Harmon v. Uintah Basin Med. Ctr.
| Decision Date | 21 June 2021 |
| Docket Number | Case No. 2:20-cv-00669-JNP-JCB |
| Parties | KEVIN KENT HARMON, JR., Plaintiff, v. UINTAH BASIN MEDICAL CENTER, NORTHEASTERN COUNSELING CENTER, and JASON SCOTT BEALES, M.D., Defendant. |
| Court | U.S. District Court — District of Utah |
Before the court are two Motions to Dismiss. The first is filed by Defendants Uintah Basin Medical Center ("UBMC") and Jason Scott Beales, M.D. ("Beales"). ECF No. 13. The second is filed by Defendant Northeastern Counseling Center ("Northeastern")1 and incorporates by reference the Motion to Dismiss filed by UBMC and Beales. ECF No. 18. Having reviewed the memoranda2, the court denies Defendants' Motions to Dismiss.
On November 24, 2018, Plaintiff Kevin Kent Harmon, Jr. ("Plaintiff") presented to UBMC's hospital emergency department following a suicide attempt.3 Plaintiff had attempted suicide earlier in the day and expressed that he was looking for other ways to kill himself. Plaintiff's attending physician on November 24 was Beales, an employee of UBMC. UBMC recognized that Plaintiff required greater psychiatric care than it could provide and arranged to transfer Plaintiff to the University Neuropsychiatric Institute of the University of Utah ("UNI") in Salt Lake County, Utah. Pending his transfer to UNI, Plaintiff was admitted to UBMC's hospital from November 24 to 25. UBMC's medical records for Plaintiff indicate that the reason for his admission was for "observation." Plaintiff's suicidal condition was never stabilized prior to his transfer to UNI.
Pursuant to UBMC's arrangements, Plaintiff was later transferred to UNI, approximately 160 miles away. Plaintiff was transferred by private vehicle. Plaintiff was not accompanied by a person who was trained or qualified to manage a suicidal patient, but rather by one able-bodied person, an 80-year-old woman, and a man who was and is paraplegic, none of whom had been instructed on how to deal with Plaintiff's condition. Plaintiff was not restrained during the transfer, nor was the private vehicle outfitted with means to do so. Plaintiff also was not sedated. During the transfer, Plaintiff again attempted suicide by jumping out of the private vehicle as it wastraveling on a highway at a speed of approximately 65 miles per hour. As a result of this suicide attempt, Plaintiff suffered several substantial injuries, including but not limited to a "[p]ermanent, severe and disabling traumatic brain injury"; "[m]ultiple skull fractures"; a concussion; "[d]iminished cognitive abilities"; "[m]emory and concentration defects"; and impaired vision, hearing, and ability to communicate. ECF No. 12 at 9.
Based upon the foregoing, Plaintiff asserts two causes of action against Defendants. First, Plaintiff sues UBMC under the Emergency Medical Treatment and Active Labor Act ("EMTALA"), 42 U.S.C. § 1395dd. Second, Plaintiff sues all three Defendants for medical malpractice. Defendants move to dismiss Plaintiff's Complaint under Federal Rule of Civil Procedure 12(b)(6). Defendants argue that Plaintiff has failed to state a cause of action under EMTALA and that Plaintiff's remaining state law medical malpractice cause of action should accordingly be dismissed, as the court only has supplemental jurisdiction over the state law claim pursuant to 28 U.S.C. § 1367. Plaintiff "agrees that if its EMTALA claim were dismissed, then the malpractice claim would be outside this court's jurisdiction." ECF No. 26 at 2.
Dismissal of a claim under Rule 12(b)(6) of the Federal Rules of Civil Procedure is appropriate where the plaintiff fails to "state a claim upon which relief can be granted." FED. R. CIV. P. 12(b)(6). When considering a motion to dismiss for failure to state a claim, a court "accept[s] as true all well-pleaded factual allegations in the complaint and view[s] them in the light most favorable to the plaintiff." Burnett v. Mortg. Elec. Registration Sys., Inc., 706 F.3d 1231, 1235 (10th Cir. 2013) (citation omitted). "To survive a motion to dismiss, a complaint must contain sufficient factual matter, accepted as true, to 'state a claim to relief that is plausible on its face.'" Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (citation omitted). The complaint must allege morethan labels or legal conclusions and its factual allegations "must be enough to raise a right to relief above the speculative level." Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555 (2007).
"Congress enacted EMTALA in 1986 to address the problem of 'dumping' patients in need of medical care but without health insurance." Phillips v. Hillcrest Med. Ctr., 244 F.3d 790, 796 (10th Cir. 2001) (citations omitted). Despite this specific purpose, EMTALA "appl[ies] equally to all individuals whether or not they are insured." Id. (citations omitted). To ensure compliance with EMTALA, Congress included a civil enforcement provision that permits individuals who suffer "personal harm as a direct result of a participating hospital's violation of" its provisions to bring a civil action against the hospital to "obtain those damages available for personal injury under the law of the State in which the hospital is located, and such equitable relief as is appropriate." 42 U.S.C. § 1395dd(d)(2)(A); Repp v. Anadarko Mun. Hosp., 43 F.3d 519, 521-22 (10th Cir. 1994).4
The Tenth Circuit has recognized EMTALA's "limited reach and purpose": "EMTALA does not set a federal standard of care or replace pre-existing state medical negligence laws." Phillips, 244 F.3d at 798 (citations omitted); see also St. Anthony Hosp. v. U.S. Dep't of Health & Human Servs., 309 F.3d 680, 694 (10th Cir. 2002) ( ; 42 U.S.C. § 1395dd(f) (). Accordingly, EMTALA provides no remedy for an "inadequate or inaccurate diagnosis." Phillips, 244 F.3d at 798 (citation omitted).
EMTALA applies to any hospital that has an emergency department and receives Medicare payments. Abercrombie v. Osteopathic Hosp. Founders Ass'n, 950 F.2d 676, 680 (10th Cir. 1991). EMTALA imposes "two primary obligations" on participating hospitals. Phillips, 244 F.3d at 796 (citation omitted). First, if an individual comes to such hospital's emergency department requesting examination and treatment for a medical condition, then the hospital has a duty to "provide for an appropriate medical screening examination . . . to determine whether or not an emergency medical condition . . . exists." 42 U.S.C. § 1395dd(a).5 Second, if an emergency medical condition exists, the hospital must provide either:
(A) within the staff and facilities available at the hospital, for such further medical examination and such treatment as may be required to stabilize the medical condition, or(B) for transfer of the individual to another medical facility in accordance with subsection (c).
Id. § 1395dd(b)(1).6 "Transfer" includes discharging the patient and moving the patient to another facility. Id. § 1395dd(e)(4). Subsection (c) provides that a transfer of an individual with a condition which has not been stabilized must be "an appropriate transfer." Id. § 1395dd(c)(1)(B). As relevant here, an "appropriate transfer" requires the transferring hospital to "provide[] the medical treatment within its capacity which minimizes the risks to the individual's health,"7 and "is effected through qualified personnel and transportation equipment, as required including the use of necessary and medically appropriate life support measures during the transfer." Id. § 1395dd(c)(2)(A), (D).
Subsections (a) and (c) impose strict liability on hospitals. Abercrombie, 950 F.2d at 681. A plaintiff may prevail under EMTALA "by showing violations of either § 1395dd(a) or § 1395dd(c); plaintiffs need not show a violation of both subsections." Urban ex rel. Urban v. King, 43 F.3d 523, 525 (10th Cir. 1994) (citation omitted). Additionally, to succeed on a claim under § 1395dd(c), a plaintiff must "prove as a condition" that "the hospital had actual knowledge of the patient's emergency medical condition." Id. at 527.
In addition to EMTALA's statutory provisions, federal regulations interpreting EMTALA, promulgated by the Department of Health and Human Services' Centers for Medicare and Medicaid Services (the "CMS regulations"), provide guidance for evaluating an EMTALA claim. See, e.g., St. Anthony, 309 F.3d at 705 (); Thomas v. Christ Hosp. & Med. Ctr., 328 F.3d 890, 893-96 (7th Cir. 2003) (); Torretti v. Main Line Hosps., Inc., 580 F.3d 168, 174 (3d Cir. 2009) (); Thornhill v. Jackson Parish Hosp., 184 F. Supp. 3d 392, 399 (W.D. La. 2016) (). But see, e.g., Moses v. Providence Hosp. & Med. Ctrs., Inc., 561 F.3d 573, 583 (6th Cir. 2009) (). The CMS...
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