Icenhour v. Burke

33 Pa. D. & C.4th 385, 1996 Pa. Dist. & Cnty. Dec. LEXIS 181
CourtPennsylvania Court of Common Pleas, Beaver County
DecidedSeptember 19, 1996
Docketno. 10504 of 1996
StatusPublished

This text of 33 Pa. D. & C.4th 385 (Icenhour v. Burke) is published on Counsel Stack Legal Research, covering Pennsylvania Court of Common Pleas, Beaver County primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Icenhour v. Burke, 33 Pa. D. & C.4th 385, 1996 Pa. Dist. & Cnty. Dec. LEXIS 181 (Pa. Super. Ct. 1996).

Opinion

KUNSELMAN, J.,

The preliminary objections of defendant, the Medical Center, Beaver, Pa. Inc., raise a question not heretofore addressed by the appellate courts of Pennsylvania. The issue is the application of the federal legislation known as the Emergency Medical Treatment and Active Labor Act, EMTALA, 42 U.S.C. §1395dd (West 1992), to claims against a hospital in state court. The factual background, taken from plaintiffs’ complaint, follows.

On March 10, 1994, plaintiff-husband, Carl A. Icen-hour, began experiencing severe pain in his chest and abdomen and went to the Medical Center’s emergency room. There he was referred to defendant, Dr. Marshall L. Burke, who accepted plaintiff-husband as his patient and undertook to examine, evaluate and diagnose his condition. Based upon his findings, Dr. Burke recom[387]*387mended an exploratory laparotomy to examine plaintiff-husband’s abdominal cavity, and admitted him to the Medical Center. Following his surgery the next day, plaintiff-husband remained at the Medical Center until March 19,1994. During his stay there, plaintiff-husband was seen and attended by Dr. Burke and his colleagues, defendants Dr. David C. Snyder and Dr. Morris M. Book.

Three days after his discharge, plaintiff-husband was seen at the office of defendant, The Book, Burke & Snyder Surgical Association. It was discovered at that time that plaintiff-husband’s sternal incision from a coronary artery bypass performed shortly before his admission to the Medical Center and the abdominal incision from the exploratory laparotomy had been infected with the staphylococcus aureus bacteria, staph infection. At the time of the events herein described, the Medical Center participated in the Federal Medicare Program.

Plaintiffs filed the instant lawsuit setting forth claims for medical malpractice, in essence, based upon the defendants’ failure to properly care for plaintiff-husband’s incisions and diagnose the infections. In Counts 11 and 12, plaintiffs further allege claims against the Medical Center under EMTALA for plaintiff-husband’s physical pain, permanent disfigurement, and mental anguish and for plaintiff-wife’s loss of consortium.

In enacting EMTALA, Congress sought to address concerns about the increasing number of reports that hospital emergency rooms were refusing to accept or treat patients with emergency conditions or were improperly transferring patients who were medically unstable because the patient was uninsured. House Committee on Ways and Means, Comprehensive Omnibus Budget Reconciliation Act of 1986, H.R. Rep. no. 241, [388]*38899th Cong., 2nd sess. 27 (1986), reprinted in 1986 U.S.C.C.A.N. 605; see also, H.R. Rep. no. 241 99th Cong., 1st sess. pt. 3, at 5 reprinted in 1986 U.S.C.C. A.N. at 726 (stating that “[t]he Judiciary Committee shares the concern of the Ways and Means Committee that appropriate emergency room care be provided to patients faced with medical emergencies and in active labor.” (emphasis added)). Thus, Congress hoped to ensure that each patient would be accorded the same level of treatment ordinarily provided to patients in similar medical circumstances. Griffith v. Mt. Carmel Medical Center, 831 F. Supp. 1532, 1539 (D.Kan. 1993).

Accordingly, EMTALA imposes two principal obligations on hospitals in emergency cases. First, it requires that when an individual seeks treatment at a hospital’s emergency room, the emergency department must provide for an appropriate medical screening examination, within that department’s capabilities, to determine whether or not an emergency medical condition exists. 42 U.S.C. §1395dd(a). Second, if screening reveals the presence of an emergency medical condition, the hospital ordinarily must stabilize the medical condition before transferring or discharging the patient. 42 U.S.C. §1395dd(b)(l); see also, 42 U.S.C. §1395dd(e)(4). Transfers without stabilization of the patient may be made if certain conditions are met. 42 U.S.C. §1395dd(c).

In their complaint, plaintiffs aver that the Medical Center violated the EMTALA’s provisions by failing to: (1) provide plaintiff-husband with an “appropriate medical screening” to determine whether an “emergency medical condition,” i.e., the staph infection in his abdominal incision, existed at the time of discharge; (2) provide such further treatment necessary to stabilize plaintiff-husband’s medical condition; and (3) stabilize [389]*389plaintiff-husband’s condition, yet discharging him without arranging for an appropriate transfer to another medical facility, or without obtaining a written request for discharge from plaintiff-husband containing the legally mandated information or complete the certification process so prescribed. In response, the Medical Center filed preliminary objections in the nature of a demurrer to these claims, which raise the issue of EMTALA’s scope.

The Medical Center first challenges plaintiffs’ claim for failure to screen plaintiff-husband for an emergency medical condition before discharging him on the basis that EMTALA does not require a medical screening upon a patient’s discharge. For the following reasons, we agree.

Section 1395dd(a) of EMTALA provides:

“(a) Medical screening requirement

“In the case of a hospital that has a hospital emergency department, if any individual (whether or not eligible for benefits under this subchapter) 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, including ancillary services routinely available to the emergency department, to determine whether or not an emergency medical condition (within the meaning of subsection (e)(1) of this section) exists.” 42 U.S.C. §1395dd(a). (emphasis added)

Congress’ repeated reference to “emergency department” in this section clearly indicates that Congress sought to set forth a course of conduct which is to be followed in a hospital’s emergency department only. There is no suggestion that these requirements extend beyond the circumstance where someone presents him[390]*390self at the emergency department and requests examination for a potential emergency medical condition, except where ancillary services are necessary to assist the emergency department.

In the instant case, there is no allegation that plaintiff-husband did not receive an appropriate medical screening when he presented in the emergency room. To the contrary, plaintiffs allege that upon coming to the emergency room at the Medical Center, Dr. Burke examined, evaluated and diagnosed plaintiff-husband. Further, in order to treat his condition, Dr. Burke admitted plaintiff-husband to the Medical Center, and scheduled him for surgery the next day.

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Bluebook (online)
33 Pa. D. & C.4th 385, 1996 Pa. Dist. & Cnty. Dec. LEXIS 181, Counsel Stack Legal Research, https://law.counselstack.com/opinion/icenhour-v-burke-pactcomplbeaver-1996.