Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-4_02-cv-03485/USCOURTS-cand-4_02-cv-03485-0/pdf.json

Nature of Suit Code: 440
Nature of Suit: Other Civil Rights
Cause of Action: 42:1395 HHS: Adverse Reimbursement Review

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United States District Court

For the Northern District of California

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 Plaintiff did not file the letter, and did not submit a certificate of service of the letter on

defendants. The court has instructed the clerk of the court to file the letter.

2

 Plaintiff suggests that he is entitled to further judicial review of his claim under either

California Code of Civil Procedure § 1094.5 or California Welfare & Institutions Code § 10962.

However, neither of those California statutes provides authority for reconsideration of an order

granting summary judgment in federal district court.

United States District Court

For the Northern District of California

UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF CALIFORNIA

JASON GRANT GARZA,

Plaintiff, No. C 02-3485 PJH

v. ORDER DENYING REQUEST 

FOR RECONSIDERATION

CITY & COUNTY OF SAN FRANCISCO,

et al.,

Defendants.

_______________________________/

The court is in receipt of a letter from plaintiff Jason Grant Garza dated November

20, 2006.1

 Plaintiff seeks an order “re-opening” the above-entitled action because of “new

evidence,” and also seeks appointment of counsel. The court interprets the request to “reopen” as a request for reconsideration under Federal Rule of Civil Procedure 60(b).2

 

Because the court finds that plaintiff’s request does not meet the standard under Rule

60(b), the request is DENIED.

BACKGROUND

Plaintiff filed this action in the Superior Court of California, County of San Francisco,

on April 26, 2002, alleging violation of the federal Emergency Medical Treatment and Active

Labor Act, 42 U.S.C. § 1395dd (“EMTALA”), and also alleging violation of his federal

constitutional rights under 42 U.S.C. § 1983, as well as various state law causes of action. 

He alleged that defendant San Francisco General Hospital (“S.F. General”), part of

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For the Northern District of California

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defendant City and County of San Francisco (“CCSF”), had refused to render emergency

medical services when he sought treatment at S.F. General on April 21, 2001. 

Plaintiff served CCSF with the summons and complaint on June 24, 2002, and

CCSF removed the action on July 19, 2002. At the initial case management conference on

December 5, 2002, the court set the pretrial schedule, including a discovery cut-off date of

June 4, 2003, and a dispositive motions hearing date on August 6, 2003 (later extended to

August 13, 2003). After the close of discovery, CCSF filed a motion for partial summary

judgment on the federal causes of action. Plaintiff filed an opposition to the motion, and the

court heard argument on August 13, 2003. 

The court granted CCSF’s motion, finding that the § 1983 claim was time-barred;

and dismissing the EMTALA claim against defendant hospital employee Paul Lewis,

because the statute does not provide for a private right of action against individuals. With

regard to the EMTALA claim against CCSF, the evidence showed that Lewis had

conducted a medical screening and determined that plaintiff was not experiencing a true

emergency. The court found that plaintiff had failed to provide evidence establishing a

triable issue with regard to whether the medical evaluation he received at S.F. General was

appropriate and whether it was comparable to those given to similarly situated patients, and

had also failed to show that he suffered from an acute or severe medical condition or that

he required immediate treatment to prevent serious bodily injury. The court issued an order

on August 14, 2003 remanding the state law claims to San Francisco Superior Court. 

Plaintiff now asserts that he has “new evidence” regarding his EMTALA claim. Specifically,

he contends that a November 16, 2006, letter from Albert Quintero, Acting Field Operations

Branch Chief – Bay Area, State of California Department of Health Services, Division of

Licensing and Certification, shows that he received only a “triage” screening, not a “medical

evaluation,” at S.F. General on April 21, 2001. 

DISCUSSION

A. Legal Standard

A district court may reconsider its grant of summary judgment under either Federal

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United States District Court

For the Northern District of California

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Rule of Civil Procedure 59(e) (motion to alter or amend a judgment) or Rule 60(b) (relief

from judgment), as appropriate. School Dist. No. 1J, Multnomah County, Or. v. ACandS,

Inc., 5 F.3d 1255, 1262 (9th Cir. 1993). A motion to alter or amend judgment pursuant to

Rule 59(e) must be filed within ten days of the entry of judgment. Fed. R. Civ. P. 59(e).

Because summary judgment was granted on plaintiffs’ federal claims on August 13, 2003, a

Rule 59(e) motion would be untimely. Where the Rule 59(e) deadline has passed, a party

seeking amendment of the judgment can move under Rule 60(b). 

 In this court, the standards set forth in Civil Local Rule 7-9 also apply. A party

seeking reconsideration must show either a) that at the time of the motion, a material

difference in fact or law exists from that which was presented to the court before entry of

the interlocutory order from which relief is sought; or 2) the emergence of new material

facts or a change of law occurring after the time of such order; or 3) a manifest failure by

the court to consider material facts or dispositive legal arguments which were presented to

the court before such interlocutory order. Civ. L.R. 7-9(b).

B. Plaintiff’s Motion for Reconsideration

Plaintiff contends that the court should reconsider its ruling on summary judgment –

specifically, the ruling that the evidence showed that plaintiff received a medical screening

at S.F. General on April 21, 2001. Rule 60(b) provides, in relevant part, 

On motion and upon such terms as are just, the court may relieve a party or a

party's legal representative from a final judgment, order, or proceeding for the

following reasons: (1) mistake, inadvertence, surprise, or excusable neglect;

(2) newly discovered evidence which by due diligence could not have been

discovered in time to move for a new trial under Rule 59(b); (3) fraud (whether

heretofore denominated intrinsic or extrinsic), misrepresentation, or other

misconduct of an adverse party; (4) the judgment is void; (5) the judgment

has been satisfied, released, or discharged, or a prior judgment upon which it

is based has been reversed or otherwise vacated, or it is no longer equitable

that the judgment should have prospective application; or (6) any other

reason justifying relief from the operation of the judgment. The motion shall

be made within a reasonable time, and for reasons (1), (2), and (3) not more

than one year after the judgment, order, or proceeding was entered or taken. 

Fed. R. Civ. P. 60(b).

The court finds that plaintiff’s motion must be DENIED because it is untimely. The

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order granting CCSF’s motion for summary judgment on the federal causes of action was

filed August 14, 2003. Plaintiff submitted his request for reconsideration more than three

years later. Under Rule 60(b), a motion for reconsideration on the basis of newlydiscovered evidence must be made within one year of the original order. 

Moreover, even were the motion not time-barred, it would not be granted because

plaintiff has not shown that the “evidence” could not with reasonable diligence have been

discovered prior to the hearing on CCSF’s motion for summary judgment. A motion for

reconsideration of an order granting summary judgment is treated similarly to a motion for a

new trial, requiring evidence or argument that could not have been presented earlier. See

Schwarzer, Tashima & Wagstaffe, Federal Civil Procedure Before Trial § 14:362.1 (2006).

Evidence is not "newly discovered" for purposes of a motion for reconsideration if it

was in the moving party's possession at the time of trial or could have been discovered with

reasonable diligence. See Engelhard Industries v. Research Instrumental, 324 F.2d 347,

352 (9th Cir.1963). Additionally, the evidence must be of such magnitude that production

of it earlier would have been likely to change the disposition of the case. Coastal Transfer

v. Toyota Motor Sales, 833 F.2d 208, 210 (9th Cir. 1987). 

Here, the letter from Mr. Quintero discusses the record of plaintiff’s medical

screening at S.F. General on April 21, 2001. The record of that “triage” screening was in

plaintiff’s possession at the time of the motion, and plaintiff previously argued in his

opposition to CCSF’s motion that the triage screening did not constitute an “appropriate

medical screening” or “evaluation” under EMTALA. However, as the court noted in the

August 13, 2003, order, plaintiff provided no evidence to counter the evidence provided by

CCSF that the triage investigation performed by Davis was appropriate under the

circumstances. Moreover, the evidence presented in connection with CCSF’s motion

showed that plaintiff was uncooperative with the triage nurses at the hospital. 

Congress enacted EMTALA to respond to the specific problem of hospital

emergency rooms refusing to treat patients who were uninsured or who could otherwise not

pay for treatment. Baker v. Adventist Health, Inc., 260 F.3d 987, 993 (9th Cir. 2001). In

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such situations, emergency rooms would either decline to provide treatment or transfer

patients in an unstable condition to other hospitals, thereby jeopardizing patients' health. 

Id. (citing H.R. Rep. No. 99-241, pt. I, at 27 (1985), reprinted in 1986 U.S.C.C.A.N. 579,

605; Jackson v. East Bay Hospital, 246 F.3d 1248, 1254 (9th Cir. 2001)). The statute is not

intended to create a national standard of care for hospitals or to provide a federal cause of

action akin to a state law claim for medical malpractice. Eberhardt v. City of Los Angeles,

62 F.3d 1253, 1258 (9th Cir.1995).

EMTALA requires that a hospital provide an "appropriate medical screening

examination within the capability of the hospital's emergency department." 42 U.S.C. 

§ 1395dd(a). This examination must determine "whether or not an emergency medical

condition . . . exists." Id. An "emergency medical condition" is one "manifesting itself by

acute symptoms of sufficient severity (including severe pain) such that the absence of

immediate medical attention could reasonably be expected to result in – (i) the placing of

the health of the individual . . . in serious jeopardy, (ii) serious impairment to bodily

functions, or (iii) serious dysfunction of any bodily organ or part . . . .“ 42 U.S.C. 

§ 1395dd(b)(1)(A). If the hospital detects an emergency medical condition, the hospital

must provide "either (A) within the staff and facilities available at the hospital, for such

medical examination and such treatment as may be required to stabilize the medical

condition, or (B) for the transfer of the individual to another medical facility." 42 U.S.C. 

§ 1395dd(b)(1). 

A hospital satisfies EMTALA's "appropriate medical screening" requirement if it

provides a patient with an examination comparable to the one offered to other patients

presenting similar symptoms, unless the examination is so cursory that it is not "designed

to identify acute and severe symptoms that alert the physician of the need for immediate

medical attention to prevent serious bodily injury." Jackson, 246 F.3d at 1256 (quoting

Eberhardt, 62 F.3d at 1257). 

In the August 14, 2003, order, the court found that plaintiff had provided no evidence

that the triage screening was not appropriate within the capability of the hospital’s

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emergency department, or that he suffered from an acute or severe medical condition. The

purported new “evidence” provided by plaintiff would not change that conclusion. Thus,

production of the evidence earlier would not have been “likely to change the disposition of

the case.” Coastal Transfer, 833 F.2d at 210.

CONCLUSION

In accordance with the foregoing, plaintiff’s request for reconsideration of the order

granting summary judgment on the EMTALA claim is DENIED. The request is untimely,

and does not satisfy the requirements of Rule 60(b). The request for appointment of

counsel is also DENIED. 

The court will entertain no further motions in this case. 

IT IS SO ORDERED.

Dated: November 30, 2006 ______________________________

PHYLLIS J. HAMILTON

United States District Judge

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