Stafford v. Burns – 12/29/2016

December 13, 2016

Arizona Court of Appeals Division One holds that heightened burden of proof for medical malpractice claims for “services in compliance with” EMTALA includes services after screening where patient was deemed not to have a medical emergency.

Arizona law requires proof by clear and convincing evidence of malpractice claim against a health professional providing “services in compliance with the Emergency Medical Treatment and Active Labor Act” (EMTALA).  A.R.S. § 12-572(A).  EMTALA requires hospitals to provide certain services to patients who go to an emergency room, including screening to determine if a patient is in an emergency medical condition and stabilizing the patient.  Parents brought a medical malpractice claim against the emergency room doctor who tested, evaluated, and monitored—but did not screen—their son for possible methadone overdose, claiming that the doctor misdiagnosed their son’s condition as stable and wrongly discharged him from care.  The jury, after being instructed that the parents needed to prove negligence by clear and convincing evidence, returned a verdict in the doctor’s favor.

On appeal, the parents raised two issues of first impression.  First, they asserted that the heightened burden of proof for EMTALA-related malpractice claims did not apply because their son had been screened and deemed not to have an emergency medical condition prior to the doctor’s treatment.  The court rejected this narrow interpretation of the statute, concluding that “services in compliance with” EMTALA included services performed after screening and stabilization where a patient’s condition could fluctuate.  The court was also guided by other court decisions holding that EMTALA imposed continuing obligations on the hospital after a patent is admitted for inpatient care.  A broad reading of the statute also served the policy goal of creating a more “inviting legal environment for emergency medical providers.”

Second, the parents argued that their failure to recover more than the $10,000 judgment offered by defendant did not warrant Rule 68(g) sanctions because that offer was not made in “good faith” and was not “reasonable” compared to the lawsuit’s probable damages.  The court rejected this argument, holding that Rule 68(g) does not impose a good faith requirement, and the parties themselves must prudently assess the risks and benefits of proceeding to trial after an offer of judgment has been made.

Judge Jones delivered the opinion; Judges Howe and Kessler concurred.