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Kauffman v. Franz

March 6, 2009

AARON KAUFFMAN PLAINTIFF
v.
PAMELA FRANZ, ET AL. DEFENDANTS



The opinion of the court was delivered by: Thomas M. Golden, J.

MEMORANDUM OPINION & ORDER

Before the Court are Defendants Pottstown Memorial Medical Center and Pottstown Hospital Company, LLC.,'s Motion for Judgment on the Pleadings (Doc. No. 23) and the "Joinder Motions" of Defendants Dr. Pamela Franz, M.D., and Dr. Stephen Spencer, M.D., (Doc. Nos. 24, 25). The Defendants have asked the Court to determine whether they are entitled to judgment as a matter of law, based on the pleadings, as to Plaintiff's sole federal claim,*fn1 which arises under the Emergency Medical Treatment and Active Labor Act ("EMTALA"), 42 U.S.C. § 1395dd. For the following reasons, the Court will grant Defendants Franz and Spencer's Joinder Motions*fn2 and deny Defendants Pottstown Memorial Medical Center and Pottstown Hospital Company, LLC.,'s Motion for Judgment on the Pleadings.

BACKGROUND

At approximately 5:00 a.m. on [March] 23, 2007,*fn3 John Kauffman ("Kauffman") contacted a friend to take him to the hospital. (Compl. ¶ 21.) He was complaining of chest pain, difficulty breathing, clamminess, and swollen feet. (Id. ¶ 21.) Kauffman was fifty-one years old. (Id. ¶ 4.) By 5:39 a.m., Kauffman arrived in the emergency room at Defendant Pottstown Memorial Medical Center,*fn4 seeking treatment for chest pains, breathing difficulties, anxiety, clamminess, and swollen feet. (Id. ¶ 22.) Kauffman's vital signs were the following: Temperature: 96.8, Pulse: 87, Respirations: 32, and Blood pressure: 132/88. (Id. ¶ 23.) "He was anxious, alert, oriented x3, and cooperative." (Id. ¶ 23.) His skin was warm and dry, and his lungs were clear. (Id. ¶ 24.)

At 5:45 a.m., Kauffman was seen by Defendant Dr. Franz, who ordered a BAT (Behavioral Avoidance Test) and a urine drug screen. (Id. ¶ 25.) At 6:00 a.m., Dr. Reeves, who is not a defendant, performed a multidiscplinary psychiatric assessment on Kauffman. (Id. ¶ 26.) His report indicated that Kauffman was brought to the emergency room by a female friend for complaints of "chest pain, high anxiety, hyperventilation, [and] sleeplessness." (Id. ¶ 27.) Dr. Reeves recommended that Kauffman set up an appointment with a psychiatrist and follow up with his primary care physician. (Id. ¶ 31.) No assessment of Kauffman's chest pain was ever performed. (Id. ¶ 33.) No electrocardiogram or blood work was ordered. (Id. ¶ 34.)No continuous cardiac monitoring was performed. (Id. ¶ 34.) No ongoing evaluation of his vital signs was conducted. (Id. ¶ 34.)

At 9:30 a.m., John Kauffman was given one mg. of a sedative, intramuscularly, after his urine drug screen came back negative. (Id. ¶¶ 38-39.) He was discharged at 9:35 a.m., and his vital signs upon discharge were the following: Pulse: 85, Respirations: 24, and Blood pressure: 140/106. (Id. ¶ 40.) His blood pressure was elevated, and he remained very anxious. (Id. ¶ 41.) No clinical impression was documented at the time of discharge. (Id. ¶ 44.)

Fewer than seven hours later, at approximately 4:00 p.m., Kauffman was found lying on his bed. (Id. ¶ 45.) He was blue in the face, and his heart was not beating. (Id. ¶ 45.) He was transported by an ambulance to Pottstown Memorial Medical Center with an admitting diagnosis of cardiac arrest. (Id. ¶ 46.) He was pronounced dead upon arrival. (Id. ¶ 47.) According to the autopsy, the cause of death was arteriosclerotic cardiovascular disease, hypertrophic cardiomyopathy, and pneumonitis. (Id. ¶ 48.)

Approximately one month later, on April 27, 2007, an addendum was added to Kauffman's chart, which documented his early morning visit to the hospital on March 23, 2007. The addendum read:

Sent back to me to put Diagnosis on chart. Pt was signed out to me c[sic] [with] Dx [diagnosis] of Anxiety, Discharge instructions written by P. Franz and on chart. Waiting for urine to be obtained then D/C [discharged] per instructions. Anxiety is diagnosis at time. (Id. ¶ 49.) Under "Clinical Impressions," the diagnoses of anxiety and hypertension were added. (Id. ¶ 50.)

The Plaintiff, the administrator of Kauffman's estate, alleges a violation of EMTALA by all of the Defendants, under the heading "First Cause of Action Emergency Medical Treatment and Active Labor Act EMTALA Violation." (Id. ¶ 70.) All of the Defendants have answered the Complaint (Doc. Nos. 13, 14). Now, they move that the Court dismiss the EMTALA claims under Rule 12(c) of the Federal Rules of Civil Procedure.

STANDARD

The same legal standard that applies to motions filed under 12(b)(6) applies to motions filed under 12(c). See Patel v. Contemporary Classics of Beverly Hills, 259 F.3d 123, 126 (2d Cir. 2001) ("The standard for granting a Rule 12(c) motion for judgment on the pleadings is identical to that of a Rule 12(b)(6) motion for failure to state a claim."); Turbe v. Government of V.I.., 938 F.2d 427, 428 (3d Cir. 1991) (applying 12(b)(6) standard to defendant's 12(c) motion). "Most of the authority on Rule 12(b)(6) applies to Rule 12(c)." 2 Moore's Federal Practice, § 12.38 (Matthew Bender 3d ed.). When reviewing the pleadings, "'[t]he facts presented [therein] and the inferences to be drawn therefrom [must be viewed] in the light most favorable to the nonmoving party.'" Rosenau v. Unifund Corp., 539 F.3d 218, 221 (3d Cir. 2008) (quoting Jablonski v. Pan Am. World Airways, Inc., 863 F.2d 289, 290-91 (3d Cir.1988)). Judgment will not be granted under Rule 12(c) unless "'the movant clearly establishes that no material issue of fact remains to be resolved and that he is entitled to judgment as a matter of law.'" Id.

ANALYSIS

Although EMTALA was enacted by Congress to address the problems associated with "patient dumping," the statute and case law applying the Act make clear that its protections flow to everyone, not just the indigent or uninsured.*fn5 See 42 U.S.C. ยง 1395dd; Gatewood v. Washington Healthcare Corp., 933 F.3d 1037, 1040-41 (D.C. Cir. 1991) (affirming the dismissal of plaintiff-widow's EMTALA claim on the rationale that allegations of mis-diagnosis are not actionable under EMTALA, while rejecting the district court's rationale that the Act's protections did not reach the deceased, who was insured). In order to recover under EMTALA, a plaintiff ...


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