377 F. Supp. 3d 99
D.P.R.2019Background
- On Oct. 1–4, 2012, Natividad Caraballo was seen at Hospital Pavia Hato Rey (10/1) and at an APS outpatient clinic (10/3); she committed suicide on 10/4/2012.
- Plaintiffs (family members/heirs) sued asserting EMTALA and Puerto Rico tort claims; original complaint filed 9/30/2014.
- District court previously granted summary judgment to APS on EMTALA claims; First Circuit vacated parts of the district court’s rulings and remanded for joinder and personal‑damages issues but left APS’s EMTALA summary judgment intact in part.
- After remand plaintiffs amended to add two heirs; APS moved for summary judgment dismissing all remaining Puerto Rico law claims (Art. 1802) as time‑barred and arguing lack of EMTALA liability because APS is not a participating hospital.
- Key undisputed timeline: 10/4/2012 (death and knowledge of death); plaintiffs requested APS medical records on 9/9/2013 and received them ~9/16/2013; original complaint filed 9/30/2014.
- Court concluded APS is not an EMTALA participant and that the Puerto Rico supplemental claims against APS are time‑barred (except as to two minor claimants, which remain without prejudice).
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Joinder of heirs (Rule 19) | Heirs were indispensable and should be joined to pursue survival/personal claims | Heirs could be joined; APS argued joinder does not save untimely claims | Court ordered joinder (amended complaint) — joinder rendered that point moot but did not revive time‑barred claims |
| EMTALA personal damages vs APS | Plaintiffs sought personal/survivor damages under EMTALA and state law remedies | APS: not a participating hospital under EMTALA; no federal liability or anchor for supplemental jurisdiction | Court: APS is not an EMTALA participant; no EMTALA damages against APS; appellate panel left APS EMTALA dismissal undisturbed |
| Puerto Rico tort claims (statute of limitations) | Plaintiffs argued discovery date/flexibility could delay accrual; obtaining records tolled or postponed accrual | APS: one‑year prescription under 31 L.P.R.A. §5298 began on 10/4/2012; no valid tolling; complaint filed too late | Held: Puerto Rico one‑year limitations ran by 10/4/2013; suit filed 9/30/2014 is time‑barred; claims against APS dismissed with prejudice (no valid tolling) |
| Minors' claims | Minor plaintiffs included in suit | APS: limitations and joinder issues apply | Held: claims of two minors dismissed without prejudice until they reach majority plus one year; all other Puerto Rico claims dismissed with prejudice |
Key Cases Cited
- Miceli v. Jetblue Airways Corp., 914 F.3d 73 (1st Cir. 2019) (summary judgment standard and evidentiary burden on nonmovant)
- Delgado‑Caraballo v. Hospital Pavia Hato Rey, Inc., 889 F.3d 30 (1st Cir. 2018) (First Circuit opinion vacating parts of district court ruling and leaving APS EMTALA dismissal intact)
- Correa v. Hospital San Francisco, 69 F.3d 1184 (1st Cir. 1995) (EMTALA liability scope and availability of state‑law damages for individuals directly harmed)
- Morales‑Melecio v. United States, 890 F.3d 361 (1st Cir. 2018) (Puerto Rico tolling/interruption principles and accrual rules)
- Rodriguez‑Suris v. Montesinos, 123 F.3d 10 (1st Cir. 1997) (accrual and prescription under Puerto Rico law)
- Rosa v. Hospital Auxilio Mutuo, 620 F.Supp.2d 239 (D.P.R. 2009) (tolling under Puerto Rico law; extrajudicial claim requirements)
- Monrouzeau v. Asociacion del Maestro, 354 F.Supp.2d 115 (D.P.R. 2005) (EMTALA two‑year limitations and tolling not readily available)