Repp v. Anadarko Mun. Hosp., 43 F.3d 519, 1994 U.S. App. LEXIS 35640 (10th Cir. 1994)

The patient made an outpatient visit to her physician complaining of a rash. He was diagnosed with shingles and prescribed medication. That same day, he experienced increased pain in his left arm, and he presented to the emergency room. He was examined by two nurses, who recorded vital signs and noted a previous cardiac bypass surgery. One of the nurses telephoned the patient’s physician whom he had seen the prior day, and the nurse was instructed to give certain injections of medication. The patient was discharged and he died in his sleep later that night of cardio-pulmonary arrest.

The plaintiff brought a failure to screen claim against the hospital and the individual physician. The physician was dismissed given that an EMTALA claim can only be brought against a qualifying hospital, a decision that was not challenged on appeal, and the hospital was also granted summary judgment on the screening claim. First, the court found that the plaintiff alleged that the nurses did not take a complete examination and did not ask the patient for a complete list of medications that he was taking. The hospital’s policy required that the patient we questioned on, among other things, pre-existing conditions, medications, and allergies. However, the court found that the nurses questions touched on both of these subjects, and that “these minimal variations from the hospital’s emergency room policy did not amount to a violation of the hospital’s standard screening procedures.” Id. at 523.

Notes: A short case with little analysis. However, the decision is notable for the deference it appeared to give the hospital staff in applying its own screening procedures. The court found that de minimis deviations from policy will not serve to establish a cognizable screening claim, finding that the particular conditions of each particular patient allows for some variability. This opinion is disparate from opinions in other Circuits that have applied the screening requirement more strictly.