The opinion
IN THE UNITED STATES DISTRICT COURT
FOR THE EASTERN DISTRICT OF OKLAHOMA
KYLE ENDICOTT, as Special )
Administrator for the Estate of )
Jennifer Crowell, )
)
)
Plaintiff, )
)
v. ) Case No. CIV-21-319-RAW
)
CHOCTAW COUNTY CITY OF HUGO )
HOSPITAL AUTHORITY, et al., )
)
)
Defendants. )
ORDER
Before the court is the motion of defendant Choctaw County City of Hugo Hospital Authority
for summary judgment. Summary judgment is appropriate if “the movant shows that there is no
genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law.”
Rule 56(a) F.R.Cv.P. A dispute is genuine if there is sufficient evidence so that a rational trier of
fact could resolve the issue either way. A fact is material if under the substantive law it is essential
to the proper disposition of the claim. Sanderson v. Wyoming Highway Patrol, 976 F.3d 1164, 1173
(10th Cir.2020). When applying this standard, the court views the evidence and draws reasonable
inferences therefrom in the light most favorable to the nonmoving party. Wright v. Experian Info.
Sols., Inc., 805 F.3d 1232, 1239 (10th Cir.2015).
On June 26, 2020, Jennifer Crowell was observed (possibly in seizure) on a street in
Hugo, Oklahoma. She was transported by ambulance to Choctaw Memorial Hospital, where
she was seen by defendants Dr. Hogan and Bullard, a nurse at the facility. The initial records
used the following language to describe Crowell: “‘suicidal thoughts (acutely psychotic),’
anxiety, hallucinations, delusions, ‘bizarre behavior,’ agitated, ‘aggressive behavior,’ and
‘violent behavior.’” As medical evaluation and treatment was attempted, Crowell hit
Bullard. The police were called and Crowell was transported to jail. Crowell’s condition did
not improve and jailers observed her banging her head on the cell. Crowell was returned to
Choctaw Memorial Hospital and later sent to Alliance Hospital in Durant, where she died on
June 30, 2020.
In the original petition filed in state court (#2-2), movant is named in the first claim
(negligence under state law), the second claim (EMTALA), and fourth claim (municipal liability
under 42 U.S.C. §1983)
As to the first claim, movant asserts that it may not be liable for the discretionary decision
of Nurse Bullard to contact the police regarding Crowell’s violent, aggressive, and abusive behavior,
citing 51 O.S. §155(5). Plaintiff has not substantively responded on this point. The motion will be
granted.
The fourth claim will be dismissed, although not on a ground expressly raised by movant.
“To state a valid §1983 claim, the plaintiff must allege that: (1) she suffered a violation of her
constitutional rights; and (2) this deprivation was caused by someone acting under the color of state
law. But [plaintiff] is unable to prevail on her §1983 claim because medical malpractice, without
more, is not a constitutional violation but is instead a state law claim.” Adkins v. Koduri, 755
Fed.Appx. 751, 753 (10th Cir.2018).1
1Unlike the Constitution, Section 1983 is not itself a source of substantive rights, but serves instead
only as a vehicle to provide relief against those who, acting under color of state law, violate federal rights
2
As to the second claim, EMTALA (the Emergency Medical Treatment and Active Labor
Act), 42 U.S.C. §1395dd, was enacted to prevent hospitals from “dumping” patients that they could
treat but who could not pay for services. Ingram v. Muskogee Reg. Med. Ctr., 235 F.3d 550, 551
(10th Cir.2000). Hospitals have two primary obligations under EMTALA. “First, the hospital must
conduct an initial medical examination to determine whether the patient is suffering from an
emergency medical condition.” Phillips v. Hillcrest Med. Ctr., 244 F.3d 790, 796 (10th Cir.2001).
Second, if an emergency medical condition exists, the hospital must “stabilize the patient before
transporting him or her elsewhere.” Id.
As to screening, EMTALA provides no remedy for claims that a hospital’s screening
procedures was inadequate, so long as “its standard screening procedure is applied uniformly” to all
similarly situated patients. Repp v. Anadarko Mut. Hosp., 43 F.3d 519, 522 (10th Cir.1994). Plaintiff
appears to accept movant’s statement that “it fully complied with all hospital policies in relation to
[Crowell’s] encounter on June 26, 2020.” (#122 at 2). The court finds any screening claim fails.2
To state an EMTALA failure to stabilize claim, a plaintiff must show (1) the patient had an
emergency medical condition3; (2) the hospital had actual knowledge of that condition; (3) that
patient was not stabilized before transfer; and (4) prior to transfer of the unstable patient, the
transferring hospital did not obtain proper consent or follow appropriate certification procedures.
created elsewhere. Sturdivant v. Fine, 22 F.4th 930, 935 (10th Cir.2022).
2The EMTALA medical screening requirement is set forth in 42 U.S.C. §1395dd(a): “the hospital
must provide for an appropriate medical screening examination within the capability of the hospital’s
emergency department.” An “appropriate medical screening examination” requires that the hospital “apply
uniform screening procedures to all individuals coming into the emergency room.” Phillips, 244 F.3d at 797.
3Defined in 42 U.S.C. §1395dd(e)(1)(A).
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Martinez v. LEA Reg. Hosp., 2022 WL 17584023, *8 (D.N.M.2022)(citing Baber v. Hospital Corp.
of America, 977 F.2d 872, 883 (4th Cir.1992)).
Viewing the record in the light most favorable to plaintiff, the court finds these elements are
satisfied for the purpose of resisting summary judgment. A mental health emergency with risk of
suicide can qualify as an emergency health condition. Id. (citing Moses v. Providence Hosp. And
Med. Ctrs., Inc., 561 F.3d 573, 585 (6th Cir.2009)). See also Jones v. Beth Israel Hosp., 2018 WL
1779344, *8 (S.D.N.Y.2018)(for the mental health point, and that transfer to jail rather than another
hospital may trigger EMTALA). The medical notes clearly indicate the hospital staff’s knowledge
of Crowell’s condition.
Stabilization is defined as “to provide such medical treatment of the condition as may be
necessary to assure, within reasonable medical probability, that no material deterioration of the
condition is likely to result from or occur during the transfer of the individual from a facility.” 42
U.S.C. §1395dd(e)(3)(A). Viewed in the light most favorable to plaintiff, the transfer of a mental
health emergency from a hospital to a jail does not meet this definition, and subsequent events bear
that out.
Finally, movant argues that it is entitled to summary judgment because recovery against it
is barred by the GTCA. The court disagrees. EMTALA limits damages to those available for
personal injury under state law. See 42 U.S.C. §1395dd(d)(2)(A). The federal statute, however,
preempts state sovereign immunity. See Root v. New Liberty Hosp. Dist., 209 F.3d 1068, 1070 (8th
Cir.2000).
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It is the order of the court that the motion for summary judgment of defendant
Hospital Authority (#113) is hereby granted in part and denied in part. Plaintiff’s state law
negligence claim and Section 1983 claim are dismissed as to movant. Plaintiff’s EMTALA
claim as to movant remains pending.
ORDERED THIS 28th DAY OF SEPTEMBER, 2023.
______________________________________
RONALD A. WHITE
UNITED STATES DISTRICT JUDGE
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