Federal District Court Rules New Jersey Medical Malpractice Cap Applies In EMTALA Case

New Jersey Medical Malpractice Cap Applies In EMTALA Case: The United States District Court for the District of New Jersey Camden Vicinage (“federal court”) stated in its Memorandum Order filed on April 26, 2023: “Under § 1395dd(d)(2)(A), an individual who suffers harm as a direct result of an EMTALA violation is entitled to obtain those damages that are “available for personal injury under the law of the State in which the hospital is located.” Because damages exceeding $250,000 would not be available if Plaintiff’s EMTALA claim were brought as a malpractice claim under New Jersey law, the Court will limit the liability of Defendants Cape Regional Medical Center and Cape Regional Health System accordingly.”

EMTALA

In 1986, Congress enacted EMTALA to address concerns that hospitals, due to economic constraints, were refusing to treat certain persons with emergency medical conditions or transferring them to other institutions, especially where such persons lacked health insurance. In response, Congress required hospitals to provide medical screening and stabilizing treatment to all individuals who present to emergency departments for care, and it empowered aggrieved individuals to bring private civil actions to recover damages.

Pursuant to 42 U.S.C. § 1395dd (EMTALA), participating hospitals are required to provide certain types of medical care to individuals who present for emergency treatment: (a) appropriate medical screening, (b) stabilization of known
emergency medical conditions and labor, and (c) restrictions on transfer of unstabilized individuals to outside hospital facilities. If the hospital determines that an individual presents with an “emergency medical condition” pursuant to the medical screening requirements of the statute, then the hospital must provide one of the following: (A) within the staff and facilities available at the hospital, for such further medical examination and such treatment as may be required to stabilize the medical condition; or (B) for transfer of the individual to another medical facility in accordance with subsection (c). Under subsection (c), a hospital may not transfer an individual with an emergency medical condition that has not been stabilized, subject to a few exceptions.

An emergency medical condition is “stabilized” within the meaning of EMTALA if no material deterioration of the condition is likely, within reasonable medical probability, to result from or occur during the transfer of the individual from a facility. The exceptions: generally, a hospital may transfer an individual whose emergency medical condition has not been stabilized if (i) the individual consents in writing, or (ii) a physician certifies at the time of transfer that “the medical benefits reasonably expected from the provision of appropriate medical treatment at another medical facility outweigh the increased risks to the individual,” or (iii) another qualified medical professional so certifies after consulting with a physician.

While an EMTALA action is distinct from a medical malpractice action under state law (EMTALA and medical malpractice under state law require a plaintiff to prove different elements), EMTALA specifically authorizes any individual who suffers personal harm as a direct result of a hospital’s violation of the statute to “obtain those damages available for personal injury under the law of the State in which the hospital is located.” 42 U.S.C. §1395dd(d)(2)(A).

in New Jersey, a plaintiff may not recover more than $250,000 from a nonprofit hospital in a civil action based on the negligence of the hospital’s agents or employees. Damages in excess of the cap are not available under state law.

The federal court stated in the case before it: “Here, the parties do not dispute that Defendants Cape Regional Medical Center and Cape Regional Health System are nonprofit entities that are organized exclusively for hospital purposes. The only question is whether EMTALA incorporates § 2A:53A–8 … To determine whether a state law limitation (such as a malpractice damages cap) applies, a court must consider how the EMTALA claim would be construed if brought under state law.”

“Here, this Court concludes that the cap on damages contemplated by N.J.S.A. § 2A:53A–8 extends to Plaintiff’s failure-to-stabilize claim under EMTALA. Plaintiff has already conceded that the state law limitation applies to his medical malpractice claims, as such claims are professional negligence claims plainly within the ambit of §2A:53A–8. [Pl.’s Opp’n 3, Docket No. 106.] Even though a failure-to-stabilize claim under EMTALA is not a negligence claim per se, Torretti, 580 F.3d at 173–74, the underlying conduct that forms the basis of Plaintiff’s claims against Defendants Cape Regional Medical Center and Cape Regional Health System is integrally connected to the Individual Defendants’ alleged malpractice and involves medical judgment and consideration of expert testimony to determine whether the Decedent was “stabilized.” See Smith, 419 F.3d at 519 (“compliance with EMTALA’s stabilization requirements entails medical judgment . . . understood . . . only through expert testimony) … Just as expert testimony is critical to understanding whether an individual who presents to a hospital with an emergency medical condition was “stabilized” within the meaning of EMTALA at the time of transfer, see Smith, 419 F.3d at 519, expert testimony is typically required in malpractice cases in New Jersey for the trier of fact to determine whether a medical provider breached a duty of care. … This Court concludes that Plaintiff’s failure-to-stabilize claim would constitute a malpractice claim if brought under New Jersey law, notwithstanding the fact that the claim does not require Plaintiff to prove the elements of professional negligence here.”

“Accordingly, just as a malpractice claim is subject to the cap on damages identified in § 2A:53A–8 … Plaintiff’s failure-to-stabilize claim shall be similarly limited. Plaintiff may only “obtain those damages available for personal injury” under New Jersey law, and damages in excess of $250,000 are not “available” pursuant to § 2A:53A–8. Therefore, if a jury finds that Defendants Cape Regional Medical Center and Cape Regional Health System violated EMTALA, any damages awarded to Plaintiff will be limited to $250,000.”

Kaye v. Nussey, Civil No. 20-9413 (RMB/SAK).

If you or a loved one may have been injured (or worse) as a result of hospital negligence in New Jersey or in another U.S. state, you should promptly find a New Jersey medical malpractice lawyer, or a medical malpractice lawyer in your state, who may investigate your hospital malpractice claim for you and represent you or your loved one in a hospital malpractice case, if appropriate.

Click here to visit our website or call us toll-free in the United States at 800-295-3959 to find medical malpractice attorneys in your state who may assist you.

Turn to us when you don’t know where to turn.