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Sanders v. Palomar Medical Center

June 30, 2010


The opinion of the court was delivered by: Hon. Michael M. Anello United States District Judge


On April 22, 2010, Defendants Palomar Pomerado Health (erroneously sued as Palomar Medical Health) and Dr. Ryan L. Nelkin, M.D. filed separate motions to dismiss Plaintiff Paul M. Sanders' complaint. [Doc. Nos. 7, 8.] Plaintiff, proceeding pro se, submitted oppositions to both motions on June 7 [Doc. Nos. 10, 12] and Defendants submitted reply briefs on June 11 [Doc. Nos. 14, 15]. The Court found Defendants' motions suitable for decision on the papers and without oral argument pursuant to Civil Local Rule 7.1(d)(1) [Doc. No. 13]. For the reasons discussed below, the Court GRANTS both motions to dismiss.


This action arises from medical services Plaintiff received on December 7, 2009 at Palomar Medical Center ("PMC") in Escondido, California. [Complaint, Doc. No. 1 ¶¶4, 6-10, 12-13.]

PMC is owned and operated by Palomar Pomerado Health ("PPH").*fn1 [PPH Mot. to Dismiss, Doc. No. 8, p.2.] According to Plaintiff, he arrived at PMC's emergency room with chest pains and high blood pressure. [Doc. No. 1 ¶¶9-10.]*fn2 Dr. Nelkin evaluated Plaintiff upon arrival, but PMC "failed to provide an appropriate medical screening examination . . . [and] medical treatment necessary to stabilize Plaintiff's dangerously high Blood Pressure [sic]." [Id. at ¶¶16-17.] PMC then allegedly discharged Plaintiff in an unstable condition because he did not have medical insurance. [Id. at ¶17.] Plaintiff asserts the treatment he received on December 7 caused his condition to worsen, "causing him unnecessary physical and emotional pain." [Id. at ¶19.] On February 2, 2010, Plaintiff again went to the emergency room at PMC. [Id.] This time, however, Plaintiff had health insurance, and PMC admitted him "for 2 days and stabilized his symptoms of chest pains and unusually high Blood [sic] pressure." [Id.]

On March 10, 2010, Plaintiff filed the present action against PMC and Dr. Nelkin alleging five unspecified counts. [See Doc. No. 1, ¶¶14-32.] Although it is unclear which counts apply to which Defendant(s), or the cause of action Plaintiff purports to assert through each count, the parties agree Plaintiff attempts to allege three types of claims for: violations of the Emergency Medical Treatment and Active Labor Act ("EMTALA") (42 U.S.C. § 1395dd) and the Health Insurance Portability and Accountability Act of 1996 ("HIPAA"), and for medical malpractice.


A complaint survives a motion to dismiss if it contains "enough facts to state a claim to relief that is plausible on its face." Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007). The court reviews the contents of the complaint, accepting all factual allegations as true, and drawing all reasonable inferences in favor of the nonmoving party. Knievel v. ESPN, 393 F.3d 1068, 1072 (9th Cir. 2005). Notwithstanding this deference, the reviewing court need not accept "legal conclusions" as true. Ashcroft v. Iqbal, -- U.S. -- , 129 S.Ct. 1937, 1949 (2009). Moreover, it is improper for a court to assume "the [plaintiff] can prove facts that [he] has not alleged." Associated General Contractors of California, Inc. v. California State Council of Carpenters, 459 U.S. 519, 526 (1983). Accordingly, a reviewing court may begin "by identifying pleadings that, because they are no more than conclusions, are not entitled to the assumption of truth." Ashcroft, supra, 129 S.Ct. at 1950.

"When there are well-pleaded factual allegations, a court should assume their veracity and then determine whether they plausibly give rise to an entitlement to relief." Id. A claim has "facial plausibility when the plaintiff pleads factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged." Id. at 1949. "The plausibility standard is not akin to a 'probability requirement,' but it asks for more than a sheer possibility that a defendant has acted unlawfully." Id. "Where a complaint pleads facts that are 'merely consistent with' a defendant's liability, it 'stops short of the line between possibility and plausibility of entitlement to relief.'" Id. (citing Twombly, 550 U.S. at 557).



(A) Health Insurance Portability and Accountability Act of 1996

Plaintiff concedes he cannot state a claim under HIPAA because the statute "does not provide any private right of action." United States v. Streich, 560 F.3d 926, 935 (9th Cir. 2009); Pl.'s Opp. to PMC Mot. to Dismiss, Doc. No. 12, p.6. Because any attempt to amend would be futile, Plaintiff's HIPAA claim is DISMISSED as to all Defendants with prejudice.

(B) Emergency Medical Treatment and Active Labor Act

EMTALA is commonly known as the "Patient Anti-Dumping Act." Jackson v. East Bay Hospital, 246 F.3d 1248, 1254 (9th Cir. 2001). Congress enacted the statute in response to concerns "that hospitals were dumping patients who were unable to pay for care, either by refusing to provide emergency treatment to these patients, or by transferring the patients to other hospitals before the patients' conditions stabilized." Id. Accordingly, under EMTALA, hospitals must provide certain minimum care to individuals who come to the hospital's emergency department. Specifically, if an individual arrives at a hospital's emergency department and requests an examination or treatment for a medical condition, the hospital must provide for (1) "an appropriate medical screening examination" within its capabilities to determine if a medical condition as defined by 42 U.S.C. § 1395dd(e)(1) exists, and (2) treatment to stabilize the individual's condition. 42 U.S.C. § 1395dd(a)-(b); see also Jackson, 246 F.3d at 1254-55. Plaintiff asserts the care he received on December 7 at PMC's emergency department violated his rights under EMTALA because PMC and its doctors did not provide Plaintiff an appropriate medical screening examination and failed to ...

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