Kimberly Ruloph v. Lammico

2025 Ark. App. 350
CourtCourt of Appeals of Arkansas
DecidedJune 4, 2025
StatusPublished

This text of 2025 Ark. App. 350 (Kimberly Ruloph v. Lammico) is published on Counsel Stack Legal Research, covering Court of Appeals of Arkansas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Kimberly Ruloph v. Lammico, 2025 Ark. App. 350 (Ark. Ct. App. 2025).

Opinion

Cite as 2025 Ark. App. 350 ARKANSAS COURT OF APPEALS DIVISION IV No. CV-24-146

KIMBERLY RULOPH Opinion Delivered June 4, 2025 APPELLANT APPEAL FROM THE SEBASTIAN V. COUNTY CIRCUIT COURT, FORT SMITH DISTRICT LAMMICO D/B/A LAMMICO RISK [NO. 66FCV-22-33] MANAGEMENT RETENTION GROUP, INC.; AND ROBERT A. IRWIN, M.D. HONORABLE R. GUNNER DELAY, APPELLEES JUDGE

AFFIRMED

RAYMOND ABRAMSON, Judge

Kimberly Ruloph appeals from an order of the Sebastian County Circuit Court

granting the motion to dismiss filed by appellees LAMMICO1 and Robert Irwin, M.D. On

appeal, Ruloph argues that the circuit court erred in determining that her claims were based

on a medical injury rather than ordinary negligence. We affirm.

I. Factual Background

According to Ruloph’s first amended and substituted complaint, on April 15, 2018,

Ruloph was walking in her church parking lot in Paris, Arkansas, when she fell and

1 LAMMICO is the liability insurer of Washington Regional Medical Center (WRMC). WRMC is a not-for-profit medical center and is not subject to suit under tort law. Under Ark. Code Ann. § 23-79-210 (Repl. 2014), LAMMICO, as the liability insurer, is subject to any liability of WRMC. dislocated her knee. Observers called 911, and Logan County Emergency Medical Services

(EMS) responded at around 11:00 a.m., within ten minutes of the initial fall. EMS noted

that Ruloph had lost a pulse in her injured leg below the knee. With this type of injury, there

is a six-hour window for restoration of blood flow to the lower leg to prevent amputation.

EMS contacted the Arkansas Trauma Call Center (ATCC) to determine where to take

Ruloph for the best treatment. The ATCC recommended that Ruloph be taken to Mercy

Hospital (Mercy) in Sebastian County because it had the closest vascular surgeon capable of

treating the knee dislocation.

At 12:09 p.m., Ruloph arrived at Mercy and was admitted at 12:12 p.m. Following

Ruloph’s admission, doctors were able to set Ruloph’s dislocated knee but were unable to

perform the necessary surgery to restore blood flow to her leg below the knee. Accordingly,

Mercy contacted ATCC at 1:12 p.m. and was informed that WRMC had a peripheral

vascular surgeon on hand. Dr. Irwin, an emergency-room physician at WRMC, spoke to the

Mercy official. After receiving Ruloph’s medical history, including the fact that she had a

pulseless lower leg, Dr. Irwin accepted Ruloph’s transfer. Only a physician is authorized to

accept the transfer of a patient. Ruloph left Mercy via ambulance at 2:55 p.m. en route to

WRMC in Fayetteville.

Once Ruloph was en route to WRMC, WRMC’s vascular surgeon was contacted, and

after reviewing Ruloph’s medical information and imaging, the surgeon determined that

he/she did not have the requisite ability to treat Ruloph’s condition and recommended that

Ruloph be sent to another facility. While Ruloph was still en route, it was determined that

2 Ruloph should be taken by air ambulance to Mercy hospital in Springfield, Missouri, where

a peripheral vascular surgeon was available. Immediately upon arrival at WRMC, Ruloph

was airlifted and arrived at Mercy Springfield at 5:55 p.m. By the time Ruloph underwent

surgery by a peripheral vascular surgeon, it was too late to save her leg, and she received an

above-the-knee amputation.

II. Procedural History

Ruloph initially brought suit against LAMMICO and Irwin 2 in the United States

District Court for the Western District of Arkansas under the Emergency Medical Treatment

and Active Labor Act (EMTALA) and also asserted corresponding state claims. The federal

district court granted summary judgment on the EMTALA claim and dismissed without

prejudice Ruloph’s remaining state-law claims on jurisdictional grounds. On March 24,

2021, Ruloph then sued appellees LAMMICO and Dr. Irwin in the Washington County

Circuit Court claiming, in part, that LAMMICO had failed to properly report and update

ATCC regarding its current ability to provide the service of a peripheral vascular surgeon

and that it and Dr. Irwin had negligently accepted Ruloph’s transfer without ascertaining or

attempting to ascertain whether a peripheral vascular surgeon was available to treat Ruloph’s

condition upon admission. Nearly a year later, on January 19, 2022, Ruloph commenced

suit against Mercy Fort Smith and its clinic in the Sebastian County Circuit Court.3 In early

2 She also sued Mercy Fort Smith and its clinic, which are not parties to this appeal. 3 Ruloph’s claims against Mercy Fort Smith and its clinic are still pending in the Sebastian County Circuit Court.

3 2023, Ruloph voluntarily nonsuited her action in Washington County and added

LAMMICO and Irwin as defendants in her Sebastain County action. At this point, Ruloph

amended her complaint to allege only ordinary negligence against LAMMICO and Dr.

Irwin. Ruloph also alleged that LAMMICO was vicariously liable for Dr. Irwin’s actions.

In the Sebastian County Circuit Court, LAMMICO and Dr. Irwin moved to dismiss,

arguing that the statute of limitations on the medical-injury claims had run or, in the

alternative, that venue was not appropriate in Sebastian County under Ark. R. Civ. P.

12(b)(3). Specific to the venue argument, these defendants asserted that because Ruloph’s

claims against them were actually claims for medical injury and not ordinary negligence, Ark.

Code Ann. § 16-60-105 (Supp. 2023) required that those claims be brought in the county in

which the alleged act or omission occurred. Because the alleged negligence of Dr. Irwin and

WRMC undisputedly occurred in Washington County, venue could only lie in Washington

County.

In support of their assertion that the claims against LAMMICO and Dr. Irwin were

claims of medical injury, they presented an affidavit from Heather Beauford, trauma program

manager at WRMC, that stated that only a medical doctor could accept a transfer of a

patient. Additionally, LAMMICO and Dr. Irwin also presented evidence that Dr. Irwin was

the physician who had accepted Ruloph’s transfer.

The Sebastian County Circuit Court held a hearing on the issues of statute of

limitations and venue. At the hearing, Ruloph’s counsel conceded that if the court found

Ruloph suffered a medical injury, then Sebastian County would not be the appropriate

4 venue to pursue a claim against LAMMICO and Dr. Irwin. Two days after the hearing,

Ruloph’s counsel wrote a letter to the circuit court stating that the case law relied on to

determine that Arkansas Code Annotated section 16-60-101(e) did not encompass claims of

medical injury predated the 2015 revisions to the venue statute.

Ultimately, the Sebastian County Circuit Court granted LAMMICO and Dr. Irwin’s

motion to dismiss. The court first noted Ruloph’s initial concession that if her claims against

LAMMICO and Dr. Irwin were found to be claims for medical injury, Sebastian County

would not be the proper venue. It then proceeded to detail the allegations in Ruloph’s

complaint and determined that Ruloph “had clearly alleged her injuries arose out of

professional services rendered by LAMMICO/WRMC and Irwin, both of whom are medical

providers.” As such, the court concluded that section 16-60-105 was the controlling statute

and that the claims against these defendants were to be transferred back to Washington

County pursuant to Arkansas Rule of Civil Procedure 12(h)(3). Ruloph did not contest the

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