Vega-Feliciano v. Doctors' Ctr. Hosp., Inc.

Decision Date30 March 2015
Docket NumberCivil No. 12–01790 ADC.
Citation100 F.Supp.3d 113
PartiesRafael VEGA–FELICIANO, by himself and on behalf of minors J.V.M. and Y.V.M., Plaintiffs, v. DOCTORS' CENTER HOSPITAL, INC., John Doe, Jane Doe, and Companies X, Y, & Z, Defendants.
CourtU.S. District Court — District of Puerto Rico

Michelle Annet Ramos–Jimenez, Luis R. Rivera–Rodriguez, Luis Rafael Rivera Law Office, San Juan, PR, for Plaintiffs.

Raphael Pena–Ramon, Pena Ramon & Co., San Juan, PR, for Defendants.

OPINION AND ORDER

AIDA M. DELGADO–COLÓN, Chief Judge.

Before the Court is defendant Doctor's Center Hospital, Inc.'s (“DCH”) Motion for Summary Judgment (“Motion”) (ECF No. 21 ), U.S. Magistrate Judge Justo Arenas' Report and Recommendation (“R & R”) that the Motion be granted (ECF No. 48 ), and plaintiffs' objections to the R & R (ECF No. 51 ).

On September 23, 2012, plaintiff Rafael Vega–Feliciano (Vega), in his own capacity and on behalf of minors J.V.M. and Y.V.M. (Collectively the Plaintiffs), filed a complaint against DCH, John Doe, Jane Doe, and Companies X, Y, & Z, pursuant to the Emergency Medical Treatment and Active Labor Act (“EMTALA”), 42 U.S.C. § 1395dd. ECF No. 1.

Plaintiffs claim that the death of Sonia Molina–Rivera (“Molina”), Vega's wife and mother to the minor plaintiffs, was the result of DCH's failure to stabilize Molina's emergency medical condition before transferring her to Auxilio Mutuo Hospital (“AMH”). Id. at ¶ 14. On December 9, 2012, DCH filed an answer to the complaint, stating that DCH complied with EMTALA requirements in Molina's screening, stabilization, and transfer. ECF No. 7, at ¶ VII–1.

On April 19, 2014, DCH filed the Motion pursuant to Rules 7.1(a), 7.1(d), 7.1(e) and 56(a) of the Local Rules of the United States District Court for the District of Puerto Rico, on the grounds that Plaintiffs failed to state a claim under EMTALA and there are no genuine issues of material facts. ECF No. 21, at 4. The Motion was referred to Magistrate Judge Justo Arenas for the issuance of a Report and Recommendation. On September 16, 2014, Magistrate Judge Arenas issued the R & R which recommended granting the Motion and dismissing the complaint. ECF No. 48. On October 9, 2014, Plaintiffs filed a timely opposition to the R & R (“Objection”) (ECF No. 51 ), to which DCH responded (ECF No. 52 ).

I. Procedural Background and Motion for Summary Judgment Standard

Inasmuch as Plaintiffs have not made a specific objection to the Magistrate Judge's recitation of the procedural background and motion for summary judgment standard, the court hereby adopts the same. ECF No. 48, at 120–21 and 123–24, ¶¶ 1–2.

II. Standard of Review for Objections to a Report and Recommendation

A district court may refer pending motions to a magistrate judge for a report and recommendation. 28 U.S.C. § 636(b)(1)(B) ; Fed.R.Civ.P. 72(b) ; L. Cv. R. 72(a). Any party adversely affected by the report and recommendation issued may file written objections within fourteen (14) days of being served with the report and recommendation. Fed.R.Civ.P. 72(d). A party that files a timely objection is entitled to a de novo determination of “those portions of the report or specified proposed findings or recommendations to which specific objection is made.” Sylva v. Culebra Dive Shop, 389 F.Supp.2d 189, 191–92 (D.P.R.2005) (citing United States v. Raddatz, 447 U.S. 667, 673, 100 S.Ct. 2406, 65 L.Ed.2d 424 (1980) ). “The district court need not consider frivolous, conclusive, or general objections.” Rivera–García v. United States, Civ. No. 06–1004(PC), 2008 WL 3287236, *1 (D.P.R. Aug. 7, 2008) (citing Battle v. U.S. Parole Comm'n, 834 F.2d 419 (5th Cir.1987) ).

Moreover, to the extent the objections amount to no more than general or conclusory objections to the report and recommendation, without specifying to which issues in the report the party is objecting, or where the objections are repetitive of the arguments already made to the magistrate judge, a de novo review is unwarranted. Id. “Instead, the report and recommendation is reviewed by the district judge for clear error.” Id. (citing Camardo v. Gen. Motors Hourly–Rate Employees Pension Plan, 806 F.Supp. 380, 382 (W.D.N.Y.1992) (“It is improper for an objecting party to ... submit[ ] papers to a district court which are nothing more than a rehashing of the same arguments and positions taken in the original papers submitted to the Magistrate Judge. Clearly, parties are not to be afforded a ‘second bite at the apple’ when they file objections to a R & R.”)).

In conducting its review, the court is free to “accept, reject, or modify, in whole or in part, the findings or recommendations made by the magistrate-judge.”28 U.S.C. § 636(a)(b)(1) ; see also Templeman v. Chris Craft Corp., 770 F.2d 245, 247 (1st Cir.1985) ; Alamo Rodríguez v. Pfizer Pharma., Inc., 286 F.Supp.2d 144, 146 (D.P.R.2003). Hence, the court may accept those parts of the report and recommendation to which the party does not object. See Hernández–Mejías v. General Elec., 428 F.Supp.2d 4, 6 (D.P.R.2005) (citing Lacedra v. Donald W. Wyatt Detention Facility, 334 F.Supp.2d 114, 125–26 (D.R.I.2004) ).

III. Legal Standard for an EMTALA Claim

EMTALA was enacted by Congress to prevent the “dumping” of patients by hospital emergency wards, and to ensure that all patients are treated equally by hospitals regardless of a patient's insurance and socio-economic status. See Correa v. Hosp. San Francisco, 69 F.3d 1184, 1189–90 (1st Cir.1995). “EMTALA is a ‘limited antidumping statute, not a federal malpractice suit’. Bryan v. Rectors & Visitors of the Univ. of Va.,

95 F.3d 349, 351 (4th Cir.1996).” Alvarez–Torres v. Ryder Memorial Hosp., Inc., 582 F.3d 47, 52 (1st Cir.2009). Under 42 U.S.C. § 1395dd, a hospital that participates in the federal Medicare program must provide (1) appropriate medical screening to an individual who arrives at its emergency department and a request for examination or treatment is made on his/her behalf, and (2) treatments required to stabilize the individual's emergency medical conditions within the hospital's capability. 42 U.S.C. §§ 1395dd(a) and 1395dd(b)(1)(A).

EMTALA does not define what an appropriate medical screening consists of; rather, it requires only that a hospital provides uniform screening for all individuals who present similar complaints. See Cruz–Vázquez v. Mennonite General Hosp., Inc., 717 F.3d 63, 69 (1st Cir.2013). A faulty screening on its own is not a violation of EMTALA. Id. at 69. The Supreme Court of the United States has held that EMTALA requires hospital to provide stabilization to an individual with an emergency medical condition, but it does not require “appropriate” stabilization. Roberts v. Galen of Virginia, Inc., 525 U.S. 249, 253, 119 S.Ct. 685, 142 L.Ed.2d 648 (1999). An individual is considered stabilized if the individual's emergency medical conditions are not likely, within reasonable medical probability, to deteriorate materially during the transfer of the individual from the hospital to another facility. 42 U.S.C. § 1395dd(e)(3)(B).

EMTALA does not impose restriction on the transfer of an individual if the individual's emergency medical condition has been stabilized. 42 U.S.C. § 1395dd. However, if a hospital does not have the capability to provide treatment required to stabilize a patient's emergency medical condition, the hospital must effectuate an appropriate transfer of the patient to another medical facility with such capability. 42 U.S.C. § 1395dd(b)(1)(B).

IV. Discussion
A. Plaintiffs' Objections to the R & R

Plaintiffs' Objection to the R & R is divided into two parts: (1) objections as to relevant facts omitted by Magistrate Judge Arenas in the R & R (“Factual Objections”), and (2) a section entitled “Legal Argument”, which objects to the conclusions of law in the R & R (“Legal Objections”). ECF No. 51. In pertinent part, Plaintiffs' objections challenge Magistrate Judge Arenas' factual findings that Molina had been stabilized before she was transferred from DCH, and the legal findings that DCH did not violate EMTALA. Id.

While an objecting party is entitled to a de novo review of the portion of the report and recommendation it objects to, no such review is necessary if the party merely repeats in its objection the same arguments it had already made in previous submissions.See Rivera–García, 2008 WL 3287236, *1. In this instance, all of plaintiffs' factual objections are assertions previously made in their “Opposing Statement of Material Facts which Bar the Entry of Summary Judgment”. ECF No. 51 at 2–9, ¶¶ 4–42, ECF No. 33. As for the legal objections offered by plaintiffs, it is, in fact, an essentially verbatim reproduction of plaintiffs' “Memorandum of Law in Support to Opposition to Motion for Summary Judgment for Lack of Subject Matter Jurisdiction and Memorandum of Law in Support Thereof”. ECF No. 51 at 9–16, ¶¶ 43–63, ECF No. 34. Since plaintiffs have failed to offer any new arguments in the Objection, a de novo review of any part of the R & R is unwarranted, and the R & R will be reviewed under the plain error standard.

B. Proposed Findings of Fact in the R & R

Magistrate Judge Arenas proposed certain facts for this Court to adopt in the R & R. In pertinent part, Magistrate Judge Arenas found: (1) Molina had a distal pancreatectomy

performed at AMH by Dr. Diego Solis (“Dr. Solis”) on September 9, 2010; (2) Molina complained of malaise, acute abdominal pain, nausea, vomiting, and difficulty breathing three days after her discharge from AMH; (3) Molina was en route to AMH in an ambulance when the paramedics decided that her condition had so deteriorated that they had to redirect her to DCH's emergency ward; (4) at DCH, several diagnostic tests were performed on Molina and various treatments were administered by the staff to stabilize her condition; (5) Vega testified that Molina was stabilized at DCH; (6) Dr. Osvaldo Niebla, the physician on duty at DCH, decided that it was...

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