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Tep v. Southcoast Hospitals Group, Inc.

United States District Court, D. Massachusetts

September 22, 2014

BUNARITH TEP, Personal Representative of the Estate of Justine Tep, Plaintiff,


LEO T. SOROKIN, District Judge.

Bunarith Tep, a widower, brought this action against Southcoast Hospitals Group, Inc. ("Southcoast") and other defendants involved in his wife's emergency medical care at the time of her death. His complaint includes a claim against Southcoast pursuant to the Emergency Medical Treatment and Active Labor Act ("EMTALA"), 42 U.S.C. § 1395dd, which places limits on when hospitals may transfer individuals presenting with emergency medical conditions. Southcoast seeks partial summary judgment, contending its liability is limited to $20, 000 under the Massachusetts charitable immunity statute, Mass. Gen. Laws ch. 231, § 85K. Tep opposes Southcoast's motion. The Court heard oral argument on September 18, 2014. For the following reasons, Southcoast's motion is ALLOWED.


A. Relevant Facts

The facts material to the pending motion are straightforward and, the parties agree, undisputed. See Doc. No. 49; Doc. No. 54 at 1.[1]

At the time of her death, Tep's wife was twenty-six years old and had a history of primary pulmonary hypertension.[2] Doc. No. 49 at ¶ 1. She arrived at the emergency room at Charlton Memorial Hospital in Fall River, Massachusetts on August 9, 2011 complaining of shortness of breath and a cough. Id . Someone at Charlton decided Mrs. Tep should be transferred to Tufts New England Medical Center, where her pulmonologist was located. Id. at ¶

2. After midnight on August 10, 2011, Mrs. Tep was placed in an ambulance to be taken to Tufts. Id. at ¶ 3. Before arriving there, Mrs. Tep went into cardiac and respiratory arrest. Id. at ¶ 4. The ambulance diverted to Milton Hospital, where Mrs. Tep died. Id. at ¶ 5.

Charlton is one of three hospitals operated by Southcoast. Id. at ¶ 8. Before its merger into Southcoast, Charlton "was incorporated for the charitable purposes of establishing, operating and maintaining a hospital for the surgical and medical care and treatment of the sick and injured." Id. at ¶ 7. Southcoast "is organized as a charitable corporation... and operated exclusively for charitable, educational and scientific purposes, including maintaining and operating charitable hospitals, " such as Charlton. Id. at ¶ 8.

During the 2010-2011 fiscal year, Southcoast generated revenue that exceeded its expenses by more than $46 million. Doc. No. 54-2 at 1. Charitable contributions and grants constituted almost $13 million of its total revenue, which surpassed $650 million. Id . Eleven of its officers received compensation of at least $200, 000; one chief executive officer was paid more than $1 million. Id. at 7-8. Southcoast's tax returns from that year reflect it performed a host of medical services, including caring for "181, 205 emergency room patients 24 hours a day 7 days a week regardless of ability to pay for such services." Id. at 2. It incurred expenses related to patient financial assistance and unreimbursed Medicaid claims (more than $16 million), and care provided to Medicare patients (at a loss of more than $28 million). Id. at 32-33.

B. Relevant Statutes

Often referred to as an "anti-dumping" law enacted in response to concerns that hospitals were refusing treatment to uninsured patients with urgent medical problems, Ramos-Cruz v. Centro Medico del Turabo , 642 F.3d 17, 18 (1st Cir. 2011), EMTALA requires hospitals to either examine and treat patients presenting with emergency medical conditions, or to provide for the transfer of such individuals to another appropriate facility, § 1395dd(b)(1). Hospitals may not transfer patients with unstable emergency medical conditions unless specific criteria are satisfied. § 1395dd(c). Under EMTALA's civil enforcement provision:

Any individual who suffers personal harm as a direct result of a participating hospital's violation of a requirement of [EMTALA] may, in a civil action against the participating hospital, obtain those damages available for personal injury under the law of the State in which the hospital is located, and such equitable relief as is appropriate.

§ 1395dd(d)(2)(A) (emphasis added). EMTALA "do[es] not preempt any State or local law requirement, except to the extent that the requirement directly conflicts with" the federal statute. § 1395dd(f).

In Massachusetts, charitable organizations are not immune from tort suits, but their civil liability is limited ...

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