Chandler v. Hospital Authority of City of Huntsville

• Decision Date: 25 August 1989
• Citation: 548 So.2d 1384
• Parties: Tammy CHANDLER, et al. v. HOSPITAL AUTHORITY OF the CITY OF HUNTSVILLE, Alabama. 87-1236.
• Court: Alabama Supreme Court

Page 1384

548 So.2d 1384

Tammy CHANDLER, et al. v. HOSPITAL AUTHORITY OF the CITY OF HUNTSVILLE, Alabama.

87-1236.

Supreme Court of Alabama.

Aug. 25, 1989.

Robert H. Ford and Daniel F. Aldridge of Brinkley, Ford, Chesnut & Aldridge, Huntsville, for appellant.

W. Stanley Rodgers and Patrick M. Lamar of Lanier, Ford, Shaver & Payne, Huntsville, for appellee.

S. Greg Burge of Heninger, Burge & Vargo, Birmingham, for amicus curiae The Alabama Trial Lawyers Ass'n.

ALMON, Justice.

Tammy Chandler brought an action against the Hospital Authority of the City of Huntsville ("the Hospital Authority"), the operator of the Huntsville Hospital, for the wrongful death of her son, Darren. The trial court entered summary judgment on the ground that Ala.Code 1975, § 22-21-137(2), granted immunity from tort actions to hospital building authorities. Chandler appealed and this Court reversed the summary judgment, holding that § 22-21-137(2) was unconstitutional. Chandler v. Hospital Authority of the City of Huntsville, 500 So.2d 1012 (Ala.1986). The Hospital Authority filed another motion for partial summary judgment, which was granted.

The only issue presented for review is whether Huntsville Hospital had a duty to provide emergency care to Darren even though his mother had no insurance and did not have the $54 emergency room fee.

On August 16, 1983, Chandler carried her 15-day-old son, Darren, to the Ambulatory Care Center ("ACC") in Huntsville for a two-week post-partem checkup. While they were at the ACC, Darren's temperature was taken and Chandler was told that Darren needed to be taken to Huntsville Hospital for emergency care. Chandler carried Darren to Huntsville Hospital as instructed, arriving at approximately 4:00 p.m.

When Chandler arrived at Huntsville Hospital, she was asked if she had either insurance or $54 for the emergency room admission fee. Chandler replied that she had neither. The admitting clerk told Chandler that Darren could not be seen without insurance or the $54 fee. Shortly thereafter, a nurse told Chandler to take Darren home and to give him Tylenol and a warm bath.

At approximately 8:00 p.m. that evening, Chandler returned to Huntsville Hospital with Darren. At approximately 11:00 p.m. Darren was seen by a doctor. He was admitted into Huntsville Hospital at that time. At approximately 4:30 p.m. the next day, he died from spinal meningitis.

This action was commenced prior to June 11, 1987, and therefore is governed by the "scintilla rule." ¹

"It is well settled that summary judgment should only be granted when, after viewing the evidence in a light most favorable to the non-moving party, it appears that there is no genuine issue of fact and that the moving party is entitled to judgment as a matter of law. Rule 56, A.R.Civ.P. A scintilla of evidence supporting the non-movant's position is all that is required to overcome a motion for summary judgment. Ward v. Rhodes, Hammond & Beck, Inc., 511 So.2d 159 (Ala.1987)."

Gunnels v. Glenn Machine Works, Inc., 547 So.2d 448 (Ala.1989); citing Car Center, Inc. v. Home Indemnity Co., 519 So.2d 1319, 1322 (Ala.1988).

In opposition to the Hospital Authority's motion for partial summary judgment, Chandler submitted a document entitled "Huntsville Hospital's Revised Admission Policies" dated August 10, 1983. The following policies were included within the document:

"POLICY ON ADMISSION AND TREATMENT IN THE EMERGENCY/OUTPATIENT DEPARTMENT OF NON-SPONSORED PATIENTS

"....

"Madison County:

"At the time a Madison County resident is scheduled to be admitted to Huntsville Hospital or arrives in the Huntsville Hospital Emergency Room and is uninsured, does not have the ability to pay for hospital services, or it is determined to be a non-emergency, patients will be denied treatment at Huntsville Hospital.

"When the patient arrives in an emergency condition, the patient will be admitted.

"DEFINITIONS

"Emergency--A person, in the opinion of the attending physician and hospital personnel, in need of immediate hospitalization or emergency treatment to save life or prevent loss of limb.

"Non-sponsored--Patients who are uninsured and unable to pay the advanced admission fee at time of admission; or do not pay their portions of charges after third party coverage has been collected and collection efforts exhausted.

"....

"ADMISSION OF NON-SPONSORED PATIENTS THROUGH THE EMERGENCY ROOM

"....

"II. Madison County

"A. Patients who arrive in the Emergency Room and are non-emergent will be denied treatment at Huntsville Hospital.

"B. Patients who arrive in the Emergency Room and are of emergency nature must be admitted. After admission is completed, however, Financial Counselor must be contacted and admission approved.

"....

"PROCEDURE FOR TREATMENT OF NON-SPONSORED PATIENTS IN EMERGENCY ROOM

"Non-sponsored patients are defined as those patients from Huntsville/Madison County who present themselves to Huntsville Hospital Emergency Department who are uninsured and unable to pay advanced admission deposits.

"1. The triage nurse performs rapid verbal visual assessment and determines that patient can go through the normal registration process.

"2. The registration clerk ascertains during registration that patient is either uninsured and responsible for his/her account (self pay), will ask for a $54.00 deposit before treatment is initiated.

"3. When deposit is received by clerk, treatment will proceed as normal. Patient cannot pay the deposit ... the CAS will be asked to assess the patient.

"4. If the presenting condition is determined to be a true emergency by the CAS, the patient will be taken to the treatment area and cared for as normal. Any condition, however, that is determined to be non-emergent, the patient will be refused treatment. Referral will be made to the North Huntsville Community Health Clinic or the phone number of the Madison County Medical Society will be given to the patient for him/her to find a private physician for health care.

"5. The CAS will document information and referrals given in the patient's medical records."

One who volunteers to act, though under no duty to do so, is thereafter charged with the duty of acting with due care. Berkel & Co. Contractors, Inc. v. Providence Hospital, 454 So.2d 496 (Ala.1984); Herston v. Whitesell, 374 So.2d 267 (Ala.1979). "[T]he existence of a voluntarily assumed duty through affirmative conduct is a matter for determination in light of all the facts and circumstances." Parker v. Thyssen Mining Construction, Inc., 428 So.2d 615 (Ala.1983).

The above-quoted admissions policies present at least a scintilla of evidence from which a jury could reasonably determine that Huntsville Hospital had assumed a duty to provide emergency care to indigent patients in emergency situations. We hold, therefore, that the trial court erred in granting the Hospital Authority's motion for partial summary judgment. The judgment of the trial court is reversed and the cause is remanded.

REVERSED AND REMANDED.

SHORES, ADAMS, HOUSTON and STEAGALL, JJ., concur.

HORNSBY, C.J., and MADDOX, JONES and KENNEDY, JJ., concur in the result.

MADDOX, Justice (concurring in the result).

On original deliverance, I dissented in part because I was of the opinion that the Hospital was immune from suit. Chandler v. Hospital Auth. of the City of Huntsville, 500 So.2d 1012, 1019 (Ala.1986) (Maddox, J., concurring in part, dissenting in part). While I am still of that opinion, the law of the case is that immunity does not apply. See my opinion concurring specially in Black Belt Wood Co. v. Sessions, 514 So.2d 1249, 1256-57 (Ala.1986) (Maddox, J., concurring specially), in which I stated:

"[P]laintiff was given the right, at that time, by a majority of this Court, to try the case again before another jury. Because that judgment was final, and plaintiff obtained the right to try the case again, I am of the opinion that the plaintiff legally obtained the right to obtain a judgment against Black Belt in another proceeding. Consequently, it is my opinion that plaintiff, having obtained a right to a new trial, is entitled to a review of the new trial without regard to my dissenting views on the first appeal, and that the judgment in this new trial must be based upon the principles of law as they exist today."

If there is no immunity, as the majority held on original deliverance, then I concur with the result reached by the majority.

KENNEDY, Justice (concurring in the result).

The majority holds that the duty of the Hospital to provide emergency care to the plaintiff's decedent arose only through the Hospital's voluntary assumption of a duty to provide emergency care to indigent citizens through its own admissions policies. I am of the opinion that, as a matter of public policy and law, such a duty exists without regard to voluntary assumption.

The United States Congress has expressed its dissatisfaction with the common law "no-duty rule" in circumstances such as those presented by this case, as seen in the anti-dumping provisions of the Comprehensive Omnibus Budget Reconciliation Act of 1986 (COBRA), codified at 42 U.S.C. § 1395dd et seq. (Supp. IV 1986). These provisions require a hospital, public or private, participating in the Medicare program and having an emergency department, to provide an appropriate examination within the department's capability to any individual who requests treatment, to determine whether an "emergency medical condition exists." If the hospital determines that the individual has an emergency medical condition or is in active labor, the hospital must provide either: a) such treatment as is required to stabilize the medical condition or to treat the active labor; or b) a transfer of the individual to another medical facility in accordance with the Act. The Act allows a hospital to transfer a patient without restriction once the patient is stabilized; however, if the patient has not been stabilized or is in active...