Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-1_16-cv-00581/USCOURTS-caed-1_16-cv-00581-2/pdf.json

Parties Involved:
Clovis Community Hospital
Defendant
Debby Genthner
Plaintiff
David Stone
Defendant

Document Text:

1

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

UNITED STATES DISTRICT COURT

EASTERN DISTRICT OF CALIFORNIA

DEBBY GENTHNER,

Plaintiff,

 v.

CLOVIS COMMUNITY HOSPITAL and 

DAVID STONE, N. P.,

 Defendants.

)

)

)

)

)

)

)

)

)

)

)

)

)

1:16-cv-00581-DAD-BAM 

ORDER DISMISSING SECOND AMENDED 

COMPLAINT WITH LEAVE TO AMEND 

THIRTY-DAY DEADLINE

Plaintiff Debby Genthner (“Plaintiff”), proceeding pro se and in forma pauperis, initiated 

this civil action on April 25, 2016. On April 28, 2016, the Court dismissed Plaintiff’s complaint 

with leave to amend. Plaintiff filed a first amended complaint on May 27, 2016. On June 22, 

2016, the Court dismissed Plaintiff’s first amended complaint for failure to state a cognizable 

claim. The Court directed Plaintiff to file an amended complaint within thirty days. (Doc. 5). 

Plaintiff’s second amended complaint, filed on July 20, 2016, is currently before the Court for 

screening. (Doc. 6).

Screening Requirement

The Court is required to screen complaints brought by persons proceeding in pro per. 28 

U.S.C. § 1915(e)(2). Plaintiff’s complaint, or any portion thereof, is subject to dismissal if it is 

frivolous or malicious, if it fails to state a claim upon which relief may be granted, or if it seeks 

Case 1:16-cv-00581-DAD-BAM Document 7 Filed 09/02/16 Page 1 of 7
2

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

monetary relief from a defendant who is immune from such relief. 28 U.S.C. § 

1915(e)(2)(B)(ii).

A complaint must contain “a short and plain statement of the claim showing that the 

pleader is entitled to relief. . . .” Fed. R. Civ. P. 8(a)(2). Detailed factual allegations are not 

required, but “[t]hreadbare recitals of the elements of a cause of action, supported by mere 

conclusory statements, do not suffice.” Ashcroft v. Iqbal, 556 U.S. 662, 678, 129 S.Ct. 1937,

1949 (2009) (citing Bell Atlantic Corp. v. Twombly, 550 U.S. 544, 555, 127 S.Ct. 1955, 1964-65 

(2007)). While a plaintiff’s allegations are taken as true, courts “are not required to indulge 

unwarranted inferences.” Doe I v. Wal-Mart Stores, Inc., 572 F.3d 677, 681 (9th Cir. 2009) 

(internal quotation marks and citation omitted). 

Pro se litigants are entitled to have their pleadings liberally construed and to have any 

doubt resolved in their favor, Wilhelm v. Rotman, 680 F.3d 1113, 1121-1123 (9th Cir. 2012), 

Hebbe v. Pliler, 627 F.3d 338, 342 (9th Cir. 2010), but to survive screening, Plaintiff’s claims 

must be facially plausible, which requires sufficient factual detail to allow the Court to 

reasonably infer that each named defendant is liable for the misconduct alleged, Iqbal, 556 U.S. 

at 678, 129 S.Ct. at 1949 (quotation marks omitted); Moss v. United States Secret Service, 572 

F.3d 962, 969 (9th Cir. 2009). The sheer possibility that a defendant acted unlawfully is not 

sufficient, and mere consistency with liability falls short of satisfying the plausibility standard. 

Iqbal, 556 U.S. at 678, 129 S.Ct. at 1949; Moss, 572 F.3d at 969.

Plaintiff’s Allegations

As with her first amended complaint, Plaintiff names Clovis Community Hospital and 

Nurse Practitioner David Stone as defendants. Plaintiff alleges that Nurse Practitioner Stone did 

not provide a proper medical assessment for severe burn damages to her mouth on April 21, 

2014, at Clovis Community Hospital. When Plaintiff arrived at the emergency room, she told an 

intake person that her mouth was badly burned and her pain was above a ten on a scale of 1-10. 

Plaintiff’s mouth and throat were “raw and on fire” and she had “sores all around the inside of 

her mouth.” (Doc. 6 at p. 1). Plaintiff waited in the emergency room for about forty minutes and 

was then called to have her vitals checked by the nurses. Nurse Practitioner Stone was one of the 

Case 1:16-cv-00581-DAD-BAM Document 7 Filed 09/02/16 Page 2 of 7
3

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

nurses in the room where Plaintiff’s vitals were taken, but he did not check Plaintiff’s mouth or 

give her any pain medication or treatment. (Doc. 6 at p. 1). Rather, Plaintiff sat in the 

emergency room with her mouth burning in pain for over four hours with no exam or treatment. 

Plaintiff alleges that she suffered for days after the visit and can still see burn marks in her mouth 

and redness in her throat. 

Plaintiff also alleges that Nurse Practitioner Stone failed to report her severe mouth burns 

to the authorities and that she continues “to suffer from repeated injuries by this perpetrator or 

perpetrators because [Nurse Practitioner] Stone did not report these injuries to law enforcement 

authorities.” (Doc. 6 at p. 4). 

Plaintiff further alleges that the hospital engaged in a conspiracy to spoil evidence and 

obstruct justice. Specifically, Plaintiff asserts that her medical records do not reflect what she 

told the intake person when she arrived at the emergency room. (Doc. 6 at p. 4). Plaintiff also 

asserts that certain city officials contacted Nurse Practitioner Stone at the hospital to prevent 

Plaintiff from being examined and from receiving any treatment for her injuries. 

Plaintiff contends that she went “to an E.N.T. doctor on April 29, 2014 to check the burn 

injuries in [her] mouth.” (Doc. 6 at p. 5). Plaintiff asserts that the nurse read the notes from 

Clovis Community Hospital, and said “how bad does your pain level have to be to get treatment 

or pain medication.” (Doc. 6 at p. 5). 

Plaintiff brings claims (Claims 1, 2, and 4) against Clovis Community Hospital pursuant 

to the Emergency Medical Treatment and Active Labor Act, 42 U.S.C. § 1395dd based on 

allegations that Nurse Practitioner Stone failed to provide a proper medical assessment and 

treatment for severe burn damages to her mouth on April 21, 2014. Plaintiff also asserts 

conspiracy claims (Claims 5 and 10) against the hospital and Nurse Practitioner Stone pursuant 

to 42 U.S.C. § 1985. Additionally, Plaintiff’s second amended complaint contains state law 

claims (Claims 6, 7 and 8) for negligence, medical negligence, malpractice and intentional and 

negligent infliction of emotional distress, along with claims (Claims 3 and 9) against the hospital 

and Nurse Practitioner Stone for alleged violations of California Penal Code § 11160 for failure 

to report her burns to authorities. 

Case 1:16-cv-00581-DAD-BAM Document 7 Filed 09/02/16 Page 3 of 7
4

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

Discussion

A. Emergency Medical Treatment and Active Labor Act (“EMTALA”)

Congress enacted the EMTALA, known as the “Patient Anti-Dumping Act,” to address 

concerns that “hospitals were dumping patients who were unable to pay for care, either by 

refusing to provide emergency treatment to these patients, or by transferring the patients to other 

hospitals before the patients’ conditions stabilized.” Jackson v. East Bay Hosp., 246 F.3d 1248, 

1254 (9th Cir. 2001). Under the EMTALA, hospitals with emergency rooms must “provide for 

an appropriate medical screening examination within the capability of the hospital’s emergency 

department ... to determine whether or not an emergency medical condition ... exists.” 42 U.S.C. 

§ 1395dd(a). Hospitals are required to conduct an examination that is “reasonably calculated to 

identify the patient’s critical medical condition.” Hoffman v. Tonnemacher, 425 F. Supp.2d 1120, 

1130 (E.D. Cal. 2006). If an emergency medical condition is discovered, then hospital staff must 

“stabilize” the patient before transferring her to another facility or discharging her. Baker v. 

Adventist Health, Inc., 260 F.3d 987, 992 (9th Cir.2001). However, a hospital is not liable under 

the EMTALA if it negligently fails to detect or if it misdiagnoses an emergency medical 

condition. Bryant v. Adventist Health System/West, 289 F.3d 1162, 1166 (9th Cir. 2002). As 

such, individuals who receive substandard medical care must pursue their remedies under state 

law and not under the EMTALA. Eberhardt v. City of Los Angeles, 62 F.3d 1253, 1258 (9th Cir. 

1995). 

Here, Plaintiff fails to state a cognizable claim against Clovis Community Hospital under 

the EMTALA related to her medical screening. Although Plaintiff alleges a failure to examine 

or screen her medical condition, exhibits attached to the second amended complaint belie her 

allegations and demonstrate that medical staff at Clovis Community Hospital triaged Plaintiff at 

approximately 5:36 p.m. on April 21, 2014, and determined that her condition was non-urgent. 

(Doc. 6 at pp. 15-20, Ex. A to Sec. Amend. Compl.). Plaintiff fails to allege facts demonstrating 

that the triage screening conducted by hospital staff was not appropriate. See, e.g. Garza v. City 

& County of San Francisco, 2006 WL 3462925, at *3-4 (N.D. Cal. Nov. 30, 2006) (denying 

request for reconsideration of order granting summary judgment; reaffirming holding that 

Case 1:16-cv-00581-DAD-BAM Document 7 Filed 09/02/16 Page 4 of 7
5

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

plaintiff had provided no evidence that the triage screening was not appropriate within the 

capability of the hospital’s emergency department). Moreover, Plaintiff presents evidence that 

she was uncooperative with Nurse Practitioner Stone, and that she eloped from the hospital. 

(Doc. 6 at pp. 14 and 15, Ex. A to Sec. Amend. Compl.). Therefore, Plaintiff’s own actions 

preclude any claim that the hospital violated the EMTALA. Further, any assertion that the triage 

evaluation failed to detect or diagnose her mouth burns must be pursued under state law, not the 

EMTALA. Bryant, 289 F.3d at 1166; Eberhardt, ; Baker v. Adventist Health, Inc., 260 F.3d 987, 

992 (9th Cir.2001) (medical malpractice is not actionable under the EMTALA). Indeed, 

“negligence in the screening process or the provision of a merely faulty screening, as opposed to 

refusing to screen or disparate screening, does not violate EMTALA, although it may implicate 

state malpractice law.” Hoffman, 425 F.Supp.2d at 1131. 

Plaintiff also fails to state a cognizable claim against the hospital regarding any purported 

failure to stabilize her before discharge because she eloped from the hospital. (Doc. 6 at p. 15, 

Ex. A to Sec. Amend. Compl.). Thus, the hospital cannot be liable under the EMTALA for 

failure to stabilize her before any discharge or transfer. 

Insofar as Plaintiff attempts to bring a claim against Nurse Practitioner Stone for 

violation of the EMTALA, she may not do so. The EMTALA does not provide a private right of 

action against hospital employees. “The plain text of the EMTALA explicitly limits a private 

right of action to the participating hospital.” Eberhardt, 62 F.3d at 1256.

For these reasons, Plaintiff fails to state cognizable claims against the hospital or Nurse 

Practitioner Stone for purported violations of the EMTALA

B. 42 U.S.C. § 1985

Plaintiff alleges that defendants conspired with city officials to deprive her of her right to 

a medical examination and treatment on April 21, 2014, at Clovis Community Hospital in 

violation of 42 U.S.C. § 1985. Section 1985 proscribes conspiracies to interfere with an 

individual’s civil rights. A claim under section 1985 must allege specific facts to support the 

allegation that defendants conspired together. Karim–Panahi v. Los Angeles Police Dep’t., 839 

F.2d 621, 626 (9th Cir.1988). A mere allegation of conspiracy without factual specificity is 

Case 1:16-cv-00581-DAD-BAM Document 7 Filed 09/02/16 Page 5 of 7
6

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

insufficient to state a claim under 42 U.S.C. § 1985. Id.; Sanchez v. City of Santa Ana, 936 F.2d 

1027, 1039 (9th Cir.1991). Here, Plaintiff fails to allege any facts to support a claim of 

conspiracy to violate her civil rights. Plaintiff’s conclusory allegations are insufficient. 

C. State Law Claims

Plaintiff has asserted several state law claims, including negligence and medical 

negligence.1 As Plaintiff has failed to state any cognizable federal claims in this action, the 

Court finds it unnecessary to screen Plaintiff’s state law claims. The Court generally declines to 

exercise supplemental jurisdiction over state law claims in the absence of viable federal claims 

and this case presents no exception. 28 U.S.C. § 1367(c)(3); Parra v. PacifiCare of Ariz., Inc., 

715 F.3d 1146, 1156 (9th Cir. 2013); Herman Family Revocable Trust v. Teddy Bear, 254 F.3d 

802, 805 (9th Cir. 2001); see also Watison v. Carter, 668 F.3d 1108, 1117 (9th Cir. 2012) (if 

court declines to exercise supplemental jurisdiction over state law claims once court dismissed 

federal claims, then the court should dismiss the state law claims without prejudice).

CONCLUSION AND ORDER

Plaintiff fails to state a cognizable federal claim. In an abundance of caution, Plaintiff 

will be provided with one additional opportunity to amend her complaint to state a cognizable 

federal claim. Lopez v. Smith, 203 F.3d 1122, 1130 (9th Cir. 2000). Plaintiff may not change the 

nature of this suit by adding new, unrelated claims in her amended complaint. George v. Smith, 

507 F.3d 605, 607 (7th Cir. 2007) (no “buckshot” complaints).

Plaintiff’s amended complaint should be brief, Fed. R. Civ. P. 8(a), but it must state what 

the named defendant did that led to the deprivation of Plaintiff’s rights, Iqbal, 556 U.S. at 678-

79, 129 S.Ct. at 1948-49. Although accepted as true, the “[f]actual allegations must be 

[sufficient] to raise a right to relief above the speculative level. . . .” Twombly, 550 U.S. at 555 

(citations omitted).

Finally, Plaintiff is advised that an amended complaint supersedes the original complaint. 

Lacey v. Maricopa Cnty., 693 F.3d 896, 927 (9th Cir. 2012) (en banc). Therefore, Plaintiff’s 

 

1

Plaintiff also alleges that Defendants violated California Penal Code §§ 11160 and 11161. Plaintiff has not 

demonstrated that that these statutory provisions authorize a private cause of action. 

Case 1:16-cv-00581-DAD-BAM Document 7 Filed 09/02/16 Page 6 of 7
7

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

amended complaint must be “complete in itself without reference to the prior or superseded 

pleading.” Local Rule 220. 

Based on the foregoing, it is HEREBY ORDERED that: 

1. Plaintiff’s second amended complaint is dismissed for failure to state a cognizable 

federal claim; 

2. Within thirty (30) days from the date of service of this order, Plaintiff shall file a 

third amended complaint; and

3. If Plaintiff fails to file a third amended complaint in compliance with this order, 

the Court will recommend that this action be dismissed with prejudice. 

IT IS SO ORDERED.

Dated: September 1, 2016 /s/ Barbara A. McAuliffe _

UNITED STATES MAGISTRATE JUDGE

Case 1:16-cv-00581-DAD-BAM Document 7 Filed 09/02/16 Page 7 of 7