Potami v. Frankel

63 Pa. D. & C.4th 216, 2000 Pa. Dist. & Cnty. Dec. LEXIS 96
CourtPennsylvania Court of Common Pleas, Dauphin County
DecidedJune 19, 2000
Docketno. 5006 S 1996
StatusPublished

This text of 63 Pa. D. & C.4th 216 (Potami v. Frankel) is published on Counsel Stack Legal Research, covering Pennsylvania Court of Common Pleas, Dauphin County primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Potami v. Frankel, 63 Pa. D. & C.4th 216, 2000 Pa. Dist. & Cnty. Dec. LEXIS 96 (Pa. Super. Ct. 2000).

Opinion

HOOVER, J.,

Plaintiffs Katherine R. Potami and Samuel J. Potami, her husband, brought suit against Sharon Frankel M.D., Harrisburg Hospital, Pinnacle Health Hospitals and Keystone Health Plan Central and asserted, inter alia, that Harrisburg Hospital and Pinnacle Health Hospitals (hereinafter the hospital) violated the Emergency Medical Treatment and Active Labor Act, 42 U.S.C. §1395(dd)(a), based upon the hospital’s alleged failure to perform appropriate medical screening at the time of Mrs. Potami’s arrival at the emergency room. The plaintiffs moved for summary judgment and argued that Harrisburg Hospital’s intake procedure, which included a “pre-authorization” call to Mrs. Potami’s primary care physician, constituted a per se violation of EMTALA, entitling plaintiff to judgment as a matter of law as to that aspect of her claim.

[218]*218For the reasons set forth below, plaintiffs’ motion for partial summary judgment is denied.

FACTUAL BACKGROUND

Plaintiff Katherine Potami alleges that on October 25, 1994 she presented to Harrisburg Hospital’s emergency room with complaints of severe mediastinal chest pain radiating into her back. Plaintiff asserts that immediately upon her arrival, the hospital staff inquired into Mrs. Potami’s health insurance coverage, which she maintained with defendant Keystone Health Plan Central. The thrust of plaintiff’s EMTALA claim against the hospital is that the emergency room staff improperly denied her a medical screening examination by an emergency room physician because she was an HMO subscriber, by placing a call for pre-authorization for the visit to her primary care physician. The record reflects that the hospital emergency room staff placed a pre-authorization call to plaintiff’s primary care physician Sharon Frankel M.D., and that Dr. Frankel did not authorize the visit. Mrs. Potami left the emergency room without receiving an examination or treatment by an emergency room physician.

The record as to what transpired upon plaintiff’s arrival at the emergency room includes the deposition testimony of the hospital’s registration clerk, Mr. Paul Corbett, and the triage nurse, Ms. Dawn Sladky. Mr. Corbett testified that upon Mrs. Potami’s arrival, he notified Nurse Sladky that there was a female in the waiting area with chest pain. The record reflects that Ms. Sladky performed a triage assessment of Mrs. Potami, which included taking her vital signs. The nurse entered the triage assessment into the emergency room record. [219]*219She then returned Mrs. Potami to the registration desk, where the clerk obtained Mrs. Potami’s HMO insurance card.

Mr. Corbett then called Dr. Frankel, the plaintiff’s primary care physician, to obtain pre-authorization for the emergency room visit. Mr. Corbett read to Dr. Frankel the triage nurse’s notes. Dr. Frankel then spoke with the triage muse and the patient by phone and diagnosed Mrs. Potami’s condition as anxiety. Dr. Frankel recommended that Mrs. Potami return home. Dr. Frankel denied authorization for the emergency room visit. Mr. Corbett testified that he advised Mrs. Potami that she could still be seen in the emergency department, but would be responsible for payment. He testified that he advised Mrs. Potami that she could call the HMO at the number on the back of the insurance card to request an appeal of the doctor’s denial.

The record also reflects that plaintiff’s husband, Mr. Potami, discussed with the emergency room personnel a willingness to personally pay for the visit by check or credit card, but that after speaking with Dr. Frankel, his wife had decided to leave. Nurse Sladky testified that she felt that an emergency room physician should see Mrs. Potami, encouraged Mrs. Potami to stay for further evaluation and indicated that she would find an emergency room doctor to come speak with her. Nurse Sladky testified that she felt that Mrs. Potami should be seen emergently, and that she considered myocardial infarction or unstable angina in the range of possible diagnoses. However, Mrs. Potami testified that based upon her phone conversation with Dr. Frankel, she felt sufficiently reassured, so that she did not insist upon being seen by a doc[220]*220tor in the emergency room. Mrs. Potami left the emergency room. The following morning, October 26, 1994, she returned to the emergency room for evaluation and treatment of an acute myocardial infarction.

According to the testimony of James Taylor M.D., Harrisburg Hospital’s policy in effect in 1994, “Guidelines for emergency care under managed health care plans,” set forth the intake procedure applicable to HMO patients. The guidelines required the outpatient clerk to contact the patient’s insurance company or primary care physician before evaluation by the emergency room physician, unless, because of the nature of the emergency, registration would not be appropriate. Under the guidelines, where pre-authorization is denied, the patient may still see an emergency room physician, although the staff is required to disclose to the patient their financial responsibility for the visit.

Defendants Harrisburg Hospital and Pinnacle Health deny that the pre-authorization call denied plaintiff a medical screening exam in violation of EMTALA, and assert that plaintiff withdrew her request for examination by an emergency room physician.

DISCUSSION

Plaintiffs have not demonstrated that the record is so free of genuine issues of material fact to entitle them to judgment as a matter of law on their claim that defendant Harrisburg Hospital violated the Emergency Medical Treatment and Active Labor Act, 42 U.S.C. §1395(dd). Summary judgment is proper only when the pleadings, depositions, answers to interrogatories, admissions on file, and affidavits demonstrate that there exists [221]*221no genuine issue of material fact and the moving party is entitled to judgment as a matter of law. Banks v. Jerome Taylor & Associates, 700 A.2d 1329 (Pa. Super. 1997); Pa.R.C.P. 1035.2. On a motion for summary judgment, the record must be viewed in the light most favorable to the non-moving party, and all doubts as to the existence of a genuine issue of material fact must be resolved in favor of the non-moving party. Kapres v. Heller, 536 Pa. 551, 640 A.2d 888 (1994). We do not find that as a matter of law, the placement of the pre-authorization call, irrespective of its purpose or effect, amounted to disparate availability of the medical screening in violation of EMTALA. Further, issues of fact exist as to the reason the medical screening of the plaintiff, Mrs. Potami, did not take place. Accordingly, plaintiffs’ motion for partial summary judgment must be denied.

The Act upon which plaintiffs base their claim, EMTALA, the “Patient Anti-Dumping Statute” requires that a hospital provide an “appropriate medical screening examination,” within the capability of the hospital’s emergency department to any individual who comes into the emergency department and requests examination and treatment. 42 U.S.C.§1395(dd)(a).

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Related

Correa v. Hospital San Francisco
69 F.3d 1184 (First Circuit, 1995)
Kapres v. Heller
640 A.2d 888 (Supreme Court of Pennsylvania, 1994)
Banks v. Jerome Taylor & Associates
700 A.2d 1329 (Superior Court of Pennsylvania, 1997)

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Bluebook (online)
63 Pa. D. & C.4th 216, 2000 Pa. Dist. & Cnty. Dec. LEXIS 96, Counsel Stack Legal Research, https://law.counselstack.com/opinion/potami-v-frankel-pactcompldauphi-2000.