Preston v. Meriter Hosp., Inc.

• Decision Date: 24 January 2008
• Docket Number: No. 2006AP3013.,2006AP3013.
• Parties: Shannon PRESTON and Charles Johnson, Individually and as Special Administrator of the Estate of Bridon Michael Johnson, deceased, Plaintiffs-Appellants<SMALL><SUP>&#x2020;</SUP></SMALL> v. MERITER HOSPITAL, INC. and The Wisconsin Patients Compensation Fund, Defendants-Respondents.
• Court: Wisconsin Court of Appeals

747 N.W.2d 173

2008 WI App 25

Shannon PRESTON and Charles Johnson, Individually and as Special Administrator of the Estate of Bridon Michael Johnson, deceased, Plaintiffs-Appellants^† v. MERITER HOSPITAL, INC. and The Wisconsin Patients Compensation Fund, Defendants-Respondents.

No. 2006AP3013.

Court of Appeals of Wisconsin.

Submitted on Briefs August 7, 2007.

Opinion Filed January 24, 2008.

On behalf of the plaintiffs-appellants, the cause was submitted on the briefs of John L. Cates and Michael J, Luebke of Gingras, Cates & Luebke, S.C., Madison.

On behalf of the defendants-respondents, the cause was submitted on the brief of Curtis C. Swanson and David J. Pliner of Corneille Law Group, L.L.C., Madison.

Before DYKMAN, VERGERONT and BRIDGE, JJ.

¶ 1 BRIDGE, J

Shannon Preston appeals an order granting summary judgment in favor of Meriter Hospital on her claim under the Emergency Medical Treatment and Labor Act (EMTALA) related to the death of her son, who was born prematurely in Meriter's birthing center. The circuit court held that, based on the undisputed facts, the EMTALA's medical screening requirement does not apply to, inpatients. It held further that because Preston was admitted as an inpatient when she was taken to the birthing center the night her son was born, her son necessarily became an inpatient for purposes of EMTALA coverage at the same time, and remained so during his birth and through his death. We agree and affirm.

FACTS AND PROCEDURAL HISTORY

¶ 2 This case is before us a second time. The underlying facts and procedural history of the case are as follows.

¶ 3 For purposes of this appeal, the following facts are undisputed. Shannon Preston arrived at Meriter Hospital on November 9, 1999 at 5:33 p.m. She was twenty-three and 2/7th weeks pregnant. She was admitted to the hospital and taken to Meriter's birthing center. At 3:55 a.m. she gave birth to a son she named Bridon Michael Johnson. The child weighed one and one-half pounds at birth and could not survive without resuscitation and the administration of oxygen and fluids. Except for nursing care, Meriter did not resuscitate or treat the child, who survived for two and one-half hours.

¶ 4 Preston sued Meriter for: (1) medical negligence; (2) failing to obtain informed consent; (3) neglecting a patient in violation of Wis. STAT. § 940.295(1)(j)1. (1997-98);¹ and (4) violating EMTALA, 42 U.S.C. § 1395dd (1994).² The circuit court granted Meriter's motion for summary judgment on all four of Preston's claims. It dismissed her medical malpractice claim for failure to identify an expert witness. It dismissed her claim for patient neglect because § 940.295(1)(j)1. is part of the criminal code and does not create a private cause of action. It dismissed her informed consent claim because such claims cannot be brought against a hospital. It also dismissed her EMTALA claim.

¶ 5 Preston appealed the dismissal of all of her claims except the claim under Wis. STAT. § 940.295(1)(j), and we affirmed the circuit court's ruling. See Preston v. Meriter Hosp., Inc. (Preston I), 2004 WI App 61, 271 Wis.2d 721, 678 N.W.2d 347. We analyzed whether Meriter violated EMTALA's "screening requirement," which obligates a hospital with an emergency department to provide an appropriate medical screening examination to any individual who "comes to the emergency department" with a request to be examined or treated for a medical condition. See 42 U.S.C. § 1395dd(a). Construing the term "comes to the emergency department," we concluded that the screening requirement applied only to patients brought to a hospital emergency room. See Preston I, 271 Wis.2d 721, ¶ 37, 678 N.W.2d 347. Because Bridon entered the hospital via the birthing center and not through the emergency room, we concluded that 42 U.S.C. § 1395dd(a) did not impose a screening requirement on Meriter. See id., ¶ 39.

¶ 6 Preston sought review of our ruling on this issue, which the supreme court granted. See Preston v. Meriter Hosp., Inc. (Preston II), 2005 WI 122, 284 Wis.2d 264, 700 N.W.2d 158. The supreme court reversed the dismissal of the EMTALA screening claim.³ Id., ¶ 42. The supreme court's ruling was based on its determination that the phrase "comes to the emergency department" applies to the hospital's birthing center as well as to its emergency room. See id., ¶ 38.

¶ 7 The majority opinion did not address the issue raised in the present appeal, namely whether the screening requirement applies to inpatients or whether the newborn infant of a woman who is herself admitted to the hospital is also an inpatient by virtue of the mother's admission. The majority referenced the "inpatient" issue in a single footnote:

Meriter raises the argument that EMTALA does not apply to Bridon because he was admitted to Meriter as an inpatient. Since we are reviewing this matter as if a motion to dismiss had been granted, we have considered only whether the facts and inferences in the complaint state a claim under EMTALA's screening requirement. Therefore, we disregard subsequent factual revelations and the legal conclusions that follow from those facts for purposes of this decision. Accordingly, based solely on the complaint, we hold that Preston has pleaded an EMTALA screening claim.

Id., ¶ 39 n. 12. The majority decision was authored by Justice Prosser, with whom four other justices joined.

¶ 8 Justice Roggensack authored a detailed dissent in which Justice Wilcox joined. Although the dissent agreed with the court's ruling that the phrase "comes to the emergency department" applies to the birthing center, Justice Roggensack observed that the majority's analysis of EMTALA "overlooks Bridon's status as an inpatient." Id., ¶ 47 (Roggensack, J., dissenting). Instead, Justice Roggensack would have held as a matter of law that: (1) the EMTALA screening requirement does not apply to hospital inpatients, and (2) Bridon became an inpatient when his mother was admitted before his birth. Id. Thus, Justice Roggensack determined; that Bridon was an inpatient rather than someone who "comes to the emergency department," and concluded that Preston's claim fell outside the scope of EMTALA and instead sounded in Wisconsin medical malpractice law. Id., ¶ 52 (Roggensack, J., dissenting).

¶ 9 A four-person concurrence authored by Justice Crooks emphasized that the inpatient issue was not addressed by the majority and indicated that the parties should brief the issue on remand:

I write to address that portion of the dissent that addresses the issue of whether or not Bridon was an inpatient for purposes of EMTALA.

The majority did not address that issue .... While the dissent suggests a roadmap for such a determination, it is merely the opinion of one justice. The issue of whether a newborn infant is considered an inpatient upon his or her mother's admission to a hospital has yet to be determined by this, or to our knowledge any other, court. The question is complicated further by the circumstances of this case, in which the hospital never intended to, nor did it, provide any treatment to Bridon. As the court of appeals' decision is reversed, and this case is remanded to the circuit court for further proceedings, the parties should fully brief this issue for the circuit court's consideration.

Id., ¶ 48-44 (Crooks, J., concurring). Justice Prosser did not join the concurrence.

¶ 10 On remand, Meriter moved for summary judgment on the inpatient issue. The circuit court granted the motion, ruling that, as a matter of law, the EMTALA screening requirement does not apply to patients admitted to the hospital. Further, the circuit court ruled as a matter of law that because Preston was admitted as an inpatient when she was taken to the hospital birthing center, Bridon necessarily became an inpatient at the same time and remained so until his subsequent death. The court's opinion largely tracked the reasoning of Justice Roggensack's dissent in Preston II. Preston appeals.

RELATIONSHIP BETWEEN PRESTON II AND THE PRESENT APPEAL

¶ 11 Preston argues that, although two Justices of the court took the position that Bridon should be considered as "automatically" admitted upon the admission of his mother, the majority opinion rejected this conclusion. In particular, Preston contends that by holding that a newborn has come to a birthing center for purposes of the screening requirement, the court implicitly held that the screening requirement continues to be in effect even after a patient's admission.

¶ 12 The supreme court's decision can be read as Preston proposes, but only if one overlooks the court's direction that the inpatient issue be addressed on remand. See Preston II, 284 Wis.2d 264, ¶ 44, 700 N.W.2d 158. We agree with the circuit court's observation that by this direction, the supreme court suggested that the question of Bridon's inpatient status could affect the validity of Preston's screening requirement claim. We therefore conclude that it was appropriate for the circuit court to reach and resolve this issue, and we do likewise.

DISCUSSION

¶ 13 Summary judgment is appropriate when there are no issues of material fact and one party is entitled to judgment as a matter of law. Wis. STAT. § 802.08(2) (2005-06). When we review a circuit court's grant or denial of summary judgment, we use the same methodology as the circuit court and our review is de novo. Green Spring Farms v. Kersten, 136 Wis.2d 304, 315, 401 N.W.2d 816 (1987).

¶ 14 EMTALA is commonly referred to as the "Anti-Patient Dumping Act." Preston II, 284 Wis.2d 264, ¶ 24, 700 N.W.2d 158. It was enacted in 1986 in response to widely publicized reports of hospital emergency rooms turning away or transferring indigents to public hospitals without prior assessment or stabilization treatment. See, e.g., Harry v. Marchant, 291 F.3d 767, 770, 772 (11th Cir.2002).

¶ 15 Under EMTALA, hospital emergency rooms are subject to two primary obligations, commonly referred to as...