Hospital Wins Summary Judgment in Mental Health Neglect Suit
Hospital Wins Summary Judgment in Mental Health Neglect Suit
On July 13, 2011, the U.S. District Court for the District of Nevada granted summary judgment to a hospital on a claim, brought by a patient's estate and family, alleging that the hospital violated EMTALA by unfairly neglecting to provide a mental health screening. The court held that the hospital could not be charged with discriminating against the patient under EMTALA when the hospital lacked the capacity to provide a mental health screening (Guzman-Ibarguen v. Sunrise Hospital and Medical Center, D. Nev., No. 2:10-cv-1228, 7/13/11).
On July 25, 2008, an ambulance was dispatched to a casino responding to a report that Oscar Aniceto Mejia-Estrada was "displaying suicidal and homicidal ideation." Mejia-Estrada was transported for evaluation to the ED at the Sunrise Hospital and Medical Center in Las Vegas, Nevada. The physician examining and evaluating the patient concluded that Mejia-Estrada did not have an "acute/emergent medical condition" and was not a suicide or homicide risk. Mejia-Estrada was discharged from the Sunrise ED approximately an hour after his arrival.
Accompanied by family members, Mejia-Estrada returned to the Sunrise ED on July 27, 2008, at 12:40a.m. In 2008, Sunrise did not have licensed psychiatric beds and, since it did not provide psychiatric services, the hospital did not have a psychiatrist listed in the physician ED on-call roster. However, all of the Sunrise ED physicians were qualified and competent to perform a medical screening examination (MSE) to determine if an emergency medical condition related to a psychiatric condition was present.
Examined and evaluated by a triage nurse and by an ED physician, Mejia-Estrada "appeared to have altered thought processes, and reported restlessness and anxiety that was moderate in severity. He denied suicidal ideation or plan. He also appeared agitated, had hyperactive body language and respiratory distress was present." Concluding that Mejia-Estrada did not have any physical illness or injury, but based on "his chief complaints of depression and anxiety, [Mejia-Estrada] was assessed as a suicide risk." The ED physician executed a form at 2:30a.m. giving medical clearance for Mejia-Estrada to have a psychiatric evaluation and also admitting him to the hospital for appropriate medical care. Issued a hospital gown and socks, Mejia-Estrada was held in the ED discharge observation unit awaiting the requisite psychiatric evaluation from Southern Nevada Adult Mental Health to determine whether he would be admitted to their psychiatric facility. An ED nurse initiated "suicide precautions" at about 5:25a.m.
At 12:45p.m. a nurse assistant found Mejia-Estrada lying face down, unresponsive, and with a faint pulse. Security, an ED nurse and a respiratory technician were contacted. The respiratory technician examining Mejia-Estrada found two socks stuck in his mouth and throat. Efforts to revive Mejia-Estrada were unsuccessful, and Mejia-Estrada was pronounced dead at or about 1:00p.m. Decedent's heirs, including Erendira Esperanza Guzman-Ibarguen, sued Sunrise and others for an alleged EMTALA violation — failing to provide an appropriate medical screening examination — and for an alleged state medical malpractice claim. The hospital moved for summary judgment on the EMTALA claim.
Drawing on the United States Court of Appeals for the 9th Circuit’s decision of Baker v. Adventist Health, Inc., 260 F.3d 987 (9th Cir. 2001), the federal district court wrote that “EMTALA explicitly limits the screening examination that a hospital is required to provide to one that is within the capability of the hospital’s emergency department.” Grounded on that appellate decision, the district court held that “[t]he record clearly establishes here that while Defendant Sunrise Hospital performed a medical screening of Mr. Mejia on July 27, 2008, it did not at that time have the capability to perform mental health screening.” For that reason, the district court determined there was no genuine issue “of material fact that Sunrise Hospital violated EMTALA . . . Sunrise Hospital cannot be charged with discriminating against Mr. Mejia by failing to provide him with mental health screening where the hospital lacked the capacity to do so.” Thus, the court granted summary judgment to the hospital on the EMTALA claim.
The district court also added that as made clear in the Ninth Circuit’s decision in Baker, EMTALA “‘. . . is not intended to create a national standard of care for hospitals or to provide a federal cause of action akin to a state law claim for medical malpractice. Indeed, EMTALA expressly contains a non-preemption provision for state remedies.” Accordingly, the court added that the question as to whether Sunrise and the other named Defendants adequately discharged their duty of care to protect against Mejia-Estrada’s suicide would continue as the Plaintiffs’ claim of medical malpractice against Defendants since this issue is not determinative of Plaintiffs’ EMTALA claim.
For the full text of the court’s decision, go to http://law.justia.com/cases/ federal/district-courts/nevada/nvdce/2:2010cv01228/74981/80.
Summary Judgment Granted to Hospital with No Capacity to Provide Mental Health Screening
On July 13, 2011, the U.S. District Court for the District of Nevada granted summary judgment to a hospital on a claim, brought by a patient's estate and family, alleging that the hospital violated EMTALA by unfairly neglecting to provide a mental health screening. The court held that the hospital could not be charged with discriminating against the patient under EMTALA when the hospital lacked the capacity to provide a mental health screening (Guzman-Ibarguen v. Sunrise Hospital and Medical Center, D. Nev., No. 2:10-cv-1228, 7/13/11).
The Facts
On July 25, 2008, an ambulance was dispatched to a casino responding to a report that Oscar Aniceto Mejia-Estrada was "displaying suicidal and homicidal ideation." Mejia-Estrada was transported for evaluation to the ED at the Sunrise Hospital and Medical Center in Las Vegas, Nevada. The physician examining and evaluating the patient concluded that Mejia-Estrada did not have an "acute/emergent medical condition" and was not a suicide or homicide risk. Mejia-Estrada was discharged from the Sunrise ED approximately an hour after his arrival.
Accompanied by family members, Mejia-Estrada returned to the Sunrise ED on July 27, 2008, at 12:40a.m. In 2008, Sunrise did not have licensed psychiatric beds and, since it did not provide psychiatric services, the hospital did not have a psychiatrist listed in the physician ED on-call roster. However, all of the Sunrise ED physicians were qualified and competent to perform a medical screening examination (MSE) to determine if an emergency medical condition related to a psychiatric condition was present.
Examined and evaluated by a triage nurse and by an ED physician, Mejia-Estrada "appeared to have altered thought processes, and reported restlessness and anxiety that was moderate in severity. He denied suicidal ideation or plan. He also appeared agitated, had hyperactive body language and respiratory distress was present." Concluding that Mejia-Estrada did not have any physical illness or injury, but based on "his chief complaints of depression and anxiety, [Mejia-Estrada] was assessed as a suicide risk." The ED physician executed a form at 2:30a.m. giving medical clearance for Mejia-Estrada to have a psychiatric evaluation and also admitting him to the hospital for appropriate medical care. Issued a hospital gown and socks, Mejia-Estrada was held in the ED discharge observation unit awaiting the requisite psychiatric evaluation from Southern Nevada Adult Mental Health to determine whether he would be admitted to their psychiatric facility. An ED nurse initiated "suicide precautions" at about 5:25a.m.
At 12:45p.m. a nurse assistant found Mejia-Estrada lying face down, unresponsive, and with a faint pulse. Security, an ED nurse and a respiratory technician were contacted. The respiratory technician examining Mejia-Estrada found two socks stuck in his mouth and throat. Efforts to revive Mejia-Estrada were unsuccessful, and Mejia-Estrada was pronounced dead at or about 1:00p.m. Decedent's heirs, including Erendira Esperanza Guzman-Ibarguen, sued Sunrise and others for an alleged EMTALA violation — failing to provide an appropriate medical screening examination — and for an alleged state medical malpractice claim. The hospital moved for summary judgment on the EMTALA claim.
The Ruling
Drawing on the United States Court of Appeals for the 9th Circuit’s decision of Baker v. Adventist Health, Inc., 260 F.3d 987 (9th Cir. 2001), the federal district court wrote that “EMTALA explicitly limits the screening examination that a hospital is required to provide to one that is within the capability of the hospital’s emergency department.” Grounded on that appellate decision, the district court held that “[t]he record clearly establishes here that while Defendant Sunrise Hospital performed a medical screening of Mr. Mejia on July 27, 2008, it did not at that time have the capability to perform mental health screening.” For that reason, the district court determined there was no genuine issue “of material fact that Sunrise Hospital violated EMTALA . . . Sunrise Hospital cannot be charged with discriminating against Mr. Mejia by failing to provide him with mental health screening where the hospital lacked the capacity to do so.” Thus, the court granted summary judgment to the hospital on the EMTALA claim.
The district court also added that as made clear in the Ninth Circuit’s decision in Baker, EMTALA “‘. . . is not intended to create a national standard of care for hospitals or to provide a federal cause of action akin to a state law claim for medical malpractice. Indeed, EMTALA expressly contains a non-preemption provision for state remedies.” Accordingly, the court added that the question as to whether Sunrise and the other named Defendants adequately discharged their duty of care to protect against Mejia-Estrada’s suicide would continue as the Plaintiffs’ claim of medical malpractice against Defendants since this issue is not determinative of Plaintiffs’ EMTALA claim.
For the full text of the court’s decision, go to http://law.justia.com/cases/ federal/district-courts/nevada/nvdce/2:2010cv01228/74981/80.