Thornhill v. Jackson Parish Hosp.

• Decision Date: 04 May 2016
• Docket Number: CIVIL ACTION NO. 15-01867
• Citation: 184 F.Supp.3d 392
• Parties: Misty Cotherman Thornhill, et al. v. Jackson Parish Hospital
• Court: U.S. District Court — Western District of Louisiana

184 F.Supp.3d 392

Misty Cotherman Thornhill, et al.

v.Jackson Parish Hospital

CIVIL ACTION NO. 15-01867

United States District Court, W.D. Louisiana, Monroe Division .

Signed May 4, 2016

William M. Street, Watson McMillin & Harrison, Monroe, LA, for Misty Cotherman Thornhill, et al.

Rene' J. Pfefferle, Jennifer Montgomery Durham, Watson Blanche et al., Baton Rouge, LA, for Jackson Parish Hospital.

RULING

ROBERT G. JAMES, UNITED STATES DISTRICT JUDGE

Plaintiffs Misty Cotherman Thornhill, individually and as Administrator of the Estate of George Richard Cotherman, Sr.; George Richard Cotherman, Jr.; Jeffery Lee Cotherman; Jason Lynn Cotherman; Melinda Cotherman Taylor; and Christopher Delane Cotherman (collectively "Plaintiffs") brought this suit against Defendant Jackson Parish Hospital ("Jackson Parish") for alleged violations of the Emergency Medical Treatment and Active Labor Act, 42 U.S.C. § 1395dd, et seq . ("EMTALA") based on the allegedly defective transfer of Cotherman from Jackson Parish to St. Francis Medical Center.¹

Pending before the Court is Jackson Parish's Motion for Summary Judgment. [Doc. No. 6]. Because Jackson Parish's duty under EMTALA ended when it admitted Cotherman as an inpatient, the motion is GRANTED.

I. FACTS AND PROCEDURAL HISTORY

Unless otherwise noted, the following facts are undisputed.

On June 15, 2013, Cotherman was transported by ambulance to the emergency department of Jackson Parish for medical treatment. Cotherman, a fifty-five-year-old smoker, complained that he had had shortness of breath for two or three weeks. [Doc. No. 6-4, p. 17]. Dr. Bryan Rosedale ("Rosedale") examined Cotherman and ordered monitoring, labs, diagnostic studies, and medications. Id. at 40-41, 44. Cotherman refused admission, transfer, and referral, and left the hospital against medical advice. Id. at 41, 52.

On June 16, 2013, Cotherman presented at Jackson Parish's emergency department via ambulance with shortness of breath and decreased level of consciousness. Id. at 9. Dr. Rosedale examined Cotherman and again ordered monitoring, labs, diagnostic studies, and medication. Id. at 8-9, 13. Cotherman's family members arrived around this time. Cotherman agreed to stay at the hospital and was admitted as an inpatient with a plan for IV fluids, IV antibiotics, IV steroids, Solu-Medrol, respiratory treatments, chest x-ray in the morning, supportive care, and reassessment. Id. at 18. Jackson Parish transferred Cotherman from the ER to the floor.

After Cotherman was admitted to the floor, additional family members arrived. Cotherman's family members requested that he be transferred to St. Francis Medical Center. The transfer was arranged. Id. at 16. Cotherman was intubated prior to transfer. Id. Plaintiffs claim that Cotherman experienced problems with his airflow which were corrected. [Doc. No. 1]. Shortly after the alleged airflow problems were corrected, Plaintiffs assert that the ambulance arrived to transport Cotherman. [Doc. No. 1]. Cotherman was placed on a portable ventilation system and transferred by Jackson Parish Ambulance Service to St. Francis Medical Center. [Doc. No. 6-4, p. 16]. The Jackson Parish Ambulance Service records indicate that the Jackson Parish Ambulance Service personnel were given instructions to monitor Cotherman's cardiac, IV, oxygen, and vent status. [Doc. No. 6-5, p. 21]. Plaintiffs claim, however, that, according to the "Transfer and Medical Necessity Form" maintained by Jackson Parish, only cardiac monitoring was applicable to Cotherman. [Doc. No. 1].

During transit, Cotherman coded, went into asystole and became cyanotic. Id. Due to the complications, Cotherman was rerouted to the North Louisiana Medical Center ("NLMC") in Ruston, Louisiana. Id. Upon arrival, it was observed that Cotherman appeared blue and dusky; he had no rise or fall to his chest, and there was no sound of air movement. Id. Despite measures taken by NLMC, Cotherman never regained consciousness. Id. He died on June 24, 2013, the ninth day after his admission to NLMC. Id.

Plaintiffs brought this suit on July 15, 2015, claiming that Jackson Parish violated EMTALA by not providing an appropriate transfer from its hospital to St. Francis Medical Center. [Doc. No. 1].²

Specifically, Plaintiffs claim that the transfer to St. Francis Medical Center was not affected through qualified personnel or through satisfactory equipment in accordance with EMTALA. They note that a work order form shows that the Jackson Parish Ambulance Service ventilator was serviced on July 2, 2013–shortly after its use on Cotherman. The work order form reported "repaired/replaced cracked, broken, and/or worn out parts." [Doc. No. 18-1, p. 10].

Plaintiffs also question why Jackson Parish Ambulance Service did not remove Cotherman from an allegedly malfunctioning vent to provide manual treatment in the hopes of reviving him. According to Plaintiffs, "the actions of the doctors, nurses, respiratory therapists, and other healthcare agents of Jackson Parish Hospital, including the emergency medical technicians of [Jackson Parish Ambulance Service], fell below the required standards of care and violated the provisions of EMTALA..." [Doc. No. 1]. Finally, Plaintiffs question whether Jackson Parish should have probed deeper into the qualifications of Jackson Parish Ambulance Service.

On August 12, 2015, Jackson Parish filed this Motion for Summary Judgment, claiming that, according to a regulation issued by the agency responsible for administering the statute, a hospital's duty under EMTALA ends when the hospital, in good faith, admits an individual for inpatient care. [Doc. No. 6]. In the alternative, Jackson Parish asserts that the transfer was affected through qualified personnel and equipment under established precedent.

Consideration of this motion was stayed for multiple months to allow Plaintiffs to conduct discovery. On December 1, 2015, Plaintiffs filed a memorandum in opposition to the motion. [Doc. No. 18]. Plaintiffs claim, among other things, that material issues of genuine fact exist with respect to Jackson Parish's choice of Jackson Parish Ambulance Service to execute Cotherman's transfer. On December 11, 2015, Jackson Parish filed a reply. [Doc. No. 19]. The matter is briefed and ripe.

II. LAW AND ANALYSIS

A. Summary Judgment Standard

Under Federal Rule of Civil Procedure 56(a), "[a] party may move for summary judgment, identifying each claim or defense—or the part of each claim or defense—on which summary judgment is sought. The court shall grant summary judgment if the movant shows that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law." The moving party bears the initial burden of informing the court of the basis for its motion by identifying portions of the record which highlight the absence of genuine issues of material fact. Topalian v. Ehrman , 954 F.2d 1125, 1132 (5th Cir.1992) ; see also FED. R. CIV. P. 56(c)(1) ("A party asserting that a fact cannot be ... disputed must support the assertion by ... citing to particular parts of materials in the record ...). A fact is "material" if proof of its existence or nonexistence would affect the outcome of the lawsuit under applicable law in the case. Anderson v. Liberty Lobby, Inc. , 477 U.S. 242, 248, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986). A dispute about a material fact is "genuine" if the evidence is such that a reasonable fact finder could render a verdict for the nonmoving party. Id.

If the moving party can meet the initial burden, the burden then shifts to the nonmoving party to establish the existence of a genuine issue of material fact for trial. Norman v. Apache Corp. , 19 F.3d 1017, 1023 (5th Cir.1994). In evaluating the evidence tendered by the parties, the Court must accept the evidence of the nonmovant as credible and draw all justifiable inferences in its favor. Anderson , 477 U.S. at 255, 106 S.Ct. 2505. However, "a party cannot defeat summary judgment with conclusory allegations, unsubstantiated assertions, or only a scintilla of evidence." Turner v. Baylor Richardson Med. Ctr. , 476 F.3d 337, 343 (5th Cir.2007) (citing Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986) ).

"Only disputes over facts that might affect the outcome of the suit under governing laws will properly preclude the entry of summary judgment." Anderson , 477 U.S. at 248, 106 S.Ct. 2505. Disputed fact issues that are "irrelevant and unnecessary" will not be considered by a court in ruling on a summary judgment motion. Id.

B. Jackson Parish's Liability under EMTALA

1. EMTALA Generally

Congress enacted EMTALA in order to prevent patient dumping, which is "the practice of some hospital emergency rooms [of] turning away or transferring indigents to public hospitals without prior assessment or stabilization treatment." See Harry v. Marchant , 291 F.3d 767, 772 (11th Cir.2002) (citing H.R. Rep. No. 99-241, pt. 3, at 5 (1986), reprinted in 1986 U.S.C.C.A.N. 726, 726-27); Gatewood v. Wash. Healthcare Corp ., 933 F.2d 1037, 1039–41 (D.C.Cir.1991) ; Cleland v. Bronson Health Care Group, Inc ., 917 F.2d 266, 268–69 (6th Cir.1990).

Importantly, EMTALA was not intended to become a federal malpractice statute. See, e.g., Marshall on Behalf of Marshall v. East Carroll Parish Hosp. Serv. Dist. , 134 F.3d 319, 322 (5th Cir.1998) ; Summers v. Baptist Med. Ctr. Arkadelphia , 91 F.3d 1132, 1136–37 (8th Cir.1996) (en banc); Vickers v. Nash Gen. Hosp., Inc ., 78 F.3d 139, 142 (4th Cir.1996) ; Correa v. Hosp. S.F. , 69 F.3d 1184, 1192 (1st Cir.1995) ; Eberhardt v. City of L.A. , 62 F.3d 1253, 1255 (9th Cir.1995) ; Urban By and Through Urban v. King , 43 F.3d 523, 525 (10th Cir.1994) ; Holcomb v. Monahan , 30 F.3d 116, 117 & n. 2 (11th Cir.1994). Rather, it was enacted to give plaintiffs an entirely new action: a cause of action based on a failure to treat. See Hardy v. N.Y.C. Health & Hosp. Corp. , 164 F.3d 789, 792 (2d Cir.1999) ...