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U.S. Court in Puerto Rico Holds Living Patient's Family Has No Cause of Action Under EMTALA

 
 

HLD, v. 28, n. 7 (July 2000)

U.S. Court in Puerto Rico Holds Living Patient's Family Has No Cause of Action Under EMTALA

Under the Emergency Medical Treatment and Active Labor Act ("EMTALA"), 42 U.S.C. � 1395dd, a hospital receiving Medicare funding must appropriately screen anyone requesting emergency room treatment, determine whether the patient is suffering from an emergency condition, and stabilize the patient before transfer. If the hospital determines that the patient is suffering from an emergency condition, the hospital must either stabilize the patient or transfer the patient to another facility that can treat the condition. To establish an EMTALA violation, a plaintiff must show that (1) the hospital is a participating hospital operating an emergency room, (2) the patient arrived at the emergency room seeking treatment, and (3) the hospital failed to appropriately screen the patient to determine whether an emergency condition existed or transferred the patient without first stabilizing the emergency condition. See Correa v. Hospital San Francisco, 69 F.3d 1184 (1st Cir. 1995), HLD, v. 23, n. 12, at p. 41.

Vianey Malave Sastre was injured in an automobile accident and was taken to the Hospital Doctor's Center ("Center") emergency room. A Center physician treated Sastre for right leg pain and ordered a Center paramedic to place a posterior splint cast on Sastre's injured leg to reduce the pain while waiting for the on-call orthopedic surgeon to arrive. Eight hours after Sastre's arrival, Sastre's husband, a registered nurse, realized that no physician was going to arrive and thus signed voluntary release papers to take Sastre to another hospital. When Sastre arrived at the other hospital, the physicians observed that her leg was severely burned because of the Center's improper splint placement. Sastre suffered permanent disfigurement and significant loss of movement in her leg. Sastre, her husband, and her daughter (collectively "plaintiffs") sued the Center, the Center physicians, and the paramedic (collectively "defendants") in federal court in Puerto Rico, alleging EMTALA violations. Defendants moved to dismiss.

The U.S. District Court for the District of Puerto Rico found that Sastre had stated an EMTALA claim, but that her husband and daughter had no cause of action under EMTALA. First, the court held that plaintiffs had sufficiently alleged that the Center had violated EMTALA by having failed to provide Sastre screening and stabilization comparable to that given to other patients in similar circumstances. Next, the court refused to excuse the Center from liability based on Sastre's having voluntarily signed herself out after having waited several hours for treatment. The court noted that EMTALA "'proscribe[s] both actual and constructive dumping of patients[,]'" see Correa, 69 F.3d at 1194, and explained that whether the Center's actions constituted a constructive discharge was a question of fact precluding dismissal. Finally, the court refused to extend an EMTALA cause of action to Sastre's husband and daughter. The court noted that EMTALA provides a cause of action for "'[a]ny individual who suffers personal harm as a direct result of a participating hospital's [EMTALA violation],'" see 42 U.S.C. �1395dd(d)(2), but found the statute's language and the legislative intent as limiting that cause of action to patients and not relatives of living patients. Accordingly, the court denied defendants' motion to dismiss Sastre's EMTALA claim, but granted their motion to dismiss Sastre's husband's and daughter's EMTALA claims.

Sastre v. Hospital Doctor's Ctr., Inc., No. 99-1833 (JP), 2000 WL 378090 (D.P.R. Mar. 10, 2000) (17 pages).

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