Quinney v. Phoebe Putney Memorial Hospital, Inc.
325 Ga. App. 112
| Ga. Ct. App. | 2013Background
- On March 16, 2009, Douglas Quinney presented to Phoebe Putney Hospital ED five days after spinal cord stimulator implant with severe back pain and inability to ambulate; triaged as acuity level 2.
- Dr. Gutierrez performed an initial exam, listed spinal abscess/hematoma in differential, ordered a CT scan, but did not perform a complete neurologic exam or repeat neurological testing despite persistent/worsening symptoms.
- The CT was interpreted as not showing abscess/hematoma; the CT report noted Quinney could not lie in the proper position for the scan, a fact Dr. Gutierrez did not note or investigate further.
- Nurses failed to perform neurological assessments beyond vitals; pain worsened despite multiple analgesic doses.
- Quinney was transferred to the neurosurgeon’s facility ~3 hours after transfer order and arrived paralyzed from an expanding spinal epidural hematoma.
- Trial court granted summary judgment for defendants, applying OCGA § 51-1-29.5 (emergency care standard requiring gross negligence shown by clear and convincing evidence) and granting judgment on the EMTALA claim; the appellate court reversed.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether OCGA § 51-1-29.5 (emergency medical care) applies | Quinney: care was not bona fide emergency care or he was treated as "stable," so statute shouldn't apply | Defendants: symptoms (severe pain, loss of ambulation, triage level 2) constituted emergency medical care | Court: § 51-1-29.5 applies because Quinney presented with acute, severe symptoms and was never shown to be stabilized |
| Whether plaintiffs met the clear-and-convincing/gross negligence threshold under OCGA § 51-1-29.5 | Quinney: expert testimony establishes deviations from accepted care (incomplete exams, failure to note CT limitation, lack of nursing neuro checks) amounting to gross negligence | Defendants: judgment affirmed because reliance on ordered CT and radiologist report was reasonable | Court: Reversed summary judgment — reasonable jury could find gross negligence by clear and convincing evidence given record and expert affidavit |
| Whether hospital violated EMTALA by transferring an unstabilized patient | Quinney: hospital knew of acute severe symptoms and inability to ambulate; transfer occurred while unstable without adequate stabilizing treatment | Hospital: lacked notice/actual knowledge of an emergency condition, so no EMTALA liability | Court: Reversed summary judgment — sufficient evidence that hospital knew of an emergency medical condition and transferred without stabilization, so EMTALA claim survives |
| Whether EMTALA requires same heightened evidentiary standard as state statute | Quinney: EMTALA claim independent of malpractice standard; does not require showing of gross negligence | Hospital: argued state standards control or defeat claim | Court: Noted EMTALA does not impose clear-and-convincing/gross-negligence burden and could support liability without that showing (court did not decide definitively) |
Key Cases Cited
- Ansley v. Raczka-Long, 293 Ga. 138 (construing summary judgment standards in Georgia)
- Woodcraft by Macdonald, Inc. v. Georgia Casualty & Surety Co., 293 Ga. 9 (de novo review of summary judgment)
- Johnson v. Omondi, 294 Ga. 74 (Supreme Court: expert evidence may permit a jury to find gross negligence under § 51-1-29.5)
- Gliemmo v. Cousineau, 287 Ga. 7 (definition of gross negligence/slight diligence)
- Pottinger v. Smith, 293 Ga. App. 626 (reliance on diagnostic test/radiologist report may preclude gross negligence where no facts undermine test reliability)
- Morgan v. North Mississippi Medical Center, 403 F. Supp. 2d 1115 (ED stabilization requirement under EMTALA and hospital transfer liability)