Preston v. Meriter Hospital in the Supreme Court of Wisconsin.

• Author: Bostrom, Barry A.
• Position: Medical malpractice

HOLDING: When a baby is born in a hospital birthing center, the newborn has come to the "emergency department" for purposes of the Emergency Medical Treatment and Active Labor Act (EMTALA). Thus, the hospital must provide "an appropriate medical screening examination" to any infant born at the hospital birthing center in order to determine whether the infant has an emergency medical condition.

Preston arrived at Meriter Hospital in Madison, Wisconsin, on November 9, 1999, at 5:33 p.m. She was 23 weeks pregnant. At the time of her hospitalization, she was unemployed and on Medical Assistance. Preston was admitted to the hospital and taken to the birthing center. There, physicians performed an ultrasound to evaluate the unborn child's condition. At 3:55 a.m. the following morning, Preston gave birth to a son whom she named Bridon Michael Johnson. The child weighed 700 grams. The hospital staff made no attempt to prolong the baby's life. Bridon died two and a half hours later.

Shannon Preston and Charles Johnson, in their personal capacity and as personal representatives of their son Bridon's estate, filed a complaint asserting four claims against Mertter Hospital and the Wisconsin Patients Compensation Fund. They sued Meriter for (1) medical negligence; (2) failure to obtain informed consent; (3) neglect of a patient, contrary to Wis. Stat. [section] 940.295(1)(j)1 (1997-98); and (4) violation of Emergency Medical Treatment and Active Labor Act (EMTALA). The trial court dismissed Preston's medical malpractice claim for failure identify an expert witness. It dismissed her claim for patient neglect because the Wisconsin statute cited was a criminal code provision and did not create a private cause of action. It dismissed her informed consent claim because such claims may be brought only against health care professionals individually, not hospitals. It dismissed her EMTALA claim because it interpreted the claim as a failure to stabilize a patient claim, and held that such a claim only applies to patient transfers. Since Preston was admitted to the hospital, not transferred to another facility, it decided that the EMTALA claim was not implicated under these facts. Preston v. Meriter Hospital, Inc., 2004 WI App. 61,271 Wis. 2d 721, 678 N.W2d 347.

The court of appeals affirmed the circuit court's grant of summary judgment to Meriter on all four claims, but it determined that the plaintiff's claim under the Emergency Medical Treatment and Active Labor Act, 42 U.S.C. [section] 1395dd (1994), really amounted to two claims, one of which was not addressed and thus dismissed by the circuit court. Preston petitioned the Wisconsin Supreme Court to review the dismissal of this second EMTALA claim, that Meriter Hospital failed to give Bridon an appropriate medical screening examination in violation of 42 U.S.C. [section] 1395dd(a).

EMTALA requires a hospital with an emergency department to provide "an appropriate medical screening examination" to any individual who "comes to the emergency department" with a request to be examined or treated for a medical condition. 42 U.S.C. [section] 1395dd(a). The court of appeals concluded that this EMTALA requirement did not apply to Bridon because he delivered in the Meriter birthing center, not its emergency room. Preston, 271 Wis. 2d at 721, [paragraphs] 37, 39. Thus, the issue to be resolved was whether the EMTALA screening requirement applied to...