Court Opinion

ID: 9568244
Source: CourtListenerOpinion
Date Created: 2023-08-21 20:01:47.489585+00
Date Added: 2024-06-11T10:24:29.735086
License: Public Domain

BAXTER, J.,
Concurring.—The question here is whether the $250,000 limit on noneconomic damages under California’s Medical Injury Compensation Reform Act (MICRA) (Civ. Code, § 3333.2) applies to a cause of action for failure to stabilize an emergency medical condition in violation of the federal Emergency Medical Treatment and Active Labor Act (EMTALA) (42 U.S.C. § 1395dd(b)). The majority answer the question in the affirmative because “[t]he trier of fact must, under EMTALA as in a medical negligence claim, consider the prevailing medical standards and relevant expert medical testimony to determine whether material deterioration of the patient’s condition was reasonably likely to occur.” (Maj. opn., ante, at p. 114.) While I also conclude that MICRA is applicable to plaintiff’s EMTALA action, I do so on a different basis.
EMTALA imposes two limited duties of care upon hospitals that have both a Medicare provider agreement and an emergency department. First, if any individual comes to the emergency department requesting examination or treatment, the hospital “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.”1 (42 U.S.C. § 1395dd(a).) Second, as relevant here, if the hospital “determines that the individual has an emergency medical condition,” it must provide, “within the staff and facilities available at the hospital, for such further medical examination and such treatment as may be required to stabilize the medical condition.” (Id.., § 1395dd(b)(l)(A).)2 Recognizing that personal injury may result directly from a hospital’s failure to provide such care, Congress authorized the filing of civil actions for the recovery of damages subject to state law limitations on damages: “Any individual who suffers personal harm as a direct result of a participating hospital’s violation of a requirement [under EMTALA] may, in a civil action against the participating hospital, obtain those damages available for personal injury under the law of the State in which the hospital is located, and such equitable relief as is appropriate.” (42 U.S.C. § 1395dd(d)(2)(A).)
*118In California, MICRA places a $250,000 limit on the ability of an injured plaintiff to recover damages for noneconomic losses “[i]n any action for injury against a health care provider based on professional negligence.” (Civ. Code, § 3333.2, subds. (a), (b).) For purposes of MICRA, “ ‘[professional negligence’ means a negligent act or omission to act by a health care provider in the rendering of professional services, which act or omission is the proximate cause of a personal injury or wrongful death, provided such services are within the scope of services for which the provider is licensed and which are not within any restriction imposed by the licensing agency or licensed hospital.” (Civ. Code, § 3333.2, subd. (c)(2).)
In my view, a hospital’s demonstrated failure to act in accordance with EMTALA is, in and of itself, “a negligent . . . omission to act by a health care provider in the rendering of professional services” under the MICRA definition of professional negligence. (Civ. Code, § 3333.2, subd. (c)(2).) As I see it, any injury action based on a hospital’s noncompliance with EMTALA’s medical screening requirement or its provision for medically necessary stabilization treatment within the hospital’s particular capabilities is an action based on professional negligence within the contemplation of MICRA.
Unlike the majority, then, I conclude, as a general matter, that any action against a hospital for a violation of EMTALA’s duty of care provisions qualifies as an action based on professional negligence subject to MICRA, without regard to whether the particular claim entails consideration of the prevailing medical standards of care generally associated with a malpractice action. (Cf. Power v. Arlington Hosp. Ass’n (4th Cir. 1994) 42 F.3d 851, 861 [concluding that an EMTALA claim based on alleged disparate medical screening by a hospital was subject to Virginia’s cap on medical malpractice damages even though the claim did not allege a breach of the prevailing standard of care].)
Chin, J., concurred.

As the majority note, most federal courts interpret the statutory phrase, “appropriate medical screening,” to refer to uniform medical screening. (Maj. opn., ante, at p. Ill, fn. 4.)

If the individual has an emergency medical condition which has not been stabilized, the hospital may not transfer the individual unless other statutory criteria are fulfilled. (42 U.S.C. § 1395dd(b)(l)(B).)