Jackson v. East Bay Hospital

Opinion by Judge O’SCANNLAIN; Partial Concurrence and Partial Dissent by Judge TASHIMA.

We must decide, among other questions, whether a hospital violates the Emergency Medical Treatment and Active Labor Act (“EMTALA”) if it fails to diagnose the *1252 cause of a patient’s emergency condition, but treats the symptoms identified, and concludes that the patient has been stabilized.

I

This appeal arises out of Robert Jackson (“Jackson”)’s visits to the Redbud Community Hospital (“Redbud”) emergency room on April 2, 4, and 5, 1996, in Clearlake, California. Redbud entered into an “Association Agreement Regarding the Affiliation of Redbud Health Care District with Adventist Health Systems/West” (the “Association Agreement”) which became effective on July 5, 1995. This agreement stated that the parties anticipated a future affiliation, and that Adventist Health Systems/West (“Adventist”) would provide Redbud with administrative and financial services. On July 1, 1997, Adventist and Redbud entered into an “Agreement for Purchase and Sale of Assets” (the “Purchase Agreement”). Adventist currently operates Redbud.

On April 2, 1996, Jackson visited the Lake County Mental Health…

concurring in part and dissenting in part:

I concur in all of the majority opinion, except Part III. Because I believe that the majority’s interpretation of Cal. Health & Safety Code § 1317 is mistaken, I respectfully dissent from that portion of the opinion.

Cal. Health & Safety Code § 1317 (a). The statute defines “emergency services and care” as

Id. § 1317.1(a)(1). The statute also contains a “safe harbor” provision:

Id. § 1317(c). There is no California case law interpreting any of these provisions.

On its face, § 1317(c) provides that a health facility shall not be liable for refusal to provide medical services, if the refusal was based upon a determination either that the patient did not have an emergency medical condition or that the health facility could not provide appropriate services, as long as that determination was made with reasonable care. Jackson’s survivors contend that the negative implication of § 1317(c) is that a facility that fails to exercise reasonable care in its diagnostic procedures is liable under § 1317(a), i.e., that § 1317(e)’s safe harbor for diagnoses performed with reasonable care implies that § 1317(a) imposes liability for diagnoses…