Court Opinion

ID: 9488956
Source: CourtListenerOpinion
Date Created: 2023-08-05 13:00:54.565209+00
Date Added: 2024-06-11T17:53:12.946843
License: Public Domain

*146ERVIN, Circuit Judge,
dissenting:
I respectfully dissent.
The majority provides a thorough analysis of Congress’s purpose in enacting EMTALA and although correct about the statute’s goals, the opinion wrongly faults Vickers for congressional imprecision. The majority’s real problem is not with what Vickers alleged, but with the statutory language, which allows an EMTALA violation to be proven even when the failure to screen or stabilize is not shown to have been based on an economic motive. Athough EMTALA was designed to end patient dumping, Congress did not specify that EMTALA claims must include proof of an economic motive. Regardless of what we divine the congressional intent to have been, the statute is perfectly clear about what a plaintiff must allege in order to state a claim.
The Federal Rules of Civil Procedure establish a notice-pleading system. Complaints should be dismissed for failure to state a claim on which relief can be granted only when, construing all allegations in the light most favorable to the plaintiff, it is clear that no set of facts could be proven under which the plaintiff would be entitled to relief. Hishon v. King & Spalding, 467 U.S. 69, 78, 104 S.Ct. 2229, 2232-33, 81 L.Ed.2d 59 (1984). Vickers alleges that Nash Hospital “did not provide Plaintiff Martin with an appropriate medical screening examination” as required by EMTALA. Specifically, the complaint alleges that Martin “received less screening, both in quantity and quality, than required under the Act, and less than those other patients presenting in this same medical condition received.” The complaint also alleges that the Hospital discharged Martin “in violation of 42 U.S.C. 1395dd(b) as Plaintiff Martin’s emergency medical condition had not been stabilized____” Vickers has effectively put Nash General Hospital on notice that he is charging them with inadequate screening and failure to stabilize under EMTALA He has not provided specific facts in support of these allegations and may very well ultimately fail in his attempt. But I believe the district court erred in dismissing the claim under Rule 12(b)(6).
The majority — after recognizing that disparate treatment is the “cornerstone” of an EMTALA claim — simply states that “mechanical invocation of the phrase” cannot “convert appellant’s allegations of misdiagnosis into a valid claim under EMTALA.” Supra n. 3. But many, if not most, of the allegations made in complaints written in the notice-pleading fashion could be read as mechanical invocations of the phrases and elements used to establish particular claims.
Comparing the present case to Baber is unavailing. As the majority recognizes, that case was decided on summary judgment, and the decision was premised on the plaintiffs failure to provide evidence of disparate treatment. This is a very different standard than that used to evaluate a motion to dismiss for failure to state a claim. The factual similarity of the two cases thus means very little in the present posture of this case.
Vickers has alleged enough to allow him to undertake discovery. This particular plaintiff ought not to be penalized for Congress’s failure to statutorily define how EMTALA differs from a medical malpractice claim under state law.
For these reasons, I would reverse the district court’s dismissal under Rule 12(b)(6) and remand for further proceedings.