| [1] |
United States Supreme Court
|
| [2] |
No. 97-53
|
| [3] |
525 U.S. 249, 119 S.Ct. 685, 142 L.Ed.2d 648, 1999.SCT.42008
<http://www.versuslaw.com>, 59 Soc.Sec.Rep.Ser. 513, 67 USLW
4062
|
| [4] |
January 13, 1999
|
| [5] |
JANE M. ROBERTS, GUARDIAN FOR WANDA Y. JOHN- SON,
PETITIONER
v.
GALEN OF VIRGINIA, INC., FORMERLY DBA HUMANA HOSPITAL
UNIVERSITY OF LOUISVILLE, DBA UNIVERSITY OF LOUISVILLE HOSPITAL
|
| [6] |
The opinion of the court was delivered by: Per Curiam.
|
| [7] |
ROBERTS v. GALEN OF VA., INC.
|
| [8] |
____ U. S. ____ (1999)
|
| [9] |
on writ of Certiorari To The United States Court Of Appeals For The
Sixth Circuit
|
| [10] |
The Emergency Medical Treatment and Active Labor Act, as added by
§9121(b) of the Consolidated Omnibus Budget Reconciliation Act of 1985,
100 Stat. 164, and as amended, 42 U. S. C. §1395dd, (EMTALA), places
obligations of screening and stabilization upon hospitals and emergency
rooms who receive patients suffering from an "emergency medical
condition." The Court of Appeals held that in order to recover in a suit
alleging a violation of §1395dd(b), a plaintiff must prove that the
hospital acted with an improper motive in failing to stabilize her.
Finding no support for such a requirement in the text of the statute, we
reverse.
|
| [11] |
Section 1395dd(a) imposes a "[m]edical screening requirement" upon
hospitals with emergency departments: "[I]f any individual ... comes to
the emergency department and a request is made on the individual's behalf
for examination or treatment for a medical condition, the hospital must
provide for an appropriate medical screening examination within the
capability of the hospital's emergency department." 42 U. S. C.
§1395dd(a). Section 1395dd(b), entitled "Necessary stabilizing treatment
for emergency medical conditions and labor," provides in relevant part as
follows:
|
| [12] |
"(1) In general
|
| [13] |
If any individual (whether or not eligible for benefits under this
subchapter) comes to a hospital and the hospital determines that the
individual has an emergency medical condition, the hospital must provide
either-
|
| [14] |
"(A) within the staff and facilities available at the hospital, for
such further medical examination and such treatment as may be required to
stabilize the medical condition, or
|
| [15] |
"(B) for transfer of the individual to another medical facility in
accordance with subsection (c) of this section. ..."
|
| [16] |
Section 1395dd(c) generally restricts transfers of unstabilized
patients, and §1395dd(d) authorizes both civil fines and a private cause
of action for violations of the statute.
|
| [17] |
Petitioner Wanda Johnson was run over by a truck in May 1992, and was
rushed to respondent's hospital, The Humana Hospital-University of
Louisville, in Louisville, Kentucky (Humana). Johnson had been severely
injured and had suffered serious injuries to her brain, spine, right leg,
and pelvis. After about six weeks' stay at Humana, during which time
Johnson's health remained in a volatile state, respondent's agents
arranged for her transfer to the Crestview Health Care Facility, across
the river in Indiana. Johnson was transferred to Crestview on July 24,
1992, but upon arrival at that facility, her condition deteriorated
significantly. Johnson was taken to the Midwest Medical Center, also in
Indiana, where she remained for many months and incurred substantial
medical expenses as a result of her deterioration. Johnson applied for
financial assistance under Indiana's Medicaid program, but her application
was rejected on the grounds that she had failed to satisfy Indiana's
residency requirements. Plaintiff Jane Roberts, Johnson's guardian, then
filed this federal action under §1395dd(d) of EMTALA, alleging violations
of §1395dd(b) of the Act.
|
| [18] |
The District Court granted summary judgment for respondents on the
grounds that the plaintiffs had failed to show that " `either the medical
opinion that Johnson was stable or the decision to authorize her transfer
was caused by an improper motive.' " The Court of Appeals affirmed,
holding that in order to state a claim in an EMTALA suit alleging a
violation of §1395dd(b)'s stabilization requirement, a plaintiff must show
that the hospital's inappropriate stabilization resulted from an improper
motive such as one involving the indigency, race, or sex of the patient.
111 F. 3d 405, 411 (CA6 1997). In order to decide whether subsection (b)
of EMTALA imposes such a requirement, we granted certiorari, 524 U. S. ___
(1998), and now reverse.
|
| [19] |
The Court of Appeals' holding -- that proof of improper motive was
necessary for recovery under §1395dd(b)'s stabilization requirement --
extended earlier Circuit precedent deciding that the "appropriate medical
screening" duty under §1395dd(a) also required proof of an improper
motive. See Cleland v. Bronson Health Care Group, Inc., 917 F. 2d 266 (CA6
1990). The Court of Appeals in Cleland was concerned that Congress' use of
the word "appropriate" in §1395dd(a) might be interpreted incorrectly to
permit federal liability under EMTALA for any violation covered by state
malpractice law. Id., at 271. Accordingly, rather than interpret EMTALA so
as to cover "at a minimum, the full panoply of state malpractice law, and
at a maximum, ... a guarantee of a successful result" in medical
treatment, ibid., the Court of Appeals read §1395dd(a)'s "appropriate
medical screening" duty as requiring a plaintiff to show an improper
reason why he or she received "less than standard attention [upon arrival]
... at the emergency room." Id., at 272.
|
| [20] |
Unlike the provision of EMTALA at issue in Cleland, §1395dd(a), the
provision at issue in this case, §1395dd(b), contains no requirement of
appropriateness. Subsection (b)(1)(A) of EMTALA requires instead the
provision of "such further medical examination and such treatment as may
be required to stabilize the medical condition." 42 U. S. C.
§1395dd(b)(1)(A). The question of the correctness of the Cleland Court's
reading of §1395dd(a)'s "appropriate medical screening" requirement is not
before us, and we express no opinion on it here.*fn1
But there is no question that the text of §1395dd(b) does not require an
"appropriate" stabilization, nor can it reasonably be read to require an
improper motive. This fact is conceded by the respondent, which notes in
its brief that "the `motive' test adopted by the court below ... lacks
support in any of the traditional sources of statutory construction."
Brief for Respondent 17. Although the concession of a point on appeal by
the respondent is by no means dispositive of a legal issue, we take it as
further indication of the correctness of our decision today, and hold that
§1395dd(b) contains no express or implied "improper motive"
requirement.
|
| [21] |
Although respondent presents two alternative grounds for the
affirmance of the decision below,*fn2
we decline to address these claims at this stage in the litigation. The
Court granted certiorari on only the EMTALA issue, and these claims do not
appear to have been sufficiently developed below for us to assess them in
any event. Accordingly, we reverse the Court of Appeals' holding that the
District Court's grant of summary judgment was proper, and remand the case
for further proceedings consistent with this opinion.
|
| [22] |
It is so ordered.
|
| |
|
| |
Opinion Footnotes |
| |
|
| [23] |
*fn1
We note, however, that Cleland's interpretation of subsection (a) of
EMTALA is in conflict with the law of other circuits which do not read
subsection (a) as imposing an improper motive requirement. See Summers v.
Baptist Med Ctr. Arkadelphia, 91 F. 3d 1132, 1137-38 (CA8 1996) (en banc);
Correa v. Hospital San Francisco, 69 F. 3d 1184, 1193-94 (CA1 1995); Repp
v. Anadarko Mun. Hosp., 43 F. 3d 519, 522 (CA10 1994); Power v. Arlington
Hosp. Ass'n, 42 F. 3d 851, 857 (CA4 1994); Gatewood v. Washington
Healthcare Corp., 933 F. 2d 1037, 1041 (CADC 1991).
|
| [24] |
*fn2
Respondents argue that the record demonstrates that did not have actual
knowledge of the patient's condition, and that the hospital properly
screened Johnson, which terminated its duty under EMTALA. We express no
opinion as to the factual correctness or legal dispositiveness of these
claims, and leave their resolution to the courts below on
remand.
|