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CAVENDER v. SUTTER LAKESIDE HOSPITAL

September 6, 2005.

MARY LOU CAVENDER, Plaintiff,
v.
SUTTER LAKESIDE HOSPITAL, INC., Defendant.



The opinion of the court was delivered by: MAXINE CHESNEY, District Judge

ORDER GRANTING IN PART AND DENYING IN PART DEFENDANT'S MOTION FOR SUMMARY JUDGMENT; DENYING PLAINTIFF'S MOTION FOR PARTIAL JUDGMENT; DISMISSING PLAINTIFF'S STATE LAW CLAIMS; VACATING HEARING.
Before the Court is defendant Sutter Lakeside Hospital, Inc.'s motion for summary judgment, pursuant to Rule 56 of the Federal Rules of Civil Procedure, and plaintiff Mary Lou Cavender's motion for partial judgment of liability, pursuant to Rule 56. Having reviewed the papers filed in support of and in opposition to the motions,*fn1 the Court deems the matters suitable for decision on the papers, VACATES the hearing scheduled for September 2, 2005, and rules as follows. BACKGROUND*fn2

On July 30, 2003, at approximately 10:30 p.m., Roderick Cavender ("Roderick") took his mother, plaintiff Mary Lou Cavender, then 80 years of age, to defendant's emergency room ("ER"), because plaintiff had been slurring her speech during the day. (See Roderick Decl. ¶¶ 1, 2.)*fn3 Roderick is not plaintiff's legal guardian, nor does he hold a power of attorney. (See Roderick Dep. at 12:3-5.)*fn4 Later that evening, Roderick was informed that plaintiff had suffered a stroke, had extremely high blood pressure and needed to be hospitalized immediately. (See Roderick Decl. ¶ 2.) At 1:30 a.m. on July 31, 2003, plaintiff was admitted to defendant's medical/surgical ward for "observation and cerebral vascular accident work-up." (See Lovejoy Decl. ¶ 2.)

  On July 31, 2003, plaintiff was given a chest x-ray, an ultrasound and other tests. (See id. ¶ 4.) That same day, plaintiff's physician, Kirk G. Andrus, M.D. ("Dr. Andrus"), examined plaintiff and formed the opinion that her stroke symptoms had "stabilized." (See Andrus Dep. at 28:20-23.)*fn5 In his notes, Dr. Andrus wrote that plaintiff "does not go to physicians and wants to go home to be with her grandson," (see Lovejoy Decl. Ex. A at 17th unnumbered page), and that he had "spent a great deal of time" talking to plaintiff about the need for her to stay in the hospital to receive treatment, (see id. Ex. A at 19th unnumbered page). At his deposition, Dr. Andrus was of the opinion that if plaintiff's condition had remained stable for 24 hours, and had she wanted to leave, she would have been discharged "within a day or two," provided that the results of a echocardiogram did not show anything "really urgent." (See Andrus Dep. at 34:20-35:6.)

  Roderick visited with plaintiff most of the day of July 31. (See Roderick Decl. ¶ 3.) When Roderick left the hospital at approximately 10:00 p.m. that evening, plaintiff was resting comfortably and was "hooked up" to medical monitoring devices. (See id.) At 11:00 p.m. that evening, defendant's nursing staff noted that plaintiff was in bed, but at 1:00 a.m. on August 1, observed that plaintiff was not in her room, and notified both plaintiff's physician and plaintiff's daughter that plaintiff had left the hospital. (See Lovejoy Decl. ¶ 4, Ex. A at 27th unnumbered page.) At approximately 1:15 a.m., Roderick was notified by his sister, plaintiff's daughter, that plaintiff was not at the hospital, after which Roderick contacted Robert Cavender ("Robert"), who is Roderick's father and plaintiff's ex-husband. (See Roderick Decl. ¶¶ 4-5.) Robert and Roderick then went to the hospital. (See id. ¶ 5.)

  Meanwhile, at the hospital, Patricia Williams ("Williams"), a certified nursing assistant, went to look for plaintiff by car and, accompanied by another nursing assistant, found plaintiff in a "ditch across the street from the back of the hospital," where they waited until help arrived. (See Williams Dep. at 15:2-20.)*fn6 Plaintiff had dressed herself before leaving the hospital and was not wearing a hospital gown. (See Smith Dep. at 33:9-10.)*fn7 Two men arrived with an ambulance and they, along with Williams, helped plaintiff up from the ditch and set her down on a gurney. (See Williams Dep. at 21:2-23.) Plaintiff, however, refused to get into the ambulance. (See id. at 21:24.) At this point, Williams, in an effort to convince plaintiff to get into Williams' car, told plaintiff that if she got in, Williams would "try not to take her back there." (See id. at 22:1-8.) After plaintiff got into the car, Williams drove plaintiff back to the hospital and parked outside of the ER door. (See id. at 22:1-2, 22-23.) Plaintiff stated to Williams that she "didn't want to go back in there." (See id. at 25:15-21.) The ER staff, including nurse Tina Smith ("Smith"), then came out of the ER with a wheelchair; Smith helped plaintiff out of Williams' car and put plaintiff in the wheelchair. (See id. at 23:1-18.) Smith, observing that plaintiff had a "hematoma" on her head, tried to encourage plaintiff to allow herself to be evaluated in the ER, but plaintiff refused. (See Smith Dep. at 29:9-13.) When Smith then stated, "just let me take you in and try to clean you up a little bit," plaintiff agreed and allowed Smith to take her into the building by wheelchair. (See id. at 37:2-5, 39:13-21.) After plaintiff was inside, Pamela Canfield, an ER registration clerk, asked plaintiff to sign a form giving defendant permission to treat her; plaintiff refused. (See Canfield Dep. at 9:14-15.)*fn8 Further, once Smith had obtained wet cloths to attempt to remove "a little bit of blood" on plaintiff's forehead, plaintiff would not allow Smith to clean her, and began yelling, "No, I'm not staying"; "You are just trying to get me to stay here"; "I want to go"; "Get me outside"; and "If you don't take me outside, I will go out myself." (See Smith Dep. at 35:15-19, 37:6-25.) When Smith advised plaintiff that she needed to stay and be evaluated by a physician and that plaintiff had previously been admitted to the hospital for a reason, plaintiff stated she did not want to stay and there was no reason for her to stay. (See id. at 35:24-36:5, 46:4-10.) Smith did not conduct a "triage assessment," as she "was not able to get [plaintiff's] vital signs," nor was she able "to take a stethoscope and listen to her lungs" or "to take a pen light and evaluate her pupils." (See id. at 42:21-43:5.) Smith did conduct, however, a mental orientation test, by propounding to plaintiff a series of questions, asking her if she knew what year it was, what her name was, where she was, who the president was, and who her primary care physician was, all of which questions plaintiff answered correctly; based on this assessment, Smith formed the opinion that plaintiff was mentally competent. (See id. at 41:18-25, 42:4-6.)

  Plaintiff got up from the wheelchair, as though she was going to attempt to walk out of the ER, and stated to Smith, "If you don't take me outside, I will walk out." (See id. at 44:19; 45:6-14.) Smith, having been informed by someone in the ER that plaintiff's family was coming to the hospital, then took plaintiff outside in the wheelchair and waited beside her. (See id. at 45:13-14, 54:8-25.) When Roderick and Robert arrived, they saw plaintiff seated in a wheelchair, with a security guard, Smith, and defendant's head nurse, Alden Rabb, R.N. ("Rabb") standing around plaintiff. (See Roderick Decl. ¶ 5.) Both Roderick and Robert made comments to indicate they wanted defendant to keep plaintiff, and Rabb and Smith stated that they could not keep plaintiff.*fn9 (See id. ¶¶ 6-7; Robert Decl. ¶ 4;*fn10 Smith Dep. at 55:8-16, 55:24-56:4, 57:13-16.) After a heated discussion about whether defendant would or could keep plaintiff, Smith helped plaintiff to Robert's car, and Roderick and Robert took plaintiff home. (See Roderick Decl. ¶¶ 7-8.)

  At some point during the above-described incident in the ER on August 1, 2005, plaintiff was presented with a form titled "Leaving Hospital Against Medical Advice," indicating that plaintiff was voluntarily leaving the hospital against the advice of Dr. Andrus; the form bears the signatures of Smith and Raab as witnesses to plaintiff's refusal to sign the form. (See Lovejoy Decl. Ex. B.) Thereafter, Dr. Andrus wrote a report titled "Discharge Summary," in which he noted: "Patient left hospital against medical advice 8/1/03." (See id. Ex. A, 14th unnumbered page.)*fn11

  Late in the evening of August 2, 2003, while plaintiff was at home, plaintiff's daughter called Roderick to advise him that "something else had happened" to plaintiff. (See Roderick Decl. ¶ 6.) At 1:30 a.m. on August 3, 2003, plaintiff was readmitted to defendant hospital, where it was determined plaintiff had suffered a second stroke. (See id.)

  LEGAL STANDARD

  Rule 56 provides that a court may grant summary judgment "if the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law." See Fed.R. Civ. P. 56(c).

  The Supreme Court's 1986 "trilogy" of Celotex Corp. v. Catrett, 477 U.S. 317 (1986), Anderson v. Liberty Lobby, Inc., 477 U.S. 242 (1986), and Matsushita Electric Industrial Co. v. Zenith Radio Corp., 475 U.S. 574 (1986), requires that a party seeking summary judgment show the absence of a genuine issue of material fact. Once the moving party has done so, the nonmoving party must "go beyond the pleadings and by her own affidavits, or by the `depositions, answers to interrogatories, and admissions on file,' designate `specific facts showing that there is a genuine issue for trial.'" See Celotex, 477 U.S. at 324 (quoting Rule 56(c)). "When the moving party has carried its burden under Rule 56(c), its opponent must do more than simply show that there is some metaphysical doubt as to the material facts." Matsushita, 475 U.S. at 586. "If the evidence is merely colorable, or is not significantly probative, summary judgment may be granted." Liberty Lobby, 477 U.S. at 249-50 (citations omitted). When determining whether there is a genuine issue for trial, "`inferences to be drawn from the underlying facts . . . must be viewed in the light most favorable to the party opposing the motion.'" See Matsushita, 475 U.S. at 587 (quoting United States v. Diebold, Inc., 369 U.S. 654, 655 (1962)).

  DISCUSSION

  In her complaint, plaintiff brings a federal claim against defendant under the Emergency Medical Treatment and Active Labor Act ("EMTALA"), 42 ...


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