Health Law Daily Wrap Up, EMTALA—D.N.M.: Patient’s EMTALA claim dismissed, medical malpractice claims remanded to state court, (Aug 19, 2025)

By Wendy Biddle, J.D.

The hospital met EMTALA requirements despite alleged missed stroke diagnosis.

The federal court in New Mexico granted summary judgment in favor of Presbyterian Healthcare Services, Inc. on an Emergency Medical Treatment and Labor Act (EMTALA) claim, finding that the patient failed to establish a genuine dispute of material fact regarding alleged EMTALA violations. The court concluded that at most, the hospital misdiagnosed the patient, which is not sufficient to create a genuine dispute of material fact as to an EMTALA claim. The court also found that the patient failed to provide what the established protocols were that the hospital allegedly deviated from. After dismissing the only federal claim in the suit and noting that diversity jurisdiction does not exist, the court declined to exercise supplemental jurisdiction over remaining state law claims and remanded them to state court (Harrison v. Bursztyn, No. 1:24-cv-00724 KWR/JFR (D.N.M. Aug. 13, 2025)).

Background. The patient, a pretrial detainee at Curry County Detention Center, suffered a stroke while in custody in May 2019. Authorities transported him to Plains Regional Medical Center, which Presbyterian Healthcare Services operates, after he experienced severely elevated blood pressure and other symptoms. An emergency room doctor evaluated the patient and ordered various diagnostic tests including a CT scan, then diagnosed the patient with hypertension and discharged him back to custody. The patient later alleged that the hospital failed to properly identify and treat his stroke.

The patient's lawsuit included multiple claims against various defendants, with the sole federal claim charging Presbyterian Healthcare Services with EMTALA violations. The EMTALA claim alleged two primary violations: failure to provide an appropriate medical screening examination according to standard procedures, and failure to stabilize the patient before discharge.

Both the patient and Presbyterian Healthcare Services moved for summary judgment.

Medical screening procedures. The patient alleged that the hospital failed to screen him according to its standard screening procedures. EMTALA requires that hospitals provide individuals with treatment in their emergency rooms with appropriate medical screening exams to determine whether an emergency exists. The court emphasized that courts give appropriate deference to existing hospital screening procedures and only inquire whether the hospital followed its own protocols, not whether those procedures provided adequate care. The court noted that a “hospital’s obligation under EMTALA is measured by whether it treats every patient perceived to have the same medical condition in the same manner.”

The court found that the patient could not show that the hospital did not follow its established procedures because he failed to identify and provide Presbyterian Healthcare's actual standard screening procedures. The patient primarily relied on a third-party continuing nursing education course for nurses as evidence of the hospital's screening requirements. The court determined this educational material could not establish the hospital's own screening procedures, noting the course simply provided education and did not create binding protocols for physicians or the hospital.

The patient also cited expert testimony regarding whether the doctor that treated the patient met the standard of care of a reasonable physician under similar circumstances. However, the court explained that whether a physician meets the standard of care remains irrelevant to an EMTALA claim, as EMTALA does not function as a medical negligence statute. The court noted that the expert failed to establish Presbyterian Healthcare Services' screening procedures or explain how the hospital deviated from its own protocols.

The patient argued that the hospital violated EMTALA by failing to observe him walking due to his restraints and by not performing a CT angiogram or CT perfusion instead of a standard CT scan. The court rejected both arguments.

The court found no evidence in the record establishing that observing a patient walking constituted standard procedure at the emergency department. The court noted that a nurse testified staff would find it unusual to ask the patient to walk given his reported dizziness, which would create a fall risk.

On the imaging issue, the court determined that even if the nursing educational material established screening procedures, it did not require a CT angiogram or perfusion. The material stated that a non-contrast CT scan constituted the gold standard and gave hospitals options among various imaging techniques without mandating specific choices.

The court also addressed the patient’s claim that staff treated him differently as a detainee. While acknowledging that EMTALA prohibits disparate treatment, the court noted that motives remain irrelevant under the statute, which examines only hospital actions. Since the patient failed to demonstrate that Presbyterian Healthcare deviated from standard procedures, the disparate treatment claim also failed.

Stabilization requirement. The patient alleged that the hospital transferred him without stabilizing his emergency medical condition, in violation of EMTALA. The court focused on the actual knowledge standard. EMTALA's stabilization requirements only apply when a hospital possesses actual knowledge of an unstabilized emergency medical condition.

The court found that Presbyterian Healthcare carried its burden by demonstrating that it diagnosed the patient with hypertension, treated that condition, and that the doctor believed he had properly diagnosed and stabilized the patient. The radiologist's report also showed no stroke on the CT scan. The patient failed to cite any evidence suggesting the hospital possessed actual knowledge he suffered from a stroke, as the symptoms lacked specificity, and the doctor diagnosed and treated a different condition.

The court therefore granted Presbyterian Healthcare’s motion for summary judgment with respect to the EMTALA claim and dismissed the claim.

Supplemental jurisdiction. After dismissing the federal EMTALA claim, the court declined to exercise supplemental jurisdiction over the remaining state law claims. The court noted that complete diversity did not exist, as the patient and multiple defendants maintain residency in New Mexico.

The court emphasized that district courts should usually decline jurisdiction over state claims when they dismiss federal claims before trial. The court applied the traditional factors of judicial economy, convenience, fairness, and comity, finding they weighed in favor of remand. The court therefore remanded the remaining claims to state court.

The case is No. 1:24-cv-00724 KWR/JFR.

Judge: Riggs, K.

Attorneys: Bridget J. Hazen (Weems Law Firm LLC) for Daniel Harrison. Chance A. Barnett (Krehbiel & Barnett, P.C.) for Enrique Bursztyn.

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