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SACRED HEART MEDICAL CENTER v. DELAWARE COUNTY (04/03/89)

COMMONWEALTH COURT OF PENNSYLVANIA


decided: April 3, 1989.

SACRED HEART MEDICAL CENTER, INC.
v.
DELAWARE COUNTY, PENNSYLVANIA, AND DELAWARE COUNTY COUNCIL AND DELAWARE COUNTY EMERGENCY HEALTH SERVICES COUNCIL, INC. AND CROZER-CHESTER MEDICAL CENTER. DELAWARE COUNTY, PENNSYLVANIA, AND DELAWARE COUNTY COUNCIL, APPELLANTS. SACRED HEART MEDICAL CENTER, INC. V. DELAWARE COUNTY, PENNSYLVANIA, AND DELAWARE COUNTY COUNCIL AND DELAWARE COUNTY EMERGENCY HEALTH SERVICES COUNCIL, INC. AND CROZER-CHESTER MEDICAL CENTER. DELAWARE COUNTY EMERGENCY HEALTH SERVICES COUNCIL, INC., APPELLANT. SACRED HEART MEDICAL CENTER, INC. V. DELAWARE COUNTY, PENNSYLVANIA, AND DELAWARE COUNTY COUNCIL AND DELAWARE COUNTY EMERGENCY HEALTH SERVICES COUNCIL, INC. AND CROZER-CHESTER MEDICAL CENTER. CROZER-CHESTER MEDICAL CENTER, APPELLANT. SACRED HEART MEDICAL CENTER, INC. V. DELAWARE COUNTY, PENNSYLVANIA, ET AL. CROZER-CHESTER MEDICAL CENTER, APPELLANT. SACRED HEART MEDICAL CENTER, INC. V. DELAWARE COUNTY ET AL. DELAWARE COUNTY ET AL., APPELLANTS

Appeals from the Order of the Court of Common Pleas of Delaware County in the case of Sacred Heart Medical Center, Inc. v. Delaware County, Pennsylvania, Delaware County Council, Delaware County Emergency Health Services Council, Inc., and Crozer-Chester Medical Center, No. 87-16650.

COUNSEL

Michael J. Ehling, Assistant County Solicitor, with him, Francis P. Connors, County Solicitor, for appellants, Delaware County, Pa., Delaware County Council, and Delaware County Emergency Health Services Council, Inc.

Donald T. Petrosa, with him, John W. Wellman, for appellant, Crozer-Chester Medical Center.

Garland D. Cherry, Sr., Cherry, Ferrara, Mutzel & Belefonte, for appellee, Sacred Heart Medical Center, Inc.

Richard L. Hughey, with him, James R. Flick, for Amicus Curiae, Boothwyn Fire Company.

Judges Palladino and Smith, and Senior Judge Kalish, sitting as a panel of three. Opinion by Judge Palladino.

Author: Palladino

[ 124 Pa. Commw. Page 550]

Crozer-Chester Medical Center (CCMC), Delaware County and Delaware County Council (County) and the Delaware County Emergency Health Services Council (EHS Council) (collectively Appellants) appeal from an order of the Court of Common Pleas of Delaware County, which granted Sacred Heart Medical Center's (Sacred Heart) motion for a preliminary injunction to enjoin CCMC, the County and the EHS Council from removing Sacred Heart as the primary ambulance service to be dispatched in response to advanced life support (ALS) ambulance calls in Upper Chichester Township, Delaware County.

This case was precipitated by the decision of the Boothwyn Fire Company (located in Upper Chichester) to no longer staff its own ambulance and respond to basic life support (BLS) ambulance calls.*fn1 Boothwyn, however, still desired to operate an ambulance service. In order to accomplish both objectives, Boothwyn decided to purchase a new ambulance and seek a hospital to provide qualified personnel to staff it. Boothwyn asked both CCMC and Sacred Heart to make a proposal to provide ambulance crews. Boothwyn would retain responsibility for maintaining the ambulance. The chosen hospital would equip and staff the ambulance to be able to respond to both BLS and ALS ambulance calls on a 24 hour a day basis. Boothwyn accepted CCMC's proposal*fn2

[ 124 Pa. Commw. Page 551]

    and approved a contract with CCMC on July 1, 1987. Sacred Heart, which had for a year stationed an ambulance of its own at the Boothwyn firehouse and provided ALS ambulance service to Upper Chichester Township, immediately withdrew their ambulance and stationed it at the Ogden Fire Company.*fn3

On July 2, 1987, Boothwyn sought endorsement for the contract from the Upper Chichester Board of Commissioners. The Commissioners, at their July 9, 1987 meeting, unanimously voted to recognize Boothwyn as the ALS-BLS ambulance service for Upper Chichester.*fn4 Thereafter Boothwyn sought approval from the EHS Council to change the designated ALS ambulance service

[ 124 Pa. Commw. Page 552]

    for Upper Chichester from Sacred Heart to Boothwyn; approval was granted at the Council's November meeting.*fn5

Sacred Heart, on December 1, 1987, filed a complaint in equity with the trial court, challenging the EHS Council's approval of the replacement of Boothwyn for Sacred Heart as the ALS ambulance service for Upper Chichester on the basis (1) that CCMC improperly solicited Boothwyn to change its method of providing ambulance service and (2) that the actions taken to replace Sacred Heart as the ALS ambulance service were not in conformity with the Emergency Medical Services Act (EMS Act), Act of July 3, 1985, P.L. 164, 35 P.S. ยงยง 6921-6938.*fn6 Sacred Heart, at the same time, also filed a

[ 124 Pa. Commw. Page 553]

    petition for a preliminary injunction to enjoin: (1) the County and the EHS Council from approving Boothwyn's proposal to substitute CCMC for Sacred Heart as the ALS ambulance service in Upper Chichester;*fn7 (2) the County and the EHS Council from removing Sacred Heart as the ALS ambulance service for Upper Chichester on the list at the County dispatch facility;*fn8 and (3) CCMC from interfering with contractual relationships between Sacred Heart and other fire companies where Sacred Heart currently provides ambulance service. The trial court, on December 22, 1987, granted the preliminary injunction and enjoined the County and the EHS Council to the extent requested in (1) and (2).*fn9

On appeal to this court, Appellants contend that the trial court's grant of Sacred Heart's request for a preliminary injunction was improper because Sacred Heart did

[ 124 Pa. Commw. Page 554]

    not demonstrate the requirements necessary for a preliminary injunction.*fn10 Our scope of review on an appeal from the grant of a preliminary injunction is to examine the record to determine if there were any apparently reasonable grounds for the grant. Mazzie v. Commonwealth, 495 Pa. 128, 432 A.2d 985 (1981).

The standard for granting a preliminary injunction is as follows:

'[F]irst, that it is necessary to prevent immediate and irreparable harm which could not be compensated by damages; second, that greater injury would result by refusing it than by granting it; and third, that it properly restores the parties to their status as it existed immediately prior to the alleged wrongful conduct.' . . .

City of Philadelphia v. District Council 33, 112 Pa. Commonwealth Ct. 90, 101, 535 A.2d 231, 236 (1987) (quoting New Castle Orthopedic Associates v. Burns, 481 Pa. 460, 464, 392 A.2d 1383, 1385 (1978)). The Pennsylvania Supreme Court has stated that the two most important requirements are the first and the second. New Castle Orthopedic Associates. The record in this case contains no evidence to support either of these requirements.

[ 124 Pa. Commw. Page 555]

With respect to the harm that Sacred Heart would suffer if it were replaced as the primary ALS ambulance service in Upper Chichester, Sacred Heart argues that it met this requirement with the testimony of its chief executive officer, Sister Mary Margaret Jackson, "relating to the annual investment of $900,000 in its emergency facilities, its three ambulances, and its 32 personnel." Sacred Heart brief at 15. This clearly does not demonstrate immediate and irreparable harm. Sister Mary Margaret's testimony shows that Sacred Heart provides ambulance service to a number of other areas:

Q: Sister, what is the full extent of Sacred Heart's coverage area? Presently.

A: Presently, the western half of the City of Chester, the communities which border Chester on the western end of Delaware County, which includes Upper Chichester, Lower Chichester, Marcus Hook, Trainer, Lynnwood, those areas. We also respond to calls from Southern New Jersey.

December 15-16, 1987 hearing, N.T. at 39. No evidence was presented to show what portion of this service consisted of the ALS ambulance service provided to Upper Chichester. Nor was there any evidence presented to show what impact the removal of Sacred Heart as the primary ALS ambulance service provider for Upper Chichester Township would have on Sacred Heart's emergency operations.

The second requirement that must be met in order to obtain a preliminary injunction is to show that a greater injury will result by refusing the injunction than by granting it. The trial court concluded that the change in ambulance service provider would be prejudicial to the community and apparently considered this to constitute a greater injury than not permitting the change to be

[ 124 Pa. Commw. Page 556]

    made. The record contains no reasonable grounds to support a conclusion that the public will be harmed by the change.

Boothwyn testified, and Sister Mary Margaret agreed, that Boothwyn was experiencing difficulty in providing BLS ambulance service to Upper Chichester in a timely fashion. Id., N.T. at 13, 191-92, 212. Sister Mary Margaret also agreed that the change would improve the response time to BLS ambulance calls. Id., N.T. at 34. Sacred Heart makes no argument that the Boothwyn ambulance, staffed by CCMC, would not be able to respond just as promptly and capably as Sacred Heart. As evidence that the change would cause greater harm than leaving the current system in place, Sacred Heart alludes to the fact that it is closer to Upper Chichester than CCMC. However, Dr. Donald DeSantis, head of CCMC's trauma center and a prior executive director of the EHS Council, testified that individuals requiring ambulance service are transported to the closest hospital capable of handling the individual's medical condition. Id., N.T. at 251-52. Even Sister Mary Margaret testified that ambulance personnel should take patients to the closest appropriate hospital, taking into consideration the patient's preference. Id., N.T. at 72. Rather than containing evidence that greater harm will result if the injunction were refused, the record shows that the BLS ambulance service would be greatly improved and that ALS service would be comparable.

The trial court also indicated that a preliminary injunction was appropriate here because the method by which the change in ALS ambulance service was approved by the EHS Council was contrary to the dictates of the EMS Act. Even assuming that the trial court is correct that Sacred Heart will prevail on this point when the merits of the case are considered, that is not a

[ 124 Pa. Commw. Page 557]

    reasonable ground on which to issue a preliminary injunction. A trial court may not issue a preliminary injunction, no matter how great the likelihood of success on the merits, if the record does not contain any apparently reasonable grounds "for the trial court to believe it was presented with a situation of 'urgent necessity.'" New Castle Orthopedic Associates, 481 Pa. at 464-65, 392 A.2d at 1385. The two most important factors in determining if a situation of urgent necessity exists are "whether an immediate and irreparable harm is actually threatened, and . . . whether greater harm is caused by issuing the injunction than by refusing it." Id. at 465, 392 A.2d at 1385. As previously noted, the record in this case contains no evidence of immediate and irreparable harm and indicates that the issuance of the preliminary injunction could cause greater harm to the public than refusing to issue the preliminary injunction.

Accordingly, the order of the trial court issuing a preliminary injunction in this case is reversed.

Order

And Now, April 3, 1989, the order of the Court of Common Pleas of Delaware County in the above-captioned case is reversed.

Disposition

Reversed.


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