Cunningham v. Fredonia Regional Hosp., 1996 U.S. App. LEXIS 26661 (10th Cir. 1996)

The plaintiff presented to the emergency department of the defendant-hospital with chest pain, nausea, and shortness of breath. A physician examined the patient and concluded that she was not suffering from an emergency medical condition and discharged her home. Later, as the chest pain grew worse, the plaintiff visited her family physician, who prescribed a pain shot at the hospital. Upon returning to the hospital, the plaintiff was evaluated only by a nurse, and was again discharged. In the night, the plaintiff died of a heart attack.

The focus of the case was on whether the hospital followed its own procedures for similarly situated patients. There were two procedures that could have been applicable: one was a policy designed for individuals who present with “life-threatening symptoms of chest pain” and that required a physician to examine the patient, while the other appeared to be a standard screening policy for all individuals who had a “valid emergency illness/injury” that was not life-threatening and under which a nurse could perform the examination. The hospital argued that the second policy was applicable because the plaintiff’s complaints of chest pain were not deemed “life-threatening.” The trial court granted summary judgment for the hospital and the Tenth Circuit affirmed, finding (1) that there was no issue of fact as to whether the hospital’s policy was ambiguous, (2) that there was no issue of fact regarding the applicability of the policy, and (3) importantly, that the trial court did not improperly resolve a factual issue by crediting the testimony of the caregivers and determining that the plaintiff did not have potential life-threatening symptoms. With respect to the third argument, the court noted that “to determine the policy was inapplicable, the district court merely had to determine the Hopsital did not think Mrs. Cunningham had ‘potentially life-threatening symptoms’ of chest pain or a high possibility of morbidity.” Id. at *8 (emphasis added).

Notes: Stretching the limit of the “perceived” symptoms analysis. Under this case, it appears that plaintiffs have to work very hard to create issues of fact as to what the caregivers “perceived.”