HCA Health Services of Indiana, Inc. v. Gregory

• Decision Date: 30 July 1992
• Docket Number: No. 10A01-9111-CV-363,10A01-9111-CV-363
• Citation: 596 N.E.2d 974
• Parties: , Medicare & Medicaid Guide P 40,963 HCA HEALTH SERVICES OF INDIANA, INC., d/b/a North Clark Community Hospital, Appellant-Defendant, v. Jennifer Elaine GREGORY, Natural Parent of Kristin Allyson Gregory, An Infant, Now Deceased, Appellee-Plaintiff, Joseph H. Beaven, M.D. and Robbie Martin, Appellees-Defendants. 1
• Court: Indiana Appellate Court

Page 974

596 N.E.2d 974

38 Soc.Sec.Rep.Ser. 184, Medicare & Medicaid Guide

P 40,963

HCA HEALTH SERVICES OF INDIANA, INC., d/b/a North Clark

Community Hospital, Appellant-Defendant, v. Jennifer Elaine GREGORY, Natural Parent of Kristin Allyson

Gregory, An Infant, Now Deceased, Appellee-Plaintiff,

Joseph H. Beaven, M.D. and Robbie Martin,

Appellees-Defendants. ¹

No. 10A01-9111-CV-363.

Court of Appeals of Indiana,

First District.

July 30, 1992.

Transfer Denied Oct. 26, 1992.

John D. Nell, Martha W. Irwin, Wooden McLaughlin & Sterner, Indianapolis, for appellant-defendant.

Edwin Sedwick, Jeffersonville, Dennis J. Hummel, Hummel & Coan, Louisville, Ky., for Jennifer Elaine Gregory.

RATLIFF, Chief Judge.

STATEMENT OF THE CASE

HCA Health Services of Indiana, Inc., d/b/a North Clark Community Hospital ("Hospital") presents this interlocutory appeal from an order denying its motion for summary judgment on the federal medicare anti-dumping claim brought by Jennifer Elaine Gregory, natural parent of Kristin Allyson Gregory, an infant, now deceased ("Gregory"). We reverse and remand.

ISSUE

We restate the issue on appeal as:

Is Gregory's federal medicare anti-dumping claim barred by the time limitation set forth in 42 U.S.C. Sec. 1395dd(d)(3)(C) ² because the procedural requirements under Indiana's Medical Malpractice Act are preempted by the mandates of the federal statute?

FACTS ³

On November 13, 1987, Gregory's daughter was discharged from Hospital, and later died. Gregory filed her proposed complaint in three counts with the Indiana Department of Insurance ("Department") on February 10, 1989; one count alleged a federal medicare anti-dumping claim under 42 U.S.C. Sec. 1395dd. See Record at 40. Gregory has not filed an action alleging the federal medicare anti-dumping claim against Hospital in state or federal court.

Hospital filed a motion for preliminary determination pursuant to IND.CODE Sec. 16-9.5-10-1 on February 28, 1991. At that time, Hospital also filed a motion for summary judgment on the federal medicare anti-dumping claim. After a hearing, the trial court denied the summary judgment motion on September 10, 1991. Record at 177-179.

On November 19, 1991, Hospital requested that the trial court certify its ruling on the summary judgment motion for interlocutory appeal pursuant to Ind.Appellate Rule 4(B)(6). The trial court certified its order on November 21, 1991, and we accepted appellate jurisdiction on March 3, 1992. Other relevant facts will be stated in our discussion.

DISCUSSION AND DECISION ⁴, ⁵

When reviewing the propriety of a ruling on a motion for summary judgment, this court applies the same standard applicable to the trial court. Webb v. Jarvis (1991), Ind., 575 N.E.2d 992, 994. We must consider the pleadings and evidence sanctioned by Ind.Trial Rule 56(C) without determining weight or credibility. Id. Only if such evidence shows that there is no genuine issue of material fact and that the moving party is entitled to judgment as a matter of law should summary judgment be granted. Id. The movant bears the burden of proving the propriety of summary judgment, and all facts and inferences to be drawn therefrom are viewed favorably to the non-movant. Jackson v. Warrum (1989), Ind.App. 535 N.E.2d 1207, 1210. Summary judgment will be affirmed on appeal if it is sustainable on any theory or basis found in the record. Wingett v. Teledyne Industries, Inc. (1985), Ind., 479 N.E.2d 51, 54.

Hospital claims that the trial court erred in denying its summary judgment motion and misconstrued the interaction between the procedural mandates of the Indiana Medical Malpractice Act ("State Act") ⁶ and the Emergency Medical Treatment and Active Labor Act ("EMTALA") ⁷. Gregory counters that the two acts are not in conflict and their required procedures may be harmonized; thus, she contends, her action under EMTALA against Hospital is not time-barred. We agree with Hospital, and find that its summary judgment motion should have been granted.

EMTALA operates to restrict, among other things, the transfer, or "dumping," of patients from hospitals until their conditions have stabilized. See 42 U.S.C. Sec. 1395dd(c); Reid v. Indianapolis Osteopathic Medical Hospital, Inc. (S.D.Ind.1989), 709 F.Supp. 853, 853-854. The enforcement provisions of EMTALA are found at 42 U.S.C. Sec. 1395dd(d), and, among other things, create a private cause of action against hospitals which improperly transfer patients. Reid, 709 F.Supp. at 854. The dispute in this action pertains to the clause governing the limitations of actions in civil enforcement, found at 42 U.S.C. Sec. 1395dd(d)(3)(C). This section provides in full:

"Limitations on actions. No action may be brought under this paragraph more than two years after the date of the violation with respect to which the action is brought."

42 U.S.C. Sec. 1395dd(d)(3)(C) (emphasis added).

This dispute also involves the doctrine of federal preemption. Preemption occurs when state law interferes with or is contrary to federal law; in those cases, the federal law effectively nullifies the state law. Santini v. Consolidated Rail Corp. (1987), Ind.App., 505 N.E.2d 832, 835. A state law must yield to a federal law if Congress clearly shows its intent to specifically regulate the matter covered by the federal law at issue. Deberry v. Sherman Hospital Association (N.D.Ill.1990), 741 F.Supp. 1302, 1307; Santini, 505 N.E.2d at 836. EMTALA addresses this issue also:

"Preemption. The provisions of this section do not preempt any State or local law requirement, except to the extent that the requirement directly conflicts with a requirement of this section."

42 U.S.C. Sec. 1395dd(f) (emphasis added). The parties dispute the application of the phrase "directly conflicts" to the State Act and its procedural requirements. Gregory maintains that no provisions of EMTALA directly conflict with the State Act, so she acted properly in following the State Act's requirements by filing her proposed complaint with the Department before filing a complaint in either state or federal court. See IND.CODE Sec. 16-9.5-9-2 (requires proposed medical malpractice complaint to be first presented to Department and medical review panel, and decision therefrom received before action may be commenced in state court). Hospital contends, however, that the procedural requirements of EMTALA and the State Act directly conflict; therefore, EMTALA preempts the State Act, and Gregory's federal claim under EMTALA is governed by EMTALA's procedural mandates, specifically the two-year statute of limitations, with which she has failed to comply.

A recent federal case has addressed the interaction between the procedural requirements of our State Act and EMTALA. See Reid, 709 F.Supp. 853. In Reid, the court addressed a similar but inverted issue to that facing us today. The plaintiff in Reid had filed an action under EMTALA in federal court, but failed to file a proposed complaint with the Department as required by the State Act. Id. at 853-854. The defendant hospital moved to dismiss because the plaintiff had failed to comply with Indiana's procedural mandates found in the State Act. The court held that "[t]he Indiana Code's provision that no cause of action against a health care provider arises until an opinion has been rendered by the state medical review panel 'directly conflicts' with section 1395dd's provision that such a cause of action arises whenever '[a]ny individual ... suffers personal harm as a direct result of a participating hospital's violation of a requirement of this section.' 42 U.S.C. Sec. 1395dd(d)(3)(A) ⁸."

Id. at 855. Thus, the court found that EMTALA preempts the State Act's procedural requirements, and does not incorporate state procedural limitations. Id.

We find the Reid court's analysis equally applicable here. Gregory's EMTALA claim against Hospital is technically not a claim for medical malpractice within the State Act, but an action based upon a violation of a federal statute. As Gregory agrees, EMTALA created a federal cause of action under federal law, governed exclusively by the federal act, but that may be pursued in federal or state fora. See Thornton v. Southwest Detroit Hospital (6th Cir.1990), 895 F.2d 1131, 1133 (actions under EMTALA may be brought in appropriate state or federal court); Reid, 709 F.Supp. at 854, n. 1. This choice of forum in which to pursue an EMTALA claim, however, does not indicate that all state procedural requirements are encompassed when maintaining an action based on the federal statute.

Rather, we agree with the Reid court's reasoning, and find that the State Act's provision requiring the filing of a proposed complaint with the Department, and the ensuing indeterminate waiting period until a medical review panel renders an opinion as a prerequisite to filing an action in court, directly conflicts with the two-year statute of limitations contained in EMTALA. See I.C. Sec. 16-9.5-9-2; 42 U.S.C. Sec. 1395dd(d)(3)(C). Specifically, the time period spent waiting for an opinion from a medical review panel may exceed the two-year statute of limitations found in EMTALA; thus, when an opinion from a medical review panel is ultimately rendered, EMTALA's statute of limitations may have already expired, barring a claim. Despite Gregory's claim to the contrary, there is no provision in EMTALA which effectively tolls the statute of limitations while awaiting a state procedural prerequisite, such as an opinion from a medical review panel, as is contained in the State Act. See 42 U.S.C. Sec. 1395dd; IND.CODE Sec. 16-9.5-9-1(b). Because of this direct conflict, EMTALA preempts the State Act, and Gregory may neither sidestep EMTALA's two-year statute of limitations for filing an action by claiming compliance with the State Act's procedures regarding the Department, nor seek to extend, expand, or enlarge her rights under the federal act with state law. We will not allow Gregory to...