Beller Ex Rel. Welch v. Health & Hospital Corp.
2012 U.S. App. LEXIS 26001
| 7th Cir. | 2012Background
- Plaintiffs allege Wishard violated EMTALA by not stabilizing Melissa Welch and Joshua Beller after EMS transported them.
- Welch was 34 weeks pregnant with prolapsed umbilical cord; hospital directed transfer to another facility.
- Wishard ambulance took Welch to Beech Grove (no obstetrics) and then Beech Grove sent to St. Francis Hospital South.
- Joshua Beller was delivered by C-section at St. Francis South but suffered severe hypoxic brain injury.
- EMTALA imposes screening and stabilization duties; the issue centers on when a patient is deemed to have come to the emergency room.
- Regulatory definitions of “comes to the emergency room” differ between 2001 and 2003 rules, affecting applicability of EMTALA to the case.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether 2003 EMTALA amendment applies retroactively | Plaintiffs contend retroactivity should be denied. | Wishard contends amendment applies retroactively. | Yes; the amendment is a retroactive clarifying rule. |
| Whether 2003 amendment is a clarification or substantive change | DHHS intent was to change the meaning to address EMS protocols. | Amendment was a clarification of existing law. | Court treats 2003 amendment as a clarification (not substantive change). |
Key Cases Cited
- Bowen v. Georgetown Univ. Hosp., 488 U.S. 204 (Supreme Court 1988) (agency retroactivity limits; rules not retroactive without express authority)
- Clay v. Johnson, 264 F.3d 744 (7th Cir. 2001) (weight of agency intent in distinguishing clarification from change)
- Middleton v. City of Chicago, 578 F.3d 655 (7th Cir. 2009) (clarifications may apply retroactively when not a substantive change)