A surgeon passes a clamp to a team member during an operation under focused lights.
PHILADELPHIA – A 7-year-old girl in need of a new heart won’t be moved to the front of the line, as a federal judge has refused to second-guess the policies governing organ transplants.
Philadelphia judge Chad Kenney ruled Wednesday against the girl’s parents, who took the U.S. Department of Health and Human Services to court earlier this month as their daughter struggles with end-stage heart failure and renal failure.
Her spot on the recipients list has been complicated by at-home treatment and severe illness. Without a transplant, the girl is sure to experience more bleeding in her airway while being unable to use a Ventricular Assist Device, the suit says.
Under the National Organ Transplant Act, the federal Organ Procurement and Transplantation Network must issue priority rankings for waiting lists that order patients “from most to least medically urgent.”
The girl’s classification as Status 1A is the highest priority, but her parents last year decided against having her hospitalized to instead care for her at home, which they have been doing since 2021. It wasn’t until Jan. 7, 2026, that she began to accrue hospital time that ranks potential recipients, but at one point she was too sick to receive a transplant and was taken off the Status 1A list for a period of time.
“The Court… understands a parent’s desire to pursue and engage all resources in an attempt to assist a severely ill child,” Kenney wrote.
“However, in this instance, Plaintiffs are asking the Court to place its thumb on the scales of justice in a context in which countless doctors, experts, transplant patients, members of the public, and other interested parties have weighed in.”
The suit called on DHHS Secretary Robert F. Kennedy, Jr. to “prevent malfunctioning” of the organ transplant system. Child Doe’s parents wrote letters to authorities in the days leading to the lawsuit.
Lawyers for the Department of Justice defended the system in a motion to dismiss, saying the case is not about empathy for the child or sympathy for her parents.
“It is about the fundamental inequity of prioritizing the Child’s life ahead of other sick children’s lives,” the motion says.
“Moving the Child up on the waiting list will move other children down. Indeed, if parents could sue HHS to gain their children a higher spot on the waiting list, then the allocation of organs would be the product of never-ending litigation favoring those that retain counsel.”
Kenney agreed with the DOJ that the plaintiffs failed to meet certain legal thresholds, especially with their claim under the Administrative Procedure Act. The APA governs federal agency actions, but it didn’t apply to this case, he wrote.
No action has been taken on the parents’ letter to authorities, which doesn’t necessarily mean they’ve been denied relief.
“Indeed, as Plaintiffs acknowledge, Defendant may very well decide after his review that the OPTN’s policies violate HHS’s regulation and that, as a result, it should begin the process of revising its policies,” Kenney wrote.
“If that does, in fact, occur, judicial review may have been unnecessary.”
