Should State Malpractice Damages Caps Apply in Federal EMTALA Actions?


Hospitals should take note of a case pending in the U.S. Court of Appeals for the Fifth Circuit concerning the applicability of state medical malpractice damages caps to claims under the federal emergency treatment law.

The appeal, Scott v. N. La. Med. Ctr., 5th Cir., No. 17-30301, appeal filed 4/17/17, questions whether claims under the Emergency Medical Treatment and Labor Act (EMTALA) are subject to damages caps present in Louisiana’s medical malpractice law.

“This is one of those cases to watch, because if it gets escalated and the U.S. Supreme Court decides the state medical malpractice caps don’t apply, hospitals can be liable for some serious damages under EMTALA,” Nathan A. Kottkamp, a health-care attorney at McGuireWoods LLP in Richmond, Va., told me.

Under EMTALA, a hospital can be held liable by an injured patient or her family if the hospital failed to follow regular procedures to diagnose and stabilize an emergency room patient. If a hospital is found to have not followed proper procedures, it could be liable for substantial damages to the patient or her family.

The parents of a young girl who was paralyzed after a hospital allegedly failed to properly diagnose an injury to her spinal cord filed the appeal after Judge S. Maurice Hicks of the Western District of Louisiana, in Monroe, ruled the damages payable for their EMTALA claims could be capped by the state law because the failure to diagnose was included in the state’s definition of malpractice.

In permitting an immediate appeal of his order, Hicks noted how his decision contrasted with a 2005 decision by Judge Helen Berrigan of the U.S. District Court for the Eastern District of Louisiana, in New Orleans, in which the damages caps were found not to apply to an EMTALA claim.

Kottkamp told me these differences in federal district court opinions within the same state are a symptom of EMTALA itself.

“Certain parts of EMTALA are extremely well defined, the law was not meant to replace the substantive medical malpractice standards of a particular state,” he said. “And similarly it is clear that EMTALA uses a malpractice standard, but it is more of a procedural malpractice standard.”

Given the stakes for hospitals and the uncertainty built into EMTALA itself, it seems that hospitals and attorneys who counsel them would be wise to watch how this case progresses.

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