Brodersen v. Sioux Valley Memorial Hosp., C 93-4011.

Decision Date19 September 1995
Docket NumberNo. C 93-4011.,C 93-4011.
Citation902 F. Supp. 931
CourtU.S. District Court — Northern District of West Virginia
PartiesDebbie BRODERSEN, Individually and as Executrix of the Estate of Kendall E. Brodersen, Plaintiff, v. SIOUX VALLEY MEMORIAL HOSPITAL, Frank Allender, D.C.; Stephen Veit, M.D.; Stephen Veit, M.D., P.C.; Thomas Gary, M.D. and T.M. Gary, M.D., P.C., Defendants.

COPYRIGHT MATERIAL OMITTED

Roxanne B. Conlin and Donna Laddy of Roxanne Conlin & Associates, P.C., Des Moines, Iowa, for plaintiff.

Edwin Evans of Davenport, Evans, Hurwitz & Smith, Sioux Falls, South Dakota, for defendant Sioux Valley Memorial Hospital.

Joseph L. Fitzgibbons of Fitzgibbons Brothers, Estherville, Iowa, and Mark R. Cozine of Martin, Wibe & Cozine, Cherokee, Iowa, for defendants Stephen Veit, M.D., Gene Michel, M.D. and Stephen Veit, M.D., P.C.

Maurice Nieland, Sioux City, Iowa, for defendants Thomas Gary, M.D., and T.M. Gary, M.D., P.C.

Michael R. Hellige of Shull, Cosgrove, Hellige, Du Bray & Lundberg, Sioux City, Iowa, for defendant Frank Allender, D.C.

                                              TABLE OF CONTENTS
                  I. INTRODUCTION AND BACKGROUND ............................................... 934
                 II. FINDINGS OF FACT .......................................................... 935
                     A. Uncontested Facts ...................................................... 935
                     B. Contested Facts ........................................................ 936
                III. STANDARDS FOR SUMMARY JUDGMENT ............................................ 936
                 IV. LEGAL ANALYSIS ............................................................ 938
                     A. The Hospital's Motion for Summary Judgment ............................. 938
                        1. The History and Purpose of the EMTALA ............................... 938
                        2. EMTALA Standards for a Claim under 42 U.S.C. ? 1395dd(a) ............ 940
                           a. Treatment or Appropriate Medical Screening ..................      940
                           b. Failure to Stabilize Claim ..................................      943
                           c. Failure to Provide Emergency Medical Care Because of Improper
                              Motive ......................................................      945
                              i. The Split In Authority On Requiring Economic Motive to Be
                                   Shown ....................................................... 946
                              ii. Analysis ..................................................... 948
                     B. Defendant Allender's Motion for Summary Judgment ....................... 950
                     C. Defendant Allender's Third Motion for Summary Judgment and For
                          Ruling Under Federal Rule of Evidence 104(a) ......................... 950
                  V. CONCLUSION ................................................................ 956
                
ORDER REGARDING MOTIONS FOR SUMMARY JUDGMENT

BENNETT, District Judge.

This lawsuit arises out of the medical treatment the decedent Kendall E. Brodersen ("Kendall") received or failed to receive from Defendants, a hospital, a chiropractor, and two physicians, in the days prior to his death on January 27, 1991. At issue in these pending motions for summary judgment are allegations in Plaintiff's complaint, inter alia, that Defendant Sioux Valley Memorial Hospital ("the Hospital") violated the federal Emergency Medical Treatment and Active Labor Act ("EMTALA") by failing to provide Kendall with appropriate medical screening, and by failing to stabilize Kendall's condition before discharging him. The Hospital has moved for summary judgment on Plaintiff's EMTALA claims. The Hospital's motion on Plaintiff's screening claim requires the court to determine if a material question of fact has been generated on the issue of whether the Hospital provided Kendall with treatment which deviated from the Hospital's standard procedures for similarly situated patients.

Plaintiff further alleges a state law negligence claim against Defendant Frank Allender, a chiropractor who treated Kendall in the days before his death. Allender has filed two motions for summary judgment. One motion raises the question of whether the court has subject matter jurisdiction over him if the Hospital's motion for summary judgment is granted. Allender's second motion for summary judgment challenges whether Plaintiff is able to establish a material fact question regarding a violation of the applicable standard of care by Allender.

I. INTRODUCTION AND BACKGROUND

Plaintiff Debbie Brodersen ("Brodersen"), on behalf of herself and as executrix of Kendall Brodersen's estate, filed her complaint against Defendants on February 17, 1993. First, in count I of the complaint, Brodersen alleges a violation of the EMTALA by the Hospital. Count II of the complaint contains a state law negligence claim against the Hospital. In count III, Brodersen alleges a negligence claim against Defendant Frank Allender. Count IV alleges negligence against Defendants Stephen Veit and Thomas Gary, treating physicians, in both their individual and corporate capacity. The second division of the complaint alleges loss of consortium by Plaintiff Debbie Brodersen.

The Hospital has moved for summary judgment pursuant to Federal Rule of Civil Procedure 56(b) on each of Brodersen's claims against it.1 The Hospital asserts that no genuine dispute exists as to the fact that Kendall Brodersen received an "appropriate" medical screening examination within the capability of the Hospital's emergency department, see 42 U.S.C. ? 1395dd(A). The Hospital asserts that it provided Kendall with treatment which did not in any way deviate from the Hospital's standard procedures for similarly situated patients. It further asserts that, because of the symptoms presented by Kendall, the protocols at the Hospital regarding the conducting of EKGs and the placement of patients in the Hospital's cardiac unit were both followed in this instance. The Hospital also asserts that no genuine dispute exists as to the fact that Kendall did not have an "emergency medical condition" at the time he was hospitalized and, even if he did, his condition was "stabilized" at the time of his discharge, see 42 U.S.C. ? 1395dd(c)(1)(A)(ii). Additionally, the Hospital contends that Brodersen is unable to meet a second requirement under EMTALA, demonstrating that the disparate treatment Kendall received was the result of an economic motive on the part of the Hospital. Finally, the Hospital contends that, once the EMTALA claim is dismissed, Plaintiff's remaining pendent claims should likewise be dismissed.

Defendant Frank Allender has also filed two motions for summary judgment. In the first, he asserts that the Hospital's motion for summary judgment is meritorious and therefore the court does not have subject matter jurisdiction over him pursuant to 42 U.S.C. ? 1395.2 He further asserts that the court should not exercise supplemental jurisdiction over him under 28 U.S.C. ? 1367. In his "third" motion for summary judgment, Allender contends that Brodersen's evidence cannot, as a matter of law, establish a violation of the applicable standard of care because none of Brodersen's experts are qualified to testify as to the standard of care for a chiropractor and that, because Brodersen does not have a qualified expert, she can establish neither the standard of care nor a violation of it.

A hearing on Defendants' motions for summary judgment was held on September 5, 1995. At the hearing Plaintiff was represented by Roxanne B. Conlin and Donna Laddy of Roxanne Conlin & Associates, P.C., Des Moines, Iowa. Defendant Sioux Valley Memorial Hospital was represented by Edwin Evans of Davenport, Evans, Hurwitz & Smith, Sioux Falls, South Dakota. Defendants Stephen Veit, M.D., Gene Michel, M.D., and Stephen Veit, M.D., P.C. were represented by Joseph L. Fitzgibbons of Fitzgibbons Brothers, Estherville, Iowa, and Mark R. Cozine of Martin, Wibe & Cozine, Cherokee, Iowa. Defendants Thomas Gary, M.D., and T.M. Gary, M.D., P.C., were represented by Maurice Nieland of Rawlings, Nieland, Probasco, Killinger, Ellwanger, Jacobs & Mohrhauser, Sioux City, Iowa. Defendant Frank Allender, D.C., was represented by Michael R. Hellige of Shull, Cosgrove, Hellige, Du Bray & Lundberg, Sioux City, Iowa. The parties have filed thorough and extensive briefs in support of their respective positions. Counsel were exceptionally well prepared for oral argument. The oral arguments were unusually spirited and reflected the hotly contested nature of this litigation. This matter is now deemed fully submitted.

II. FINDINGS OF FACT
A. Uncontested Facts

For the purposes of this summary judgement motion only, the court finds the following facts:

The record reveals that the following facts are undisputed. Kendall Brodersen worked on Thursday, January 24, 1991. That evening, Brodersen complained to his wife, Debbie Brodersen, about suffering both back and chest pain. Kendall told Debbie to contact a chiropractor regarding treatment. Debbie arranged for Kendall to be seen by Defendant Frank Allender, D.C., that evening. Allender examined Kendall the evening of January 24, 1991. Kendall reported that he was suffering from upper and middle back pain, neck pain, chest pain, sore throat and headaches in the temple area. Kendall indicated that, at approximately 4:30 p.m., someone at work had grabbed him about his neck and pulled him backwards, and that he had begun to have pain at 6:00 p.m. that evening.

Kendall returned to Dr. Allender the next day, January 25, 1991. On Saturday, January 26, 1991, Kendall saw both Dr. Allender and Defendant Stephen Veit, M.D., a general practitioner in Cherokee, Iowa. Kendall informed Veit that he had been coughing up bloody phlegm for two days, was nauseous, and had pain when breathing in deeply. At the time of his examination by Dr. Veit, Kendall had normal blood pressure levels, but had a slightly elevated temperature. Dr. Veit's diagnosis was that Kendall had a bronchial infection. Dr. Veit prescribed...

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