Beller v. Health & Hosp. Corp. of Marion Cnty., Ind. (Summary)

EMTALA

Beller v. Health & Hosp. Corp. of Marion Cnty., Ind., No. 11-3691 (7th Cir. Dec. 20, 2012)

The United States Court of Appeals for the Seventh Circuit affirmed a district court’s grant of summary judgment to an ambulance service and its affiliated entities in a lawsuit alleging that the ambulance service had violated EMTALA by transferring a mother in labor rather than stabilizing her by delivering her child, which resulted in the baby suffering severe brain damage from hypoxia.

The appeals court stated that the core issue in the case was whether the 2001 or 2003 regulatory definition of when a person is deemed to have “come to the emergency room” applies.  The 2001 regulation stated that “comes to the emergency department” included “ambulances owned and operated by the pertinent hospital, even if not on hospital grounds.”  The 2003 regulation provided that “an individual in an ambulance owned and operated by the hospital is not considered to have ‘come to the hospital’s emergency department’ if…the ambulance is operated under the communitywide emergency medical service protocols.”

An agency’s regulation or rule that clarifies an unsettled or confusing area of law may be applied retroactively. The district court found that the 2003 regulation was just such a clarification (and not a substantive change) in regard to the term “comes to the emergency department.”  The appeals court agreed and ruled that because the ambulance was operating under the EMS protocol when the plaintiffs were in it, the plaintiffs had not “come to the emergency department” and EMTALA did not apply.