*2 jection pain, heat, apply for told him to and Miller, Rock, AR, argued, P. Little Stuart personal physician day. to see the next appellee. for requested stay hospital to at Summers ARNOLD, Before RICHARD S. Chief overnight, indicating up that he did not feel McMILLIAN, Judge, and HEANEY and to the over-five-hour drive back home. Dr. Judges. Circuit request, stating Ferrell denied the that he think did not Summers’ condition warranted HEANEY, Judge. Circuit hospitalization. appeals Harold Summers the district later, days staying Two at after home grant summary judgment Bap- court’s pain, bed due to his Summers was taken (Baptist) tist Medical Center on Summers’ Hospital ambulance to Bernard’s St. where Emergency claim under the Medical Treat- diagnosed an with acute comminuted (EMTALA), ment and Active Labor Act vertebrae, 1395dd(a) fracture of one of his a sternal (Supp.1995).1 U.S.C. Because fracture, multiple presented genuine rib fractures that led Summers issue of mate- fact, hemo-pneumothoraces. rial we reverse. to bilateral Sum- spent days in mers fourteen St. Bernard’s
I. BACKGROUND unit intensive care for his condition. Summary judgment appropriate only genuine when there is no issue as to II. DISCUSSION dispute may
material fact so that
solely
Baptist
pro-
legal grounds.
decided
Summers claims that
failed to
Fed.
56(c);
Lockhart,
Holloway v.
appropriate
R.Civ.P.
813 vide him with an
medical screen-
argument,
interrogatories.
deny
1. At oral
Summers
to
also moved
this motion and have
addendum,
Baptist
strike
sisting
Medical Center's
con-
all
before us.
considered
of the evidence
responses
supplemental
to Summers’
Baptist
would
produce
evidence
EMTALA. 42 to
violation
mg examination
1395dd(a) requires
same condi-
another
1395dd. Section
all
provide
to
x-rays
rooms
differ-
additional
tion as Summers
screening examina-
“appropriate
an
medical
disagree.
treatment. We
ent
an
or not
emer-
to determine whether
tion”
*3
developed general screening
Baptist has
42
exists.
U.S.C.
condition2
gency medical
incoming patients are
by which
to
procedures
1395dd(a).
§
com-
patient’s
that
upon
treated based
not de
Although the statute does
history.
symptoms, and medical
plaints,
interpreted it to
“appropriate,” we
fine
deposition Dr.
during his
specifically,
More
uniform, non-discriminatory medical
mean
screening
that under these
stated
Ferrell
Birkeness,
34 F.3d
Williams
treatment.
complained of
had
procedures,
Summers
Cir.1994)
(8th
(citing Brooks v. Ma
695, 697
did, Bap-
pain,
claims he
chest
as Summers
Inc.,
708, 710-
996 F.2d
Hosp.,
ryland Gen.
provided
plaintiff
the
with a
should have
tist
(4th Cir.1993),
noting agreement with
11
and
Thus,
that a trier
x-ray.
is essential
chest
it
Circuits). EMTALA is
and Sixth
the D.C.
whether or not Summers
of fact determine
and it
malpractice statute
does
not a federal
does
complaint.
a
Dr. Ferrell
not
made such
emergency health care
a national
not set
pain.
complaining of chest
recall Summers
standard;
misdiagnosis or inade
claims of
hand,
that
malprac
on the
insists
he
are
to the state
other
quate treatment
left
Williams,
at
Nor
difficulty
34 F.3d
is
his chest and
tice arena.
of
in
statute that
EMTALA an anti-discrimination
recollection
breathing.
If
Ferrell’s
is
prove that he
plaintiff to
requires a
correct,
does not have
cause
then Summers
was motivat
“dumped” or that
treatment
1395dd(a). EMTALA
of action under section
discrimination.3
particular type of
by a
ed
to be a substitute for medi-
is not intended
hospitals to de
Rather,
requires
EMTALA
If, however,
malpractice action.
one be-
cal
identify crit
that
screening procedures
velop
testimony,
Baptist
then
did
lieves Summers’
apply
procedures
the
and
ical conditions
to
screening
give
the
examination
not
Summers
patients
All
com
uniformly
patients.
to all
Baptist provides
that Dr. Ferrell concedes
to
problem
exhibiting
or
plaining of the same
persons
complaints of that nature.
must receive similar
symptoms
the same
given emer
screening
from a
examinations
case,
posture
we
the
of this
conclude
Given
Williams,
697;
34 F.3d at
Ba
gency room.
that there
that Summers has demonstrated
is
Am.,
Corp.
977
Hospital
ber v.
of
symptoms
fact as what
Sum-
an issue of
to
Cir.1992).
(4th
Thus, not all medical
879
emergency
presented at
the
room.
mers
into
claims can be converted
malpractice
factual issue is material and must be
The
EMTALA actions.
by
to resolve whether
decided
a factfinder
uniformly apply
screen-
Baptist failed to
standard,
correct
Applying the
required under EMTALA.
ing procedures as
that Summers failed
court
district
concluded
ability
pay
hospitalization.
“emergency
Summers'
to
medical condi-
to
defines
statute
The
deny
Al
pay
an EMTALAclaim.
tion” as:
does
him
manifesting
though Congress originally enacted EMTALAto
itself
medical condition
[A]
(includ-
severity
denying
symptoms
hospitals
sufficient
prevent
acute
treatment based
from
pain)
that the absence of im-
pay,
plain
such
patient’s inability
severe
the statute's
to
reasonably be
could
mediate medical attention
applies
"any
language
individual.”
to
expected to result
241(1),
in—
1395dd(a);
H.R.Rep.
see
No.
99th
(i) placing
individual ...
the health of the
(1986), reprinted
Cong.,
in 1986
2d Sess.
jeopardy,
serious
42, 605;
Washington
Gatewood v.
U.S.C.C.A.N.
functions,
(ii)
bodily
impairment to
serious
(D.C.Cir.
Corp., 933 F.2d
Healthcare
or
1991)
concluding
history yet
(acknowledging this
(iii)
any bodily organ
dysfunction of
serious
seeking
applies
individual
statute
to
part.
assistance).
We
construe
must
room
1395dd(e)(l)(A) (Supp.1995).
42 U.S.C.
Congress
been written.
If
the statute as it has
application, it
to narrow the statute's
Bap-
wishes
undisputed
informed
It
that Summers
is
language.
statutory
money
amend
and that he had
tist that
had insurance
generality,
therefore reverse the district court’s
an intermediate level of
an exam-
summary
grant
judgment
and remand this
ple
very
taken from the
case before us. Dr.
appropriate
ease to the district court for the
testified,
would,
physician
Ferrell
as
finding
fact
and resolution
Summers’
“necessary
it
accu-
complete,
to obtain a
claim.
rate
history,”
mine),
App.
(emphasis
A-25
from
brought
who fall and are
ARNOLD,
Judge,
RICHARD S.
Chief
history
immobilized. The
obtained here did
dissenting.
(or
not contain the fact
what Mr. Summers
right
fact)
I think the District Court was
to says
plaintiff complained
is a
that the
complaint,
briefly
this
to
dismiss
write
Therefore,
pain.
this
was not
why.
explain
screening normally given
to other
*4
patients. Q.E.D.
very argument,
This
or
simple
This
reason for reversal is
Court’s
it,
something very
appears
near to
in the
easily
says
grasped:
Mr. Summers
he
Brief,
Appellant’s Reply
p.
only
It is
a
complained
pain.
of
chest
Ferrell does
reasoning adopted by
variation of the
the
any
complaint,
not remember
such
but con-
Yet,
opinion today.
in
Court
it would
complain
that patients
cedes
of chest
any
an
plain-
allow EMTALA action
a
time
pain
normally given
x-ray.
are
a chest
Mr.
history
inaccurately
tiffs medical
is
taken.
given
x-ray.
Summers was
no such
There-
fore,
complain
pain
if in fact he did
of chest
The fact is that Mr. Summers was treated
(a dispute
require
of fact that would
a trial if
(whether
not)
correctly
exactly
any
as
material),
it
Mr.
is
Summers was treated
patient
other
would
been. Let’s as-
differently
hospital’s
prac-
from the
normal
pain.
sume he
of chest
There is
tice.
proof
anyone
complaining
no
else
of
view,
syllogism
my
The
is neat —in
too
given
chest
would have been
a chest x-
neat,
Emergency
because it
converts
ray
particular day.
If
this
Dr. Ferrell
Medical Treatment and Active
Act
Labor
ignored
didn’t hear Mr.
or if he
(EMTALA),
1395dd,
into a
fed- patient’s complaint,
may
guilty
the doctor
be
statute,
malpractice
eral
a result disavowed
(a
malpractice
question
express
I
on which
plaintiff
and this Court alike. Consid-
view), but,
shows,
no
so far as this record
following:
hospital’s
er the
normal screen-
any
would have made the same mistake with
ing procedure
emergency patients
is to
patient.
other
(Presumably
treat them with due care.
ev-
this.)
ery hospital
say
would
There is a
under Williams
The
concedes that
Court
genuine
fact
issue of material
as to whether a
Birkeness,
(8th
Cir.1994),
rectly Mr. Summers what fact that the in view of the understandable a week at four working 80 hours was
doctor Reply emergency rooms. hospital different made, it should if mistake was 3. But
Brief in the pursued in a tort action
have been (there diversity citi- being no
state courts dumped.
zenship). Mr. Summers against for finan- was not discriminated
He I he has reasons. believe
cial or other has, that statute EMTALA as
no claim under I now, uniformly interpreted. re-
until been
spectfully dissent.
ORDER 18, 1996
Jan. sug- rehearing with
Appellee’s petition for *5 rehearing has been con-
gestion for en banc granted. The the court and is
sidered judgment court entered on
opinion and of the 9,1995, are vacated.
November Tuesday, argument will be
The en banc Louis, 9, 1996, p.m. in St. MO.
April at 3:00 America,
UNITED STATES of
Plaintiff-Appellee, Leroy JENSEN, Defendant-
Donald
Appellant.
No. 94-3863. Appeals, Court of
United States
Eighth Circuit. 16, May
Submitted Nov.
Decided Rehearing
Rehearing Suggestion for
En Banc Dec. Denied