Preston v. Meriter Hospital, Inc.

• Decision Date: 13 July 2005
• Docket Number: No. 2003AP1376.,2003AP1376.
• Parties: Shannon PRESTON, Plaintiff-Appellant-Petitioner, Charles JOHNSON and Estate of Bridon M. Johnson, Plaintiffs, v. MERITER HOSPITAL, INC. and Wisconsin Patients Compensation Fund, Defendants-Respondents.
• Court: Wisconsin Supreme Court

284 Wis.2d 264

2005 WI 122

700 N.W.2d 158

Shannon PRESTON, Plaintiff-Appellant-Petitioner, Charles JOHNSON and Estate of Bridon M. Johnson, Plaintiffs, v. MERITER HOSPITAL, INC. and Wisconsin Patients Compensation Fund, Defendants-Respondents.

No. 2003AP1376.

Supreme Court of Wisconsin.

Oral argument April 28, 2005.

Decided July 13, 2005.

For the plaintiff-appellant-petitioner there were briefs by Scott D. Obernberger and Obernberger & Associates, LLC, Milwaukee, James M. Bopp, Jr. and Thomas J. Marzen and National Legal Center for the Medically Dependent & Disabled, Inc., Terre Haute, IN, and oral argument by Thomas J. Marzen.

For the defendant-respondent, Meriter Hospital, Inc., there was a brief by Curtis S. Swanson, David J. Pliner and Corneille Law Group, L.L.C., Madison, and oral argument by David J. Pliner.

¶ 1. DAVID T. PROSSER, J.

This is a review of a published decision of the court of appeals, Preston v. Meriter Hospital, Inc., 2004 WI App 61, 271 Wis. 2d 721, 678 N.W.2d 347. Shannon Preston and Charles Johnson, in their personal capacity and as personal representatives of their son Bridon's estate, filed a complaint asserting four claims against Meriter Hospital and the Wisconsin Patients Compensation Fund.¹ The court of appeals affirmed the circuit court's grant of summary judgment to Meriter on all four claims, but it determined that the plaintiff's claim under the Emergency Medical Treatment and Active Labor Act (EMTALA), 42 U.S.C. § 1395dd (1994),² really amounted to two claims, one of which was not addressed and thus dismissed by the circuit court. Preston petitioned this court to review the dismissal of this second EMTALA claim, that Meriter Hospital failed to give Bridon an appropriate medical screening examination in violation of 42 U.S.C. § 1395dd(a). ¶ 2. EMTALA requires 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. 42 U.S.C. § 1395dd(a). The court of appeals concluded that this EMTALA requirement did not apply to Bridon because he arrived at Meriter through the birthing center, not the emergency room. Preston, 271 Wis. 2d 721, ¶¶ 37, 39. We must resolve whether the EMTALA screening requirement applies to an infant born in a hospital birthing center. Specifically, we must interpret whether the statutory phrase "comes to the emergency department" requires a baby to be born in a hospital emergency room for the EMTALA screening requirement to apply.

¶ 3. Preston argues that the court of appeals' narrow interpretation of § 1395dd(a) is not consistent with the intent of EMTALA, and that a hospital's emergency department encompasses its birthing center. Thus, Meriter had a duty to screen Bridon. Conversely, Meriter argues that EMTALA does not impose a duty to screen a newborn presented in the birthing center, because the birthing center is not "the emergency department" and because, in Bridon's case, he was an "inpatient," to whom the EMTALA screening requirement does not apply.

¶ 4. We agree with Preston with respect to the hospital's duty to screen.³ Based on the allegations in the complaint, Meriter had a duty to give Bridon an appropriate screening examination to determine whether he had an emergency medical condition. When a baby is born in a hospital birthing center, the newborn has come to the emergency department for purposes of the EMTALA duty to provide a medical screening examination. Because the court of appeals interpreted EMTALA differently, we reverse.

¶ 5. This case involves a grant of summary judgment by the circuit court. However, the court of appeals reviewed Meriter's motion on Preston's EMTALA screening claim as if it were a motion to dismiss rather than a summary judgment motion. Here, our review is de novo, whether we apply the methodology appropriate for review where summary judgment has been granted or the methodology for review where a motion to dismiss has been granted, benefiting as usual from the analyses of the circuit court and the court of appeals. Under these circumstances, we will review the Meriter motion on the EMTALA screening claim in a manner similar to that of the court of appeals. Consequently, we decide merely whether the requirement of EMTALA, that any individual who "comes to the emergency department" of a hospital must be provided appropriate medical screening, applies to an infant born in an emergency medical condition at a hospital's birthing facility. We do not decide whether Meriter's response to Bridon's presence satisfied its duty to provide an appropriate medical screening examination.

I. FACTS AND PROCEDURAL HISTORY

¶ 6. Preston arrived at Meriter Hospital in Madison on November 9, 1999, at 5:33 p.m. She was 23-and-2/7ths weeks pregnant and had leaked amniotic fluid for a number of days. At the time of her hospitalization, Preston was unemployed and on Medical Assistance.

¶ 7. Preston was admitted to the hospital and taken to the birthing center. There, physicians performed an ultrasound to evaluate the unborn child's condition. At 3:55 a.m. the following morning, Preston gave birth to a son whom she named Bridon Michael Johnson. The child weighed 700 grams. The hospital staff made no attempt to prolong the baby's life, and Bridon died two-and-a-half hours later.

¶ 8. Preston's complaint alleged the following:

. . . .

4. On November 10, 1999 Plaintiff, Shannon Preston, gave birth on an emergency basis to Plaintiffs' decedent, Bridon Michael Johnson while an inpatient at Defendant Meriter Hospital, Inc.

5. Following the birth of the minor child, Defendant Meriter Hospital, Inc.'s employees and agents were aware of the birth of the child and aware of his emergent need of medical care, but failed, refused, and neglected to provide any care whatsoever to the newborn infant, who was at a gestational age of 23 and 2/7th weeks, weighed one and one half pounds, and was 13 inches in length.

6. Defendant Meriter Hospital, Inc. and its employees knew, that without at a minimum resuscitation and the administration of oxygen and fluids, that the infant child had virtually no medical chance to survive, but nevertheless intentionally withheld all treatment for the infant child who therefore died after two and one half hours of life.

. . . .

14. The conduct of the Defendant Meriter Hospital, Inc. and its employees was in violation of 42 U.S.C. § 1395dd.

15. Plaintiffs Bridon Michael Johnson and Shannon Preston were discriminated against and refused treatment because they lacked private health insurance, contrary to 42 U.S.C. § 1395dd....

Paragraphs 14 and 15 were printed under the heading "EMTALA CLAIM."

¶ 9. Preston sued Meriter for (1) medical negligence; (2) failure to obtain informed consent; and (3) neglect of a patient, contrary to Wis. Stat. § 940.295(1)(j)1. (1997-98),⁴ in addition to (4) violation of EMTALA. The Dane County Circuit Court, Stuart A. Schwartz, Judge, granted Meriter summary judgment on all four of Preston's claims. The circuit court dismissed Preston's medical malpractice claim for failure to identify an expert witness. It dismissed her claim for patient neglect because Wis. Stat. § 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.

¶ 10. Following Meriter's motion for summary judgment, the court received additional evidence. The court was told that Meriter physicians had determined, based on the prebirth ultrasound, that Bridon's lungs were so underdeveloped that he would likely die shortly after being born. The court was told health care personnel made observations of Bridon shortly after his birth and assigned Bridon an Apgar score of one.⁵ Based on this information and because Preston did not particularize her EMTALA claim, the court interpreted the claim as one of failing to stabilize the medical condition of an individual who comes to the hospital, in violation of 42 U.S.C. § 1395dd(b). The court stated: "Preston's complaint focuses on the hospital's failure to treat/resuscitate Bridon immediately after his birth. This allegation appears to implicate the EMTALA's stabilization requirement and not the screening requirement." The court reached this conclusion at least in part because Preston stated in a brief to the court that:

There are many obligations under the EMTALA statute including an obligation to stabilize severely ill people before transferring them or discharging them, as well as mandated uniform methods for screening patients in emergency rooms et. al. None of those requirements is a consideration in the Preston case, since we are only claiming that Meriter Hospital failed to stabilize an acutely ill newborn, Bridon Johnson.

(Emphasis added.) This statement to the court supplies the basis for Meriter's argument that Preston waived any claim that Meriter failed to provide an appropriate medical screening examination.

¶ 11. Although the circuit court granted summary judgment to Meriter on the hospital's motion, it focused on EMTALA's stabilization requirement and did not rule directly on a claim that Meriter violated EMTALA's screening requirement. The court of appeals reviewed Preston's screening claim pursuant to the motion-to-dismiss methodology. Preston, 271 Wis. 2d 721, ¶ 30 ("We consider the facts pled true and construe inferences from the pleadings in favor of the party against whom the motion is brought."). ¶ 12. As noted previously, because our review is de novo, whether we apply the methodology appropriate for review where summary judgment has been granted or the methodology for review where a motion to dismiss has been granted, we will review the circuit court's grant of summary judgment on Preston's screening claim as if it were decided...