Hardy v. New York City Health and Hospitals Corp., 164 F.3d 789, 1999 U.S. App. LEXIS 567 (2d Cir. 1999)

The patient had a long history of hypertension, and she presented to the hospital’s ER with complaints of nausea, vomiting, dizziness, diarrhea, and high blood pressure for the past several days. Because her symptoms persisted, she was brought by ambulance to another hospital’s ER. After arriving, the patient’s blood pressure increased to 195/143. She was given medication, which reduced her BP, and she was discharged with instructions to have her BP checked daily for a week and to follow-up with her Primary Care Physician. One day later, an ambulance was called to the patient’s home, and was suffering from a stroke. She was admitted, but became partially paralyzed and permanently disabled.

The plaintiff filed negligence and EMTALA claims for failure to screen and stabilize. Because the hospital she was sent to was owned by the State, the defendants argued that the plaintiff was required to file a notice of claim, as required by statute. The hospital, however, failed to plead this affirmative defense in its answer. First, the court analyzed whether the state notice of claim provision could act as a bar to the EMTALA claims. The court employed a broad reading of the civil enforcement provision of EMTALA, 42 U.S.C. § 1395dd(d)(2)(A), finding that the state notice was part of the “law of the State in which the hospital is located,” given Congress’s concern with supplanting state medical malpractice law and remaining mindful of the perceived “medical malpractice crisis” that prompted many states to enact specific legislation for these claims. The court rejected an alternate argument from the plaintiff that EMTALA preempted the notice statute, finding that “New York’s notice-of-claim law does not thwart EMTALA’s purpose. Instead [the requirement] simply addresses a concern that [EMTALA] does not, namely the historical concern of governmental bodies that they be given reasonably prompt notice of tort claims against them.”