Psychiatric Hospital Can’t Shake Emergency Treatment Claims

Stay ahead of developments in federal and state health care law, regulation and transactions with timely, expert news and analysis.

By Matthew Loughran

An Indiana psychiatric hospital without its own emergency department couldn’t dismiss claims it violated a federal emergency treatment law in dealing with a suicidal individual ( Stewart v. Parkview Hosp., Inc. , 2017 BL 377357, N.D. Ind., No. 1:16-cv-138, 10/20/17 ).

Parkview Hospital Inc. in Fort Wayne, Ind., failed in an effort to dismiss claims that its inpatient psychiatric hospital, Parkview Behavioral Health Hospital, violated the Emergency Medical Treatment and Labor Act (EMTALA) by following the hospital’s policy for after-hours emergency patients and directing the man, Tyquan Stewart, to the nearby emergency department at Parkview Randallia Hospital. Instead of going to Randallia, Stewart crashed his car into a building in an attempt to commit suicide.

Under EMTALA, any hospital that has an emergency department can’t turn away an individual with an emergency condition before performing a proper screening examination and necessary stabilization treatment. The U.S. District Court for the Northern District of Indiana said Oct. 20 that the existence of an affiliated emergency department less than a mile away from Parkview Behavioral Health may have triggered the law’s duty to screen and stabilize Stewart instead of sending him out to find the emergency department on his own.

“This is a very straighforward reading of the law,” David W. Frank, an attorney with Christopher C. Myers & Associates in Fort Wayne, Ind., who represented Stewart, told Bloomberg Law. “If you show up at the hospital property and request emergency care, you’ve done your duty as a patient under EMTALA, and the hospital can’t then turn around and say that’s not good enough.”

Representatives for Parkview didn’t respond to Bloomberg Law’s request for comment.

Suicidal Patient

Stewart drove to Parkview Behavioral Health in the early morning hours of Dec. 20, 2015, and asked to be admitted, claiming he was having suicidal thoughts. Under a hospital policy at the time, the security guard on duty denied him access and told him to go to Parkview Randallia for admission, because that facility had a 24-hour emergency department.

Shortly after that, Stewart drove his car into an apartment building in an effort to commit suicide. Police who arrived on the scene took him to Parkview’s main campus for admission where he was detained for the next four days.

“This was someone who the hospital knew had a long history of mental illness,” Frank said. “He had PTSD [post-traumatic stress disorder], he had literally almost been shot to death earlier, he had been treated at the hospital before and here he was, driving up to the door of the mental health hospital, notifying them that he was suicidal and that he planned on using his car to commit suicide, and they told him to go away and use his car to go to another hospital a mile away.”

Four months after the incident, Stewart brought a civil rights suit against a variety of state and county officials for conditions in the Allen County Jail and the Indiana State Prison, but he included a claim for “malpractice” against Parkview for denying his request for admission to the behavioral health hospital. Later amended versions of the complaint refined that claim to include EMTALA violations against the hospital and state-law negligence claims against the security guard who directed him away.

Sometime after the incident, Parkview changed its policy on after-hours arrivals at the behavioral health hospital to require the hospital to transport any individuals to Randallia for admission to the emergency department.

Not Medical Malpractice

In addition to allowing the EMTALA claim to survive pretrial judgment, the court also refused to dismiss the negligence claims Stewart asserted against the hospital’s security guard.

The hospital had argued that a negligence claim against the hospital or its employees for failure to treat was governed by the Indiana Medical Malpractice Act and thus Stewart was required to bring his claims to the state Department of Insurance before bringing a claim in federal court.

The court disagreed, saying Stewart was never admitted and thus never qualified as a patient of the hospital under the medical malpractice statute.

“Negligence is a state-by-state thing, but this is something that is necessarily going to be intertwined with EMTALA,” Frank said. “If you show up at the hospital and someone turns you away without any screening or treatment, of course it can’t be a medical malpractice claim. They’ve denied you the status of being a patient in the first place.”

Frank said the case reflected the treatment gap that mentally ill patients are facing.

“We have a growing awareness of the need to take mental health seriously and to listen to the people who have that disability,” he said. “We have to listen to them and treat them seriously and not as just a burden on society.”

Stewart is represented by Christopher C. Myers & Associates in Fort Wayne, Ind. Parkview is represented by Rothberg Logan & Warsco LLP in Fort Wayne, Ind.

To contact the reporter on this story: Matthew Loughran in Washington at mloughran@bna.com

To contact the editor responsible for this story: Brian Broderick at bbroderick@bna.com

For More Information

The court's opinion is at http://src.bna.com/tAY.

Copyright © 2017 The Bureau of National Affairs, Inc. All Rights Reserved.

Request Health Care on Bloomberg Law