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Perry v. Owensboro Health, Inc.

United States District Court, W.D. Kentucky, Owensboro Division

July 20, 2015

KEVIN LEE PERRY, Individually, and as Administrator of the Estate of MADONNA G. PERRY, Deceased, N.P., minor, by his father and next friend Kevin Perry, and ANDREA SMITH BUTLER Plaintiffs,


JOSEPH H. McKINLEY, Jr., Chief District Judge.

This matter is before the Court on Defendant's Motion for Judgment on the Pleadings [DN 30] pursuant to Federal Rule of Civil Procedure 12(c) and 12(h)(2)(B). Fully briefed, this matter is ripe for decision. For the following reasons, the Motion for Judgment on the Pleadings is GRANTED.


The standard of review for a Rule 12(c) motion for judgment on the pleadings "is the same as for a motion under Rule 12(b)(6) for failure to state a claim upon which relief can be granted." Fritz v. Charter Twp. of Comstock, 592 F.3d 718, 722 (6th Cir. 2010) (citing Ziegler v. IBP Hog Mkt., Inc., 249 F.3d 509, 511-12 (6th Cir. 2001)); Fed.R.Civ.P. 12(b)(6); Fed.R.Civ.P. 12(c). Upon a motion to dismiss for failure to state a claim pursuant to Federal Rule of Civil Procedure 12(b)(6), a court "must construe the complaint in the light most favorable to plaintiff[], " League of United Latin American Citizens v. Bredesen, 500 F.3d 523, 527 (6th Cir. 2007), "accept all well-pled factual allegations as true, " id., and determine whether the "complaint states a plausible claim for relief, " Ashcroft v. Iqbal, 556 U.S. 662, 679 (2009). Under this standard, the plaintiff must provide the grounds for his or her entitlement to relief, which "requires more than labels and conclusions, and a formulaic recitation of the elements of a cause of action will not do." Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555 (2007). A plaintiff satisfies this standard only when he or she "pleads factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged." Iqbal, 556 U.S. at 678. A complaint falls short if it pleads facts "merely consistent with' a defendant's liability, " id. at 678 (quoting Twombly, 550 U.S. at 557), or if the alleged facts do not "permit the court to infer more than the mere possibility of misconduct, " id. at 679. Instead, the allegations must "show[] that the pleader is entitled to relief.'" Id. at 679 (quoting Fed.R.Civ.P. 8(a)(2)).


As required by Rule 12(b)(6)'s analytical framework, the Court treats as true the following non-conclusory factual allegations stated in Plaintiffs' Third Amended Complaint.

Madonna G. Perry ("Perry") was treated through the emergency room at Owensboro Health ("OHI"), on two separate occasions on November 6, 2009. (3d Am. Compl. [DN 6-4] ¶ 8.) During both admissions to the OHI emergency room, Perry "complained of a non-healing surgical wound, fever, nausea, vomiting[, ] and diarrhea. She was found to be hypertensive and had an escalated white blood cell count." (Id. ¶ 12[1].[1]) On both visits, Perry received medical care and treatment from OHI physicians and other medical personnel. (Id. ¶¶ 8-11.) Perry was discharged home from both emergency room admissions at OHI, "despite her rapidly deteriorating condition." (Id. ¶ 12[2].) After her second discharge, Perry "returned to her home in pain and went to bed suffering through the night and into the next morning." (Id. ¶ 14.) On November 7, 2009, Perry "awoke in pain, took her medicine[, ] and went back to bed. Several hours later [she] was found dead in her bed." (Id. ¶ 15.)

Plaintiffs, who are surviving family members of Perry, filed suit against OHI and other defendants pursuant to state tort law, asserting negligence claims and claims for loss of consortium, in Daviess County Circuit Court. (See Original Compl. [DN 6-6].) On April 2, 2014, Plaintiffs filed in state court their Third Amended Complaint, which, inter alia, [2] added a claim against OHI pursuant to the Emergency Medical Treatment and Active Labor Act ("EMTALA"), 42 U.S.C. § 1395dd, for OHI's alleged failure to appropriately screen, diagnose, stabilize, treat, and transfer Perry adequately, causing or contributing to her death. (See 3d Am. Compl. [DN 6-4].) Defendant then removed the action from Daviess County Circuit Court to this Court on April 28, 2014, based on federal question jurisdiction. (See Removal Notice [DN 1].)[3]

Defendant filed this motion for judgment on the pleadings under Rule 12(c) and (h)(2)(B), arguing that the Court should dismiss Plaintiffs' EMTALA claims because the facts alleged in the Third Amended Complaint fail to state a claim under EMTALA upon which relief can be granted and that the Court should decline to exercise supplemental jurisdiction over the state-law claims. (Def.'s Mot. J. Pleadings [DN 30].) Plaintiffs opposed the motion and submitted numerous exhibits in support of their opposition, yet consistently stated Rule 12(b)(6) was the applicable standard of review. (Pls.' Resp. to Def.'s Mot. J. Pleadings [DN 33].) Defendant replied in opposition [DN 34] asserting that the pleadings were sufficient to resolve this controversy and asking the Court to exclude information beyond the pleadings and examine whether Plaintiffs state a plausible claim for relief under EMTALA based solely on the pleadings. See Fed.R.Civ.P. 12(d). Defendant alternatively argued-in the event that the Court opted to consider matters outside the pleadings and therefore convert Defendant's motion into one for summary judgment pursuant to Rule 12(d)-that it is entitled to summary judgment on Plaintiffs' EMTALA claims and attached evidence in support of that argument. (Def.'s Reply [DN 34].) As it believes the pleadings are sufficient to resolve this controversy, the Court, in its discretion, excludes the matters outside the pleadings that were presented by the parties.[4]


Plaintiffs assert that Defendant violated the Emergency Medical Treatment and Active Labor Act ("EMTALA"), 42 U.S.C. § 1395dd. Congress enacted EMTALA in 1986 "in response to a growing concern that hospitals were dumping' patients unable to pay, by either refusing to provide emergency medical treatment or transferring patients before their emergency medical conditions were stabilized." Brooks v. Md. Gen. Hosp., Inc., 996 F.2d 708, 710 (4th Cir. 1993); Cleland v. Bronson Health Care Grp., Inc., 917 F.2d 266, 268 (6th Cir. 1990). Pre-EMTALA, these "dumped" patients were left without a remedy, as traditional state tort law does not provide a remedy for failure to treat. See Brooks, 996 F.2d at 710; Gatewood v. Wash. Healthcare Corp., 933 F.2d 1037, 1041 (D.C. Cir. 1991) ("[EMTALA] is not intended to duplicate preexisting legal protections, but rather to create a new cause of action, generally unavailable under state tort law, for what amounts to failure to treat."); Thorton v. Sw. Detroit Hosp., 895 F.2d 1131, 1133 (6th Cir. 1990). "EMTALA was not intended to establish guidelines for patient care, to replace available state remedies, or to provide a federal remedy for medical negligence." Harry v. Marchant, 291 F.3d 767, 773 (11th Cir. 2002); see, e.g., Vickers v. Nash Gen. Hosp., Inc., 78 F.3d 139, 142 (4th Cir. 1996) (quoting Power v. Arlington Hosp. Ass'n, 42 F.3d 851, 856 (4th Cir. 1994)) ("EMTALA is not a substitute for state law malpractice actions, and was not intended to guarantee proper diagnosis or to provide a federal remedy for misdiagnosis or medical negligence."); Gatewood, 933 F.2d at 1039 ("[T]he Emergency Act does not create a broad federal cause of action for emergency room negligence or malpractice."); Cleland, 917 F.2d at 268, 272; Hines v. Adair Cnty. Pub. Hosp. Dist. Corp., 827 F.Supp. 426, 431-32 (W.D. Ky. 1993) ("In other words, Congress did not intend to create a federal tort of negligence or to require the application of a negligence standard in an analysis of either of these federal duties as an alternative to state medical malpractice claims.").

To accomplish its goal of ensuring that all patients seeking necessary emergency medical care receive it, irrespective of their ability to pay, EMTALA imposes two requirements on hospitals that both participate in Medicare and maintain an "emergency department." First, to provide any individual presented for treatment with "an appropriate medical screening... to determine whether or not an emergency medical condition... exists." 42 U.S.C. § 1395dd(a) (the "screening" requirement). Second, and only if "the hospital determines that the individual has an emergency medical condition, the hospital must provide either... for such further medical examination and such treatment as may be required to stabilize the medical condition, or for transfer of the individual to another medical facility." 42 U.S.C. § 1395dd(b)(1) (the "stabilization" requirement).

The parties do not contest that OHI is a participating hospital with an emergency department and that Perry arrived at the OHI emergency room seeking medical treatment. At issue is whether the well-pled factual allegations in Plaintiffs' Third Amended Complaint state plausible claims for relief pursuant to EMTALA's screening and stabilization provisions. Plaintiffs contend that the facts as pled in their Third Amended Complaint show Defendant failed to provide an appropriate medical screening examination and failed to stabilize Perry despite her rapidly deteriorating condition. (See Pls.' Resp. to Def.'s Mot. J. Pleadings [DN 33] 6.) For the reasons explained below, the Court finds that Plaintiffs' Third Amended Complaint fails to allege necessary elements of both a screening ...

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