Justia U.S. 1st Circuit Court of Appeals Opinion Summaries

Plaintiff filed a disparate screening claim in the U.S. district court alleging that she arrived at the emergency department of Hospital with an emergency medical condition as defined by the Emergency Medical Treatment and Active Labor Act (EMTALA), that Hospital failed to screen her appropriately, and that Hospital failed to stabilize or properly transfer her before release, thus violating the requirements of EMTALA. The district court dismissed Plaintiff's complaint as stating facts limited to a medical malpractice claim and holding that EMTALA does not create a federal cause of action for medical malpractice. The First Circuit Court of Appeals vacated the district court's dismissal, holding that Plaintiff presented sufficient evidence to show that a trialworthy issue existed as to her disparate screening claim. Remanded for trial on Plaintiff's EMTALA claim as well as her Puerto Rico law claims. View "Cruz-Vazquez v. Mennonite Gen. Hosp., Inc." on Justia Law

Flying from Cairo to New York, a flight attendant thought plaintiff looked ill and recruited a second-year medical resident to perform an examination. The resident thought that plaintiff was suffering an ischemic stroke or transient ischemic attack. The pilot made an emergency landing and, less than two hours later, plaintiff was treated at a hospital. The hospital did not administer an intravenous shot of tissue plasminogen activator (t-PA), a form of thrombolytic therapy that dissolves clots, but is not appropriate for all patients. His condition deteriorated, then stabilized, and he was transferred for care in New York. The district court held a "Daubert" hearing in plaintiff's malpractice claim and two experts gave vastly different opinions about whether failure to administer t-PA caused plaintiff's injuries. The court held that the standard for causation was "more likely than not" and that Maine had not adopted the "lost chance" doctrine, excluded plaintiff's expert, and granted summary judgment for defendants. The First Circuit affirmed, holding that plaintiff failed to show causation.

Until 2005, when the Puerto Rico Board of Medical Examiners promulgated a first-in-the-nation regulation that limited the practice of cosmetic medicine to particular classes of medical specialists, all licensed physicians in Puerto Rico could perform cosmetic surgery. The Board enforced the regulation against a physician who did not possess the required specialty board certification. The district court disposed of challenges on the ground that the defendants enjoyed various kinds of immunity and did not reach constitutional issues. The First Circuit affirmed, rejecting claims that the suspension of plaintiff's license amounted to a substantive due process violation and was retaliation for past testimony. The Board afforded due process protections in its hearing process.