing home, assisted living, and wrongful death cases, and is recognized in Best Lawyers in America and Michigan Super Lawyers.