Emergency Medical Treatment & Labor Act (EMTALA); Prima facie claim under 42 USC § 1395dd; Cleland v Bronson Health Care Group, Inc (6th Cir); Causation & expert testimony; MCR 2.116(C)(10); Galuten v Williamson Cnty Hosp Dist (Unpub 6th Cir)

The court held that plaintiff stated a prima facie EMTALA claim, so summary disposition under MCR 2.116(C)(8) was improper. However, if found that summary disposition under MCR 2.116(C)(10) was proper because plaintiff failed to create a factual question that the alleged EMTALA violation caused Mr. O’Brien’s death. Mr. O’Brien arrived at defendant-Trinity’s emergency department with a Type A aortic dissection, was accepted for transfer to Trinity Ann Arbor, and then had to be transferred again to the University of Michigan after Trinity’s vascular surgeon became unavailable, but he died during that transfer. The trial court dismissed the suit on multiple grounds, including failure to state an EMTALA claim and lack of factual support. On appeal, the court first held that the complaint was legally sufficient because a prima facie EMTALA stabilization-or-transfer claim requires allegations that the hospital was covered by EMTALA, the patient sought treatment, the hospital had actual knowledge of an emergency medical condition, the hospital committed “one or more EMTALA violations,” and the plaintiff suffered “personal harm as the result of the hospital’s EMTALA violation[.]” The court next held, however, that plaintiff failed on causation at the summary-disposition stage because the key question was whether the physician’s erroneous certification that Mr. O’Brien was stabilized, while otherwise transferring him under a statutory exception, “caused Mr. O’Brien to die, as opposed to the aortic dissection itself.” The court explained that a causation opinion on this issue “would require familiarity with the medical conditions, timing, and treatment issues,” that it turned on “questions of medical judgment beyond a jury’s common knowledge,” and that plaintiff offered “no evidence of causation, let alone expert testimony of same.” Because of that failure, the court affirmed dismissal under MCR 2.116(C)(10). Affirmed in part and reversed in part.