Appeal from the United States District Court for the Central District of California. D.C. No. CV 91-04949-JMI (J). James M. Ideman, District Judge Presiding.
Before: Harry Pregerson, Cecil F. Poole, and Dorothy W. Nelson, Circuit Judges. Opinion by Judge Harry Pregerson.
PREGERSON, Circuit Judge:
Plaintiff-Appellant Roland Charles Eberhardt ("Eberhardt"), the father of decedent Allan Eberhardt, appeals the district court's grant of summary judgment in favor of Defendants-Appellees San Pedro Peninsula Hospital and Dr. Larry Orosz. Eberhardt sued the hospital and Dr. Orosz for discharging his son in an unstable mental condition, in violation of the Emergency Medical Treatment and Active Labor Act, 42 U.S.C. § 1395dd (1986). Eberhardt's son was fatally shot by Los Angeles police officers 30 hours after he was discharged. We have jurisdiction under 28 U.S.C. § 1291. We affirm.
On July 18, 1991, neighbors of Allan Eberhardt called paramedics to report that Allan was suffering from a heroin overdose. Allan admitted to smoking heroin and taking cocaine. The paramedics found that Allan, who was 23 years old, was orientated, had a blood pressure of 130/96, a pulse of 64, respirations of 22, reactive pupils, and clear lungs. The paramedics applied oxygen and administered .8 mg. of Narcan, a drug that reverses the effects caused by morphine and other opioid drugs. The paramedics then transported Allan to San Pedro Peninsula Hospital.
At the hospital, Allan told the triage nurse that he had snorted cocaine and then smoked heroin. The nurse's notes indicate that Allan's chief complaint was a "heroin o.d.," and that he had a history of "psych and cocaine use." Initially, Allan refused treatment, but with coaxing, he agreed to let Dr. Larry Orosz, an emergency medicine physician, examine him.
Dr. Orosz found that Allan's blood pressure had dropped to 130/90, his respirations had dropped to 20, and his pulse remained at 64. Dr. Orosz concluded that the Narcan had improved Allan's condition. Initially lethargic, Allan was now alert and orientated. Dr. Orosz performed a physical examination and found that Allan was within normal parameters. Dr. Orosz did not order any laboratory tests, nor did he conduct a psychiatric evaluation or a mental status evaluation.
Dr. Orosz diagnosed a heroin overdose and administered an additional 2 mg. of Narcan. Dr. Orosz then advised Allan to seek follow-up treatment at Harbor General Hospital for long-term methadone treatment. Allan signed a Patient Instruction Sheet, then pulled out his IV and walked out of the emergency room. Dr. Orosz testified in his deposition that right before Allan walked out, Allan told him that he was experiencing a feeling of "impending doom" and that Allan "was upset because we saved his life." Orosz Deposition at 24.
Thirty hours later, on July 20, 1990, Los Angeles police officers found Allan, who was armed with a machete, breaking the windows of a private residence. The police record indicates that when Allan charged at one of the officers with the machete, the officers shot him several times. The police record also indicates that he was "crazed out." One witness to the shooting testified that Allan shouted "kill me" and "put me out of my misery" before the police shot him. Allan was taken to San Pedro Peninsula Hospital, where he was pronounced dead. A toxicology report by the coroner shows that Allan had a blood alcohol level of .05. No drugs were detected in his system.
On July 1, 1992, Plaintiff-Appellant Roland Charles Eberhardt, Allan's father, filed a Second Amended Complaint for Damages for Allan's wrongful death. Eberhardt claimed that San Pedro Peninsula Hospital and Dr. Orosz violated the Emergency Medical Treatment and Active Labor Act ("EMTALA"), 42 U.S.C. § 1395dd (1986), when they discharged Allan in an unstable mental condition.*fn1 The district court granted summary judgment in favor of Dr. Orosz because it concluded that the EMTALA does not allow a private right of action against the responsible physician, only the hospital. The district court also granted summary judgment in favor of the hospital because it concluded that the decedent's death was not the "direct result" of the hospital's alleged violation of the EMTALA.*fn2 Eberhardt now appeals.
A grant of summary judgment is reviewed de novo. Jesinger v. Nevada Federal Credit Union, 24 F.3d 1127, 1130 (9th Cir. 1994). The panel must determine, viewing the evidence in the light most favorable to the nonmoving party, whether there are any genuine issues of material fact and whether the district court correctly applied the relevant substantive law. Id.
A. Private Right of Action Against Physicians
In 1986, Congress enacted the Emergency Medical Treatment and Active Labor Act, commonly known as the "Patient Anti-Dumping Act," in response to a growing concern about "the provision of adequate emergency room medical services to individuals who seek care, particularly as to the indigent and uninsured." H.R. Rep. No. 241, 99th Cong., 1st Sess. (1986), reprinted in 1986 U.S.C.C.A.N. 726-27. Congress was concerned that hospitals were "dumping" patients who were unable to pay, by either refusing to provide emergency medical treatment or transferring patients before their conditions were stabilized.
42 U.S.C. § 1395dd(a) provides that if any individual comes to the emergency department of a hospital which participates in Medicare, and a request is made on the individual's behalf for examination or treatment for a medical condition, the hospital "must provide for an appropriate medical screening examination within the capability of the hospital's ...