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Cruz-Vazquez v. Mennonite General Hospital, Inc.

United States Court of Appeals, First Circuit

May 29, 2013

HAZEL I. CRUZ-VAZQUEZ; RAUL A. CRUZ-RIVERA; LUCY I.VAZQUEZ-RIVERA; CONJUGAL PARTNERSHIP CRUZ-VÁZQUEZ;BENJAMÍN MARTÍNEZ-REYES; BENJAMÍN MARTÍNEZ-MORALES; NITZA I. REYES; CONJUGAL PARTNERSHIP MARTÍNEZ-REYES, Plaintiffs, Appellants,
v.
MENNONITE GENERAL HOSPITAL, INC.; DR. BRENDA M. TORRES-PEREZ; JOHN DOE; CONJUGAL PARTNERSHIP DOE-TORRES; DR. EDUARDO GÓMEZ-TORRES; JANE DOE; CONJUGAL PARTNERSHIP DOE-GÓMEZ; ADVANCED OB-GYN, PCS; SIMED; COMPANIES A-Z; PETER POE; MARY MOE, Defendants, Appellees, MINERVA DIAZ-ARISTUD; CONJUGAL PARTNERSHIP GOMEZ-DIAZ, Defendants.

APPEAL FROM THE UNITED STATES DISTRICT COURTFOR THE DISTRICT OF PUERTO RICO[Hon. José Antonio Fusté, U.S. District Judge]

Pedro F. Soler-Muñiz for appellants.

Anselmo Irizarry-Irizarry, with whom Matta & Matta, PSC, was on brief for appellees.

Before Torruella, Lipez and Howard, Circuit Judges.

TORRUELLA, Circuit Judge.

This appeal concerns whether the district court erred in dismissing a disparate screening claim under the Emergency Medical Treatment and Active Labor Act ("EMTALA"), 42 U.S.C. § 1395dd. After carefully reviewing the record, we vacate the district court's dismissal and remand for further proceedings.

I. Background

A. Factual Background

1. Cruz-Vázquez's Medical Treatment

At around 10:15 p.m. on January 4, 2007, Plaintiff-Appellant Hazel Cruz-Vázquez ("Cruz-Vázquez"), then in her third trimester of her first pregnancy, arrived at the emergency room of Defendant-Appellee Mennonite General Hospital ("Mennonite") requesting medical services. She complained of vaginal discharge and blood spotting but denied experiencing pelvic pain, dysuria or feverishness. Cruz-Vázquez also felt fetal movement upon her arrival to the emergency room. She was evaluated by the on-duty emergency physician, Dr. Brenda M. Torres-Pérez ("Dr. Torres"), who performed a pelvic exam and found that Cruz-Vázquez's cervix was not dilated. No other exams were performed.

At around 10:55 p.m., Dr. Torres called Cruz-Vázquez's obstetrician, Dr. Eduardo Gómez-Torres ("Dr. Gómez"), who advised Dr. Torres to administer 0.25mg of Bretine and 50mg of Visatryl, to discharge Cruz-Vázquez in stable condition, and to instruct her to follow up at his private office the following morning at 8:00 a.m. Dr. Torres followed those instructions. Cruz-Vázquez was discharged and sent home on January 5, 2007, at 12:15 a.m., less than two hours after her arrival. Cruz-Vázquez's condition was recorded in the medical record as "discharge condition stable."

Cruz-Vázquez was seen the following morning at 8:14 a.m. by Dr. Gómez in his private office. She complained of continued blood spotting but no pelvic pain. Dr. Gómez performed a pelvic exam which revealed a blood collection pool in her vagina and cervix dilation of seven centimeters. Cruz-Vázquez's fetus was floating in breech position. Dr. Gómez diagnosed Cruz-Vázquez as suffering from an incompetent cervix, and he recommended that she be transferred to another hospital.[1] Cruz-Vázquez agreed, and she was transferred in stable condition.

Following admission to the San Juan City Hospital that morning, Cruz-Vázquez underwent a cesarean section. Her baby was born a living baby girl at 12:12 p.m. The baby died on January ...


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