Woman claims hospital did not offer appropriate exam

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Where a woman alleged that she went to a hospital emergency room with infected sores and a variety of symptoms, but that she did not receive the type of screening that the hospital would ordinarily conduct for patients with the same symptoms, she plausibly alleged a claim for violation of the Emergency Medical Treatment and Active Labor Act.

Background

Jolena Renea Sorbara brought this action against Carilion Rockbridge Community Hospital and two of its employees, alleging that the hospital failed to provide her with either an appropriate medical screening examination or the treatment required to stabilize her deep tissue infections in violation of the Emergency Medical Treatment and Active Labor Act, or EMTALA, and that both Carol Bernier (a physician in Carilion Rockbridge’s emergency department) and William Ferrell (a physician assistant in the same department) committed medical malpractice in violation of Virginia state law. Pending before the court is defendants’ motion to dismiss.

Failure to screen

Sorbara alleges that she reported to the Carilion Rockbridge emergency room requesting examination/treatment of infected sores on her right index finger and right thigh, chills, nausea, and a fever, and further reported a “previous ‘severe’ MRSA infection.” Given that medical information, Carilion Rockbridge would then be obligated under EMTALA to provide a “medical screening examination within the capability of [its] emergency department” that is appropriate for the condition and symptoms identified.

Sorbara alleges that the “normal screening examination” that Carilion Rockbridge “routinely provide[s]” to patients presenting as she did is “to obtain a specimen to culture to determine what type of bacteria is causing the infection.” And finally, she asserts that Carilion Rockbridge failed to provide such a screening.

To be sure, many of the complaint’s factual allegations are confusingly worded. For example, in several paragraphs the complaint provides different descriptions of Sorbara’s “emergency medical condition” with varying levels of specificity. This introduces some ambiguity as to the precise state in which Sorbara presented at the Carilion Rockbridge—especially considering the later allegation that Sorbara’s visit diagnosis only reflects an “abscess of [the] right finger of [the] right hand (primary)” and an “abscess of [the] right leg.”

But at bottom, she does allege that she presented with infected sores and a variety of symptoms yet did not receive the type of screening that Carilion Rockbridge would ordinarily conduct for patients so presenting. Whether Sorbara will ultimately be able to marshal evidence to that end at trial or in opposition to a motion for summary judgment is unclear, especially given the extent to which her allegations are based “upon information and belief.”

Failure to stabilize

However, with respect to the EMTALA failure-to-stabilize claim, Sorbara’s scattered allegations are deficient. In claiming that Carilion Rockbridge failed to treat her, Sorbara described the mode of treatment that the hospital would normally employ for a patient with “multiple deep tissue infections producing pus-filled abscesses, chills, and fever.” But according to the complaint, the hospital’s diagnosis of Sorbara only reflected an “abscess of [the] right finger of [the] right hand (primary)” and an “abscess of [the] right leg.”

Sorbara’s claim is, in essence, that she was not treated in the same manner as Carilion Rockbridge would ordinarily treat someone with multiple deep tissue infections—a condition which, according to Sorbara’s own complaint, the hospital never diagnosed. Because the hospital is not obligated to treat conditions it does not detect, Sorbara’s failure-to-stabilize claim must fail as a matter of law.

Malpractice claims

Because the federal EMTALA claim in Count One will survive the motion to dismiss with respect to a failure-to-screen theory, the court has not dismissed all claims over which it has original jurisdiction. Finding no other “compelling reasons for declining jurisdiction,” the court will exercise supplemental jurisdiction over Counts Two and Three.

Defendants’ motion to dismiss granted in part, denied in part.

Sorbara v. Carilion Rockbridge Community Hospital, Case No. 7:23-cv-00078, Aug. 28, 2023. WDVA at Roanoke (Dillon). VLW 023-3-515. 10 pp.