Anne Marie Nolen, a pediatric nurse, appealed a summary judgment against her in a case involving Boca Raton Community Hospital, Dr. Geoffrey Zann, and nurse Joan Reinsvold. The district court ruled that Nolen's complaint under the Emergency Medical Treatment and Active Labor Act (EMTALA) and Florida law failed. Nolen, who was 22 weeks pregnant with triplets, sought treatment at the hospital on May 4, 2000, due to cramping and a mucous discharge. She was admitted as an outpatient and initially assessed by nurse Reinsvold, who monitored her vital signs and fetal heart rates. Dr. Zann examined Nolen about an hour later, finding her cervix neither dilated nor thinned and concluding that her condition was stable. He discharged her with instructions to keep a follow-up appointment with her perinatologist, Dr. Scott. After leaving the hospital, Nolen experienced worsening symptoms but did not contact the hospital or Dr. Zann. At her follow-up appointment, Dr. Scott noted signs of potential pre-term labor but determined that Nolen was not in labor during her hospital visit the previous day.
Nolen was transferred to Broward General Hospital on May 7, 2000, due to its superior neonatal care unit after experiencing pre-term labor. Her first baby was stillborn, and although her other two babies were born alive, they did not survive past May 24, 2000. Nolen filed a complaint on May 3, 2002, under 42 U.S.C. § 1395dd, alleging that the Hospital failed to provide an adequate screening examination, did not stabilize her condition, and wrongfully discharged her, violating the Emergency Medical Treatment and Labor Act (EMTALA). She was granted leave to amend her complaint to include medical malpractice claims under Florida law, adding Dr. Zann, Reinsvold, and nurse Slavicek as defendants. The district court did not exercise jurisdiction over most state-law claims and granted summary judgment to the Hospital and other defendants on the EMTALA claims and the remaining state-law claim. Nolen waived any arguments regarding the state-law claim by not addressing it in her brief.
Regarding the summary judgment standard, it is applicable when there is no genuine issue of material fact, and the moving party is entitled to judgment as a matter of law. The court reviews these rulings de novo. Nolen claimed the Hospital did not have a standard written screening procedure or failed to follow it, which she argued violated EMTALA. She also contended that the district court improperly considered evidence showing she was not in pre-term labor during her May 4 examination. Both arguments were addressed and rejected, with the court noting EMTALA was enacted to prevent hospitals from transferring patients without proper care, not as a federal malpractice statute. EMTALA mandates hospitals provide appropriate medical screenings and stabilization for emergency conditions.
Nolen's claim that the Hospital was mandated to have a written screening procedure is unfounded, as established by the Eighth Circuit in Summers v. Baptist Medical Center Arkadelphia, which found that unwritten procedures do not violate EMTALA. Section 1395dd(a) does not require a written procedure. Nolen also argues that the Hospital did not adhere to its own policies in screening her for pre-term labor. However, if the screening provided to Nolen aligns with what any other patient under similar circumstances would receive, there is no EMTALA liability. The Hospital demonstrated that Nolen received the appropriate screening based on the applicable policy, and evidence showed that her care exceeded that of 94% of similar patients. Hospitals may adjust screening procedures based on individual patient conditions, as supported by precedents from the Fourth and Ninth Circuits. Nolen's primary care was managed by her private physician, who had the expertise to provide care beyond the basic EMTALA screening. The district court's decision to grant summary judgment was appropriate, as Nolen failed to provide sufficient evidence to create a genuine issue of material fact regarding the adequacy of her screening. The court noted that a single affidavit from a physician is insufficient to challenge the hospital's evidence. Consequently, the district court's summary judgment is affirmed.
