McClure v. Parvis
294 F. Supp. 3d 318 (2018)
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Rule of Law:
An inordinately long delay in providing a medical screening to a patient who presents at an emergency department may be the functional equivalent of a denial of screening, thereby stating a viable claim for a violation of the Emergency Medical Treatment and Labor Act (EMTALA).
Facts:
- On the morning of September 8, 2015, Dawn McClure awoke with a severe headache and vision problems.
- McClure had an appointment with her primary care physician at Penn Valley Medicine Unionville, but because she arrived fifteen minutes late, the staff refused to see her and directed her to an urgent care facility.
- At the urgent care center, McClure presented with a headache, disorientation, and vomiting, prompting a call for an ambulance.
- The ambulance transported McClure to the Chester County Hospital (CCH) Emergency Department, arriving at approximately 12:50 p.m.
- McClure was registered upon arrival with noted symptoms of 'Vomiting, Vision Problems' but was not seen by any medical personnel until 4:42 p.m., nearly four hours later.
- Shortly after 4:55 p.m., a CT scan revealed a 'Large right parietal hemorrhage,' which the attending physician designated a 'neurological emergency'.
- As a result of the hemorrhage and delayed treatment, McClure suffered permanent injuries, including vision loss in her left eye and difficulties with balance and coordination.
Procedural Posture:
- Dawn McClure filed a medical malpractice and EMTALA action in the United States District Court against Chester County Hospital (CCH), Penn Valley Medicine Unionville, Dr. Eric Parvis, and the Trustees of the University of Pennsylvania.
- Defendant CCH filed a motion to dismiss McClure's claim under the Emergency Medical Treatment and Labor Act (EMTALA).
- Defendants Trustees of the University of Pennsylvania and Penn Valley Medicine Unionville filed a motion to dismiss the corporate negligence claims against them.
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Issue:
Does a hospital's significant delay in providing a medical screening to a patient who presents at the emergency department constitute a failure to provide an 'appropriate medical screening' under the Emergency Medical Treatment and Labor Act (EMTALA)?
Opinions:
Majority - Savage, District Judge
Yes, a significant delay in screening may be the functional equivalent of a denial of screening, which is sufficient to state a claim for failure to provide an 'appropriate medical screening' under EMTALA. The court reasoned that while EMTALA does not create a federal cause of action for medical malpractice based on a faulty diagnosis, it does create liability for a failure to screen. An inordinately delayed or wholly inadequate screening can be deemed a denial of screening altogether. McClure was not seen by medical personnel for nearly four hours after her arrival at the emergency room with symptoms of vomiting and vision problems. This delay is sufficient at the pleading stage to allege that she received no meaningful screening while her emergency condition deteriorated, distinguishing her claim from cases involving mere delays in treatment after an initial screening was performed. Therefore, the factual question of whether the delay amounted to a denial of screening must be resolved after discovery, not on a motion to dismiss.
Analysis:
This decision clarifies that an EMTALA 'failure to screen' claim is not limited to an outright refusal to see a patient but can also be established by a delay so significant that it constitutes a functional denial of a screening. This lowers the pleading burden for plaintiffs harmed by long emergency room wait times, allowing such cases to proceed to discovery rather than being dismissed at the outset. The ruling reinforces the critical distinction between a failure to screen (an EMTALA violation) and a faulty screening or delayed treatment after screening (a state medical malpractice claim), providing guidance for how courts should categorize claims based on emergency department delays.
