Marshall ex rel. Marshall v. E. Carroll Parish Hosp. Serv. Dist., 134 F.3d 319, 1998 U.S. App. LEXIS 1806 (5th Cit. 1998)

The patient was a fifteen-year-old girl who was brought the emergency room by ambulance. She was at school and “wouldn’t move.” In the emergency room, the patient was nonverbal, but was cooperative with staff. After a physician performed several tests, she was diagnosed with a respiratory infection and discharged. The patient’s failure to communicate was not diagnosed, but the family was advised to continue any medications prescribed by their family physician. Later that day, her symptoms worsened and she was brought to another hospital, who diagnosed a stroke.

The plaintiff alleged both failure to screen and failure to stabilize claims. First, regarding the failure to screen claim, the court found that affidavits submitted by representatives of the hospital showed that the patient was provided with a “standard” screening examination that would have been performed on any other patient, and an EMC was not identified. The plaintiff, however, also submitted an affidavit from a nurse who was at the ER that day, who stated that she had seen the ER physician and another nurse arguing about whether to discharge the patient. She also testified that similar patients had, in the past, been admitted for further testing. The court was not swayed, and found that the affidavit was conclusory and the nurse unqualified to testify as to standards for physicians. As such, the plaintiff could not overcome the affidavits submitted by the hospital in support of the summary judgment motion. Second, the failure to stabilize claim was also dismissed, given that the hospital did not have actual knowledge of an EMC.

Notes: This is a case where the court was faced with conflicting affidavits from the respective sides regarding what a “standard” screening evaluation was. Because the court found the plaintiff’s nurse unqualified to testify as to testify about symptoms and treatment of this patient as compared to others, this case reinforces the concept that an EMTALA claim must be supported by expert testimony.