Root v. Liberty Emergency Physicians, Inc.

• Decision Date: 27 October 1999
• Docket Number: No. 98-1233-CV-SJ-1.,98-1233-CV-SJ-1.
• Citation: 68 F.Supp.2d 1086
• Parties: Benjamin and Amy ROOT, individually and as Next friends of Elizabeth Root, a minor, Plaintiffs, v. LIBERTY EMERGENCY PHYSICIANS, INC., et al., Defendants.
• Court: U.S. District Court — Western District of Missouri

68 F.Supp.2d 1086

Benjamin and Amy ROOT, individually and as Next friends of Elizabeth Root, a minor, Plaintiffs, v. LIBERTY EMERGENCY PHYSICIANS, INC., et al., Defendants.

No. 98-1233-CV-SJ-1.

United States District Court, W.D. Missouri, St. Joseph Division.

October 27, 1999.

COPYRIGHT MATERIAL OMITTED

Kenneth E. Siemens, Watkins, Boulware, Lucas, Miner, Murphy & Taylor, St. Joseph, MO, for plaintiffs.

Liberty Emergency Physicians, William Dirk Vandever, Kansas City, MO, Jayson A. Ford, Kelly L. McClelland, McClelland Law Firm, Liberty, MO, for defendants.

ORDER

WHIPPLE, District Judge.

Pending before the Court are Defendant New Liberty Hospital District's ("Liberty Hospital") Motion to Stay Proceedings Pending Appeal and Motion To Quash Notice of Deposition. The Court finds that Liberty Hospital's filing of a Notice of Appeal divests this Court of jurisdiction over any issues on appeal. Although Liberty Hospital is only one Defendant in this multi-defendant action, and the issue of sovereign immunity constitutes only a small part of the case, the Court will stay all proceedings pending the outcome of Liberty Hospital's appeal.

I. BACKGROUND

Plaintiffs claim that Liberty Hospital's mistreatment of Plaintiff Amy Root caused her infant daughter Elizabeth Root to suffer severe brain damage. Amy Root ("Root"), an insulin-dependent diabetic who was thirty-one weeks pregnant, arrived at Liberty Hospital on November 30, 1996 seeking treatment for nausea, dehydration, and vomiting. Root alleges that Liberty Hospital's emergency staff never screened her for the onset of diabetic ketoacidosis, despite the fact that she exhibited classic warning signs. Root also alleges that Liberty Hospital released her without first stabilizing her condition. Within thirty hours of her release, Root arrived at St. Luke's Hospital in a severe diabetic ketoacidosis state. She immediately delivered her daughter, Elizabeth Root, by emergency cesarean section. Elizabeth Root is severely brain-damaged. Plaintiffs allege that Defendants' actions and inaction caused Elizabeth Root's brain damage.

Particularly relevant to the pending motion is Plaintiffs' claim against Liberty Hospital for violation of the Emergency Medical Treatment and Active Labor Act ("EMTALA"), 42 U.S.C. § 1395dd et seq. EMTALA requires that hospitals conduct appropriate screening of patients brought into the emergency room, and prohibits hospitals from transferring patients with unstable medical conditions. See 42 U.S.C. § 1395dd(a)-(b). EMTALA explicitly creates a private right of action for damages against hospitals that have injured patients by failing to fulfill these requirements.¹ To determine the measure of damages available for a violation of EMTALA courts must look to the personal injury laws of the state where the hospital is located. See id.

Liberty Hospital moved the Court for an Order dismissing Plaintiff's complaint, claiming sovereign immunity under Mo. Rev.Stat. § 537.600. Section 537.600 grants the State of Missouri and its political subdivisions sovereign or governmental tort immunity from claims of liability under state law. This Court denied Liberty Hospital's Motion to Dismiss, finding that EMTALA preempted § 537.600. See Root v. Liberty Emergency Physicians, Inc., No. 98-1233 (W.D.Mo. June 22, 1999). Liberty Hospital appealed the Court's denial of sovereign immunity and requests that this Court stay its Order and proceedings pending appeal.

II. LEGAL STANDARD

Generally, the filing of a Notice of Appeal confers jurisdiction in the appellate court over all matters appealed. It also divests the district court of jurisdiction over any aspects of the case relating to the appeal. See Johnson v. Hay, 931 F.2d 456, 459 (8th Cir.1991). Many district courts, faced with a similar appeal and motion to stay after having denied immunity, determine that a stay of all proceedings is required pending the outcome of appeal. See Jones v. Clinton, 879 F.Supp. 86, 87 (E.D.Ark.1995) (stating that "[a]n appeal from a denial of official immunity requires a stay of all proceedings pending resolution of the appeal."); see also Dickerson v. McClellan, 1994 WL 577519, at *1 (6th Cir.1994) (stating that "[b]ecause an order denying qualified immunity is immediately appealable, it follows that in most cases a stay of the trial proceedings may be necessary to preserve the issue.") Only when a party's appeal is "utterly lacking in merit," and made for the purpose of delay, may the district court proceed with trial. See Johnson, 931 F.2d at 459. In order to determine if the proceedings in this case must be stayed pending appeal, this Court must first determine if the appellate court has jurisdiction over Liberty Hospital's appeal, and then determine if Liberty Hospital's appeal is "utterly lacking in merit."

III. DISCUSSION

A. Appellate Court's Jurisdiction Over Liberty Hospital's Appeal

Plaintiffs argue that Liberty Hospital's appeal will be dismissed for lack of jurisdiction. Specifically, Plaintiffs focus on procedural defects in Liberty Hospital's appeal. Unlike denials of qualified immunity, which are immediately appealable, Plaintiffs argue that Liberty Hospital's appeal of this Court's denial of sovereign immunity is interlocutory.² Plaintiffs argue that Liberty Hospital failed to follow certain procedures necessary to secure the appellate court's jurisdiction over an interlocutory appeal. Specifically, Plaintiffs contend that Liberty Hospital failed to obtain this Court's certification that its Order was appealable. See 28 U.S.C. § 1292(b) (requiring a district court to certify that its ruling is immediately appealable). The Court, however, finds that Liberty Hospital has an immediate right to appeal the denial of sovereign immunity.

A district court decision is immediately appealable if it falls under the collateral order exception to the final judgment rule.³ Decisions falling within the collateral order exception are considered final for purposes of appeal. Appellate courts have jurisdiction to hear appeals of all final decisions, regardless of whether a district court certifies the appeal. See 28 U.S.C. § 1291 (1994). A district court's denial of constitutionally-based immunities, such as qualified or Eleventh Amendment immunity, almost always fall under the collateral order exception because "the essence of absolute immunity is its possessor's entitlement not to have to answer for his conduct in a civil damages action." Mitchell v. Forsyth, 472 U.S. 511, 525, 105 S.Ct. 2806, 2815, 86 L.Ed.2d 411 (1985). When the source of immunity is a state statute or state common law, however, the analysis is slightly more complex, as some states grant immunity from liability rather than immunity from suit. See Griesel v. Hamlin, 963 F.2d 338, 339-40 (11th Cir.1992). When a state statute grants a party immunity from suit the denial of such immunity is immediately appealable. See id. (stating that a denial of state-based sovereign immunity granting immunity from suit falls within the collateral order doctrine). Section 537.600 grants the State of Missouri and its subdivisions immunity from suit. See Aiello v. St. Louis Community College, 830 S.W.2d 556, 558 (Mo.Ct.App. 1992) (stating that § 537.600 gives immunity from suit). Accordingly, Liberty Hospital is entitled to an immediate appeal of this Court's denial of sovereign immunity. Because the Eighth Circuit has jurisdiction over Liberty Hospital's appeal, this Court is divested of jurisdiction and should not proceed with trial unless the appeal is "utterly lacking" in merit.

B. Merits of Liberty Hospital's Appeal

In its Order of June 22, 1999, this Court found that Mo.Rev.Stat. § 537.600, which grants the State of Missouri and its political subdivisions tort immunity from claims of liability under state law, is in direct conflict with EMTALA, a federal statute creating a cause of action against hospitals that violate the statute's provisions. To that end, the Court held that EMTALA preempted § 537.600 and that Liberty Hospital was therefore not immune from suit. Liberty Hospital argued in its Motion to Dismiss that there is no conflict between EMTALA and § 537.600 because EMTALA directly references state law in its civil cause of action provision and expressly states that the statute was not intended to preempt any state law. To determine if Liberty Hospital's appeal has any merit, the Court must reconsider its analysis of this issue.

1. EMTALA's Preemption of Rev. Mo.Stat. § 537.600

A federal statute preempts state law when the federal law is intended to occupy a field of law exclusively, or when state law conflicts with a federal statute. See Freightliner Corp. v. Myrick, 514 U.S. 280, 288, 115 S.Ct. 1483, 1487, 131 L.Ed.2d 385 (1995). Courts must consider Congressional intent when determining whether a federal statute occupies a field or conflicts with state law. See Ingersoll-Rand Co. v. McClendon, 498 U.S. 133. 137-38, 111 S.Ct. 478, 482, 112 L.Ed.2d 474 (1990). Congressional intent is usually ascertained by considering the statute's explicit language as well as its purpose and history. See id.

(a) EMTALA's Private Cause of Action for Patient Dumping

EMTALA states that hospitals containing emergency departments must provide all individuals requesting treatment at their emergency rooms "an appropriate medical screening examination within the capability of the hospital's emergency department to determine whether or not an emergency medical condition ... exists." 42 U.S.C. § 1395dd(a). EMTALA also requires that hospital emergency rooms provide to individuals with emergency medical conditions "such treatment as may be required to stabilize the medical condition" or "[a] transfer of the individual to another medical facility in accordance with subsection (c) of this section." Id. at § 1395dd(b) (subsection (c) of EMTALA requires that hospitals restrict transfers until the patient is stabilized). As...