Dollard v. Allen, 02-CV-87-B.
| Decision Date | 01 May 2003 |
| Docket Number | No. 02-CV-87-B.,02-CV-87-B. |
| Parties | Kelli DOLLARD, Plaintiff, v. Charles R. ALLEN, M.D.; John A. Whipp, M.D.; Fremont Orthopedic Associates, P.C.; and Lander Valley Medical Center, LLC, Defendants. |
| Court | U.S. District Court — District of Wyoming |
Mel C. Orchard, III, Meyer & Williams, Jackson, WY, for Plaintiff.
Jeffrey C. Brinkerhoff, Brown, Drew & Massey, Casper, WY, Corinne E. Rutledge, James Kaste, Lathrop and Rutledge, Cheyenne, WY, Scott E. Ortiz, Williams, Porter, Day & Neville, Casper, WY, for Defendants Charles R. Allen, M.D, John A. Whipp, M.D. and Fremont Orthopedic Associates, P.C, Lander Valley Medical Center, LLC.
ORDER GRANTING LANDER VALEY MEDICAL CENTER, LLC'S MOTION FOR PARTIAL SUMMARY JUDGMENT
This case arises out of the unanticipated compression of Plaintiffs sacral nerve roots. The matter is before the Court on Defendant Lander Valley Medical Center, LLC's Motion for Partial Summary Judgment. Upon reading the briefs, hearing oral argument, and being fully advised of the premises, the Court FINDS and ORDERS as follows:
Statement of Parties and Jurisdiction
Plaintiff, Kelli Dollard, is a thirty-two year old female who resides in Lander, Wyoming.
Defendant Lander Valley Medical Center, LLC ("LVMC") is a Wyoming limited liability company with its principal place of business in Lander, Wyoming. LVMC is subject to the provisions of the Emergency Medical Treatment and Active Labor Act ("EMTALA"). 42 U.S.C. §§ 1395cc, 1395dd(e)(2).
The Court exercises jurisdiction pursuant to 28 U.S.C. §§ 1331, 1367. Venue is proper. 28 U.S.C. § 1391(b).
In December 1998, Plaintiff was working as a certified nursing assistant at the LVMC. (Def. LVMC's Mot. for Partial Summ. J. ("Def.'s Mot. for Summ. J."), Exh. C, at pp. 10, 55). While Plaintiff was assisting a patient shower, she slipped on some soapy water and fell. (Id. at pp. 58-59). As a result of the fall, Plaintiff suffered a herniated disc in her back. (Id. at p. 11).
On December 28, 1998, Plaintiff visited Dr. Charles R. Allen regarding her back injury. (Id. at p. 58). A little over a year later, Plaintiff visited Dr. Allen again because she was suffering from severe lower back pain. (Id. at p. 66). Plaintiff periodically visited Dr. Allen for the next six months while she received spinal injections in an attempt to alleviate her lower back pain. (Id. at pp. 69, 72, 76-79, 81, 84).
On June 25, 2000, Plaintiff began experiencing numbness in her buttocks. (Id. at p. 90). The next morning, Plaintiff called Dr. Allen and informed him that her back pain was getting worse and that she felt numbness in her buttocks. (Id. at pp. 93-95). Dr. Allen informed Plaintiff that he would prescribe some pain medication for her. (Id.). Plaintiff picked up that pain medication and returned home to rest. (Id. at p. 87).
On the morning of June 27, 2000, Plaintiff called Dr. Allen again. (Id. Exh. C, at p. 100). Plaintiff informed Dr. Allen that her pain medication was not helping and that her back pain was getting worse. (Id.). Upon learning this, Dr. Allen informed Plaintiff that he wanted to admit her to the hospital for pain management and rest. (Id., Exh. A, at pp. 96-97).
That day, Plaintiff arrived at the LVMC around 1:45 p.m. (Id. Exh. C, at p. 108). When Plaintiff arrived, she walked past the hospital lobby and directly to the medical/surgery unit. (Id. at p. 100). Plaintiff did not go to the emergency room for the purpose of an examination or medical screening. (Id. at p. 239). When Plaintiff arrived at the hospital, she knew she was being admitted because of her back pain, as she had discussed with Dr. Allen earlier that day. (Id. at p. 240). Plaintiff did not anticipate being examined or diagnosed by any physician other than Dr. Allen during her stay at the LVMC. (Id.).
Once Plaintiff was in the medical/surgery unit, a nurse took her to a hospital room. (Id. at p. 100). Per Dr. Allen's written instructions, Plaintiff was administered a shot of pain medicine and given a heating pad for her lower back. ).
On June 28, 2000, around 9:30 a.m., Dr. Allen visited Plaintiff. (Id., Exh. C, at p. 105). Plaintiff informed Dr. Allen that she was "feeling okay" and that the burning in her legs and lower back pain were not as severe. (Id.). Plaintiff also informed Dr. Allen that she felt an increase in the numbness she was experiencing. (Id.). After this discussion with Plaintiff, Dr. Allen made the decision to discharge Plaintiff from the hospital. (Id. at p. 246).
On the morning of June 29, 2000, Plaintiff began experiencing excruciating pain in her stomach and was unable to urinate. (Id. at p. 117). Plaintiff called the hospital and was readmitted that evening. (Id. at pp. 120-21). At LVMC, Dr. John A. Whipp determined that Plaintiff had a large ruptured disc in her back, which had been the cause of her severe pain and numbness. (Id.).1 On June 30, 2000, Dr. Whipp performed surgery on Plaintiffs lower back. At that time, it was determined Plaintiff was suffering from "almost a cauda equina type syndrome," which is an extremely rare neurological disorder.2 (Pl.'s Resp., Exh. D, at p. WHI0116). Symptoms of the cauda equina syndrome include: (1) bilateral sciatica; (2) bowel and bladder dysfunction; (3) analgesia in the buttocks, genitalia, and thigh area; and (4) a decrease in rectal sphincter tone. (Def.'s Mot. for Summ. J., Exh. A, at p. 11; Pl.'s First Supplemental Resp., at pp. 117); see also 13 Roscoe N. Gray, M.D., & Louise J. Gordy, M.D., Attorneys' Textbook of Medicine § 176.32 (3d ed. & Supp. 2002). Cauda equina syndrome has been described as "the only true low back pain emergency." Id.
Plaintiff filed suit alleging that LVMC violated EMTALA, 42 U.S.C. § 1395dd, and was negligent in treating and discharging her. (First Am. Compl., at ¶¶ 15-33). Specifically, Plaintiff alleges that LVMC failed to properly screen and stabilize her emergency medical condition. (Id. at ¶ 29).
Summary judgment is proper when there is no genuine issue of material fact to be resolved at trial. Fed.R.Civ.P. 56(c); Nebraska v. Wyoming, 507 U.S. 584, 590, 113 S.Ct. 1689, 123 L.Ed.2d 317 (1993). Thus, a district court may grant summary judgment "if the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue of material fact and that the moving party is entitled to a judgment as a matter of law." Fed.R.Civ.P. 56(c); Nelson v. Geringer, 295 F.3d 1082, 1086 (10th Cir.2002). "An issue of material fact is genuine where a reasonable jury could return a verdict for the party opposing summary judgment." Seymore v. Shawver & Sons. Inc., 111 F.3d 794, 797 (10th Cir.1997).
Defendant LVMC argues that Plaintiff's EMTALA claims fail because she was never presented at LVMC's emergency department. (Def. LVMC's Mem. of Law in Supp. of Mot. for Partial Summ. J, at pp. 7-11). Alternatively, Defendant LVMC argues that even if EMTALA applies to individuals who are not admitted to a hospital's emergency department, Plaintiff has not raised a genuine issue of material fact that LVMC failed to follow its medical screening procedures or that she had an emergency medical condition that needed to be stabilized. (Id.).
Plaintiff responds that LVMC had a duty to screen her for an emergency medical condition and to stabilize that condition notwithstanding the fact she never went to LVMC's emergency department. (Pl.'s Resp, at pp. 5, 9-11). Plaintiff also argues that LVMC violated its own policies and procedures regarding medical screening and stabilization. (Id. at pp. 5-8).
Congress' purpose in enacting EMTALA was to prevent patient dumping—the practice of refusing to treat uninsured patients. Abercrombie v. Osteopathic Hosp. Founders Ass'n, 950 F.2d 676, 680 (10th Cir.1991).3 EMTALA was not designed to function as a federal malpractice statute or to supplant state law medical malpractice suits. 42 U.S.C. § 1395dd(f); Repp v. Anadarko Mun. Hosp., 43 F.3d 519, 522 (10th Cir.1994); Phillips v. Hillcrest Med. Center, 244 F.3d 790, 798-99 (10th Cir.2001).
A hospital can violate EMTALA in two ways. 42 U.S.C. § 1395dd(a)-(c). First, under EMTALA's medical screening requirement, a hospital is liable when it fails to follow its own standard screening procedures in determining whether an individual who "comes to the emergency department" of the hospital has an emergency medical condition. 42 U.S.C. § 1395dd(a); Repp, 43 F.3d at 522 & n. 4. Under the plain language of § 1395dd(a), the medical screening requirement is not implicated if the plaintiff "did not go to the emergency room of the hospital." Urban v. King, 43 F.3d 523, 525 n. 2 (10th Cir.1994). Second, under EMTALA's stabilization before transfer requirement, a hospital is liable if it detected an emergency medical condition for any individual who came "to the hospital," but failed to stabilize that condition before transferring the individual. 42 U.S.C. § 1395dd(b)-(c); Collins v. DePaul Hosp., 963 F.2d 303, 305, 308 (10th Cir. 1992).
In enacting EMTALA, Congress did not conjugate any of the subsections of § 1395dd. The Circuit Courts of Appeal are split on whether EMTALA should be construed in the conjunctive or disjunctive. The Tenth Circuit has not provided district courts in this Circuit with a clear direction on which approach it follows.
Under the conjunctive approach, ETALA is construed as setting forth one cause of action based upon three sequential requirements. First, under subsection (a), the hospital has the duty to screen any individual who...
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