218 F.3d 78 (1st Cir. 2000), 99-2153, Reynolds v. Mainegeneral Health

Docket Nº:99-2153
Citation:218 F.3d 78
Party Name:CINDY REYNOLDS, INDIVIDUALLY, AND AS PERSONAL REPRESENTATIVE OF THE ESTATE OF WILLIAM D. REYNOLDS; TINA MOORE, AS NEXT FRIEND OF KELLIANN RAE REYNOLDS, A MINOR; Plaintiffs, Appellants, v. MAINEGENERAL HEALTH, Defendant, Appellee.
Case Date:July 17, 2000
Court:United States Courts of Appeals, Court of Appeals for the First Circuit
 
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218 F.3d 78 (1st Cir. 2000)

CINDY REYNOLDS, INDIVIDUALLY, AND AS PERSONAL REPRESENTATIVE OF THE ESTATE OF WILLIAM D. REYNOLDS; TINA MOORE, AS NEXT FRIEND OF KELLIANN RAE REYNOLDS, A MINOR; Plaintiffs, Appellants,

v.

MAINEGENERAL HEALTH, Defendant, Appellee.

No. 99-2153

United States Court of Appeals, First Circuit

July 17, 2000

Heard May 12, 2000

Page 79

Joseph M. Jabar, with whom Daviau, Jabar & Batten and DavidaM. Glasser were on brief, for appellants.

George C. Schelling, with whom Gross, Minsky, Mogul & Singal, P.A. was on brief, for appellee.

Before: Torruella, Chief Judge, Lipez, Circuit Judge, and Keeton,[*] District Judge.

KEETON, District Judge.

This appeal requires us to interpret the scope of coverage under the Emergency Medical Treatment and Active Labor Act (EMTALA), 42 U.S.C. § 1395dd, for secondary risks associated with emergency conditions. After reviewing the record in light of the statutory scheme, we affirm the district court's summary judgment in favor of defendant-appellee MaineGeneral Health.

I. The Facts

Because we are reviewing the district court's summary judgment in favor of defendant-appellee, we recite the facts in the light most favorable to the plaintiffs-appellants. See Fed. R. Civ. P. 56.

On September 8, 1996, William D. Reynolds was driving a car that collided head-on with another vehicle. As a result of the accident, Mr. Reynolds suffered various injuries including several fractures of bones in his lower right leg and left foot. Mr. Reynolds was taken immediately by ambulance from the accident scene to the emergency room of Kennebec Valley Medical Center (now known as the MaineGeneral Medical Center and referred to throughout this opinion for convenience as "MaineGeneral" or the "hospital"). After an emergency room nurse had triaged Mr. Reynolds, he was examined by Dr. Harry Grimmnitz, the emergency room physician. Dr. Grimmnitz evaluated Mr. Reynolds, took an oral medical history, and ordered a series of laboratory tests, x-rays, and an abdominal CT scan. After considering this information, Dr. Grimmnitz determined that Mr. Reynolds suffered from multiple trauma to his lower right leg, including a probable open fracture of the right tibia and fibula and possible fracture of the left foot, and from a possible intra-abdominal injury.

Dr. Grimmnitz then requested consultations from Dr. Alexander Wall, a surgeon, and Dr. Anthony Mancini, an orthopedic

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surgeon. Dr. Wall reported slight right upper quadrant tenderness with a negative CT scan of the abdomen. Dr. Mancini examined Mr. Reynolds in the emergency room and took another oral medical history. Dr. Mancini determined that the injuries to Mr. Reynolds' lower extremities required surgery. Mr. Reynolds was transferred to the operating room where Dr. Mancini performed a closed reduction and intramedullary rodding of the right tibia fracture and a closed reduction and percutaneous pinning of the left second, third, and fourth metatarsal neck and head fractures. Following surgery, Mr. Reynolds was admitted to the hospital floor, where the hospital staff monitored his condition and he began receiving physical therapy.

On September 13, 1996, Mr. Reynolds was returned to the operating room for closure of his right lower leg wound. On September 14, 1996, he was discharged from the hospital. On September 19, 1996, he died of a massive pulmonary embolism that emanated from deep veinous thrombosis ("DVT") at the fracture site on his right leg.

Plaintiffs proffered the affidavit of Mr. Reynolds' mother-in-law, Shirley Kimball, who was in the emergency room at MaineGeneral after the accident but before Mr. Reynolds had surgery. Ms. Kimball states that she saw a man in a white lab coat ask Mr. Reynolds if he had any allergies or medical problems of which the hospital should be aware. Ms. Kimball alleges that Mr. Reynolds told the man "that his family had a blood clotting problem on his father's and brothers' side of the family whenever they had a trauma." Appendix to Appellants' Brief at 130.

Plaintiffs proffered the affidavits of several family members, each of whom alleges that he or she told a MaineGeneral employee in the hospital room after Mr. Reynolds underwent surgery that Mr. Reynolds had a family history of hypercoagulability.

II. Procedural Background

On September 8, 1998, plaintiff-appellant Cindy Reynolds, widow of the decedent William D. Reynolds, filed a complaint in the United States District Court for the District of Maine in her personal capacity and as the personal representative of the Estate of the decedent. Mr. Reynolds' minor daughter, Kelliann Reynolds, is also a plaintiff-appellant. The complaint alleged that Mr. Reynolds presented to the emergency department at MaineGeneral on September 8, 1996, with an emergency medical condition as defined by EMTALA, 42 U.S.C. § 1395dd(e)(1); that MaineGeneral failed to screen Mr. Reynolds appropriately for DVT, as required under 42 U.S.C. § 1395dd(a); and that MaineGeneral failed to stabilize Mr. Reynolds for DVT before releasing him on September 14, 1996, thus violating the requirements of 42 U.S.C § 1395dd(b).

In a memorandum of decision dated September 8, 1999, Magistrate Judge Beaulieu granted defendant-appellee's motion for summary judgment, having concluded that the facts did not support a federal claim for failure to screen under EMTALA even though they supported a state-law claim for negligent diagnosis and treatment. Magistrate Judge Beaulieu further held that plaintiffs' claim for failure to stabilize fails as a matter of law because the hospital was not aware that Mr. Reynolds was suffering from DVT. Plaintiffs filed their notice of appeal to this court on October 6, 1999.

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