Nolen v. Boca Raton Community Hosp., Inc.

• Decision Date: 18 June 2004
• Docket Number: No. 04-10228 Non-Argument Calendar.,04-10228 Non-Argument Calendar.
• Citation: 373 F.3d 1151
• Parties: Anne Marie NOLEN, individually, and as natural heir of the Estate of Baby B, and Baby C, Plaintiff-Appellant, v. BOCA RATON COMMUNITY HOSPITAL, INC., a Florida corporation, Geoffrey Zann, M.D., Joan Reinsvold, RN, Susan Slavicek, Defendants-Appellees.
• Court: U.S. Court of Appeals — Eleventh Circuit

373 F.3d 1151

Anne Marie NOLEN, individually, and as natural heir of the Estate of Baby B, and Baby C, Plaintiff-Appellant, v. BOCA RATON COMMUNITY HOSPITAL, INC., a Florida corporation, Geoffrey Zann, M.D., Joan Reinsvold, RN, Susan Slavicek, Defendants-Appellees.

No. 04-10228 Non-Argument Calendar.

United States Court of Appeals, Eleventh Circuit.

June 18, 2004.

Peter Loblack, Law Office of Peter Loblack, P.A., Miami, FL, for Plaintiff-Appellant.

John W. Mauro, Hal B. Anderson, Billing, Cochran, Heath, Lyles & Mauro, Ft. Lauderdale, FL, for Defendants-Appellees.

Appeal from the United States District Court for the Southern District of Florida.

Before CARNES, HULL and PRYOR, Circuit Judges.

PER CURIAM:

Anne Marie Nolen appeals from a summary judgment entered against her. The district court held that Nolen's complaint, brought under both the Emergency Medical Treatment and Active Labor Act (EMTALA), 42 U.S.C. section 1395dd, and Florida law, failed as a matter of law. We affirm; the district court properly granted summary judgment in favor of the Boca Raton Community Hospital, Inc. (Hospital).

I. FACTS AND PROCEDURAL HISTORY

Nolen was a pediatric nurse at the Hospital. She was about twenty-two weeks pregnant with triplets and had insurance coverage. At approximately 5:00 p.m. on May 4, 2000, Nolen arrived at the Hospital for a labor check at the direction of her physician, Dr. Zann. The Hospital admitted Nolen as an outpatient about twenty minutes later. She complained of cramping and a mucous discharge that she feared signaled the onset of labor.

Nolen was first treated by a Hospital nurse, Reinsvold, in the labor and delivery unit of the Hospital, One Family Place. Reinsvold undertook preliminary care processes, including the following measures: taking Nolen's vital signs, taking Nolen's medical history, listening to the unborn babies' hearts, conducting a fetal monitor, and giving an initial examination of Nolen's abdomen. Nolen was attached to a fetal monitor, which detects uterine contractions and uterine irritability, for more than an hour. Reinsvold also paged Dr. Zann to see Nolen shortly after Nolen's admission to One Family Place.

After the initial assessment performed by Reinsvold, Dr. Zann arrived to examine Nolen, who was still on outpatient status, about an hour and ten minutes after she was first registered by the Hospital. Dr. Zann performed a visual exam of Nolen's cervix, took a culture of her vagina, and fully evaluated Nolen's cervix. Nolen's cervix was found to be neither dilated nor thinned. The laboratory results from the culture were negative. Dr. Zann concluded that Nolen's lower uterine segment was consistent with what he expected from a normal pregnancy in this circumstance. Dr. Zann performed an ultrasound to evaluate each of the three fetal heart rates. He did not order further testing.

Dr. Zann concluded that Nolen was not dilated and that she had only one conclusive episodic contraction, which occurred at 5:32 p.m. Another potential episodic contraction occurred at 6:04 p.m., but it was inconclusive because Nolen was being repositioned when the fetal monitor registered that movement. Satisfied that Nolen had been adequately diagnosed and stabilized, Dr. Zann discharged her from the Hospital at 6:48 p.m. He ordered Nolen to keep her scheduled appointment with her perinatologist, Dr. Scott, the next morning.

After leaving the Hospital, Nolen's condition changed for the worse. She testified at deposition that she began cramping after leaving the Hospital. She made no effort to contact Dr. Zann or the Hospital after this change in condition.

When she reached Dr. Scott's office the next morning, Nolen fully described the events of the previous day. Nolen also told Dr. Scott of the change in condition she experienced after leaving the Hospital. Dr. Scott examined Nolen and concluded that she may have been entering pre-term labor on that day because the partial effacement and dilation of her cervix. Dr. Scott determined that Nolen could not have been entering pre-term labor on the previous day when she was at the Hospital in the care of Dr. Zann.

Dr. Scott sent Nolen back to the Hospital to suppress her pre-term labor. Nolen stayed there until May 7, 2000, when she was transferred to Broward General Hospital because it had a superior neonatal care unit. Nolen went into pre-term labor. Her first baby was stillborn, and her other two babies were born alive. Neither of her two live births survived past May 24, 2000, however.

Nolen filed a complaint under 42 U.S.C. section 1395dd on May 3, 2002, and alleged that the Hospital (1) did not provide her with an adequate screening examination, (2) did not stabilize her labor condition adequately, and (3) discharged her in violation of the EMTALA. Nolen received leave from the district court to amend her complaint to include six counts of medical malpractice under Florida law. Dr. Zann, Reinsvold, and Slavicek, another nurse from the Hospital, were added as defendants on those claims. The district court declined to exercise jurisdiction over all but one of the state law claims.

Both parties filed cross-motions for summary judgment after the close of discovery. The district court granted the motions made by the Hospital and the other defendants on all three counts under the EMTALA and the remaining state law claim. Nolen does not address the grant of summary judgment by the district court on her state law claim in her brief before this Court, so any arguments on that claim are waived. Farrow v. West, 320 F.3d 1235, 1242 (11th Cir.2003); Kelliher v. Veneman, 313 F.3d 1270, 1274 n. 3 (11th Cir.2002); Greenbriar, Ltd. v. City of Alabaster, 881 F.2d 1570, 1573 n. 6 (11th Cir.1989).

II. STANDARD OF REVIEW

Summary judgment is only appropriate if "the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law." Fed.R.Civ.P. 56(c); Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 247, 106 S.Ct. 2505, 2510, 91 L.Ed.2d 202 (1986) (quoting Fed.R.Civ.P. 56(c)). Summary judgment should be granted when, after an adequate time for discovery, a party fails to make a showing sufficient to establish the existence of an essential element of that party's case. Celotex Corp. v. Catrett, 477 U.S. 317, 322, 106 S.Ct. 2548, 2552, 91 L.Ed.2d 265 (1986). "We review the district court's rulings on motion for summary judgment de novo, applying the same legal standards that bound the district court." Carter v. Galloway, 352 F.3d 1346, 1348 (11th Cir.2003).

III. ANALYSIS

Nolen asserts two grounds on which the district court erred in holding that the Hospital gave her an appropriate screening when she entered as an outpatient on May 4, 2000. First, she contends that the Hospital did not have a standard written screening procedure or, alternatively, that the Hospital did not follow its screening procedure, either of which, she contends, violated the EMTALA. Second, Nolen argues that the district court should not have considered the evidence submitted by the Hospital that proved Nolen was not, in fact, in pre-term labor when she was examined at the...