It was the duty of the hospital, because there was an emergency
medical condition, to
A) provide such medical examination and treatment
necessary to stabilize the medical condition within the
staff and facilities available ; or
B) to transfer the plaintiff (decedent) to another medical
1) obtaining informed consent from the plaintiff (decedent)
in writing; or
2) issuing and signing a Certificate of Transfer certifying
that the medical benefits reasonably expected from the
transfer outweigh any increased risks to the individual
from transfer; or
3) allowing a qualified medical person to issue the
Certificate of Transfer after a physician has made the
actual certification, and subsequently signs the
Do you believe, based on the evidence, that the hospital performed
its duty in regard to the plaintiff (decedent)?
Yes ______ No ______
This instruction should be given if a determination that there is an emergency
medical condition has been made. After such determination, the screening
requirements obviously have no application because regardless of their efficacy,
the proper determination has been made that requires further examination and
treatment within the hospital's capabilities, or transfer to an appropriate
There will be necessary variations depending on the facts of each case,
and whether there is a liability question or a damages claim only . Since the
damages allowed to the individual by the statute are those "available for
personal injury under the law of the State in which the hospital is located," §
1395dd(d)(2)(A), the general damages instruction will apply. But it must be
emphasized that such damages are available under EMTALA only when the
personal harm is a direct result of the hospital's violation of the statute, not by
any harm caused by the medical negligence of personnel or the hospital .
Despite the above analysis, the fact that the trial court did not give a
directed verdict on the EMTALA claim is not grounds for reversal of the jury
verdict or judgment in this case . The Court of Appeals reached the same
conclusion about the necessity of a directed verdict, but held that a new trial
on damages would be required under Stringer v. Wal-Mart Stores, Inc . , 151
S.W .3d 781, 801 (Ky. 2004). In Stringer, the plaintiffs raised three claims--
intentional infliction of emotional distress, defamation, and invasion of
privacy-that had overlapping but not completely coterminous injuries. Thus,
because the defendants were entitled to directed verdicts on two of the three
claims, this Court vacated the damages award and ordered a retrial on
damages only as to the remaining claim.
In making the wrongful death claim in this case, the Appellants alleged
multiple tortious acts, and the trial court eventually instructed on three
theories against the hospital based on those alleged acts : a policy and
procedures claim, a general medical negligence claim, and the EMTALA claim.
Regardless of the route taken to liability, the injury under all three claims was
the same-the death of Mrs. Shreve . Likewise, the proof of damages was the
same for all three theories, including the claim under EMTALA, which allows
state personal injury damages under 42 U.S.C . § 1395dd(d)(2) . The jury found
liability under all three theories, two of which were not appealed to this Court.
Because the injury and damages under those theories of liability were the same
as under the EMTALA claim, this case is distinguishable from Stringer.
Stringer involved three separate torts, with overlapping but ultimately different
injuries . But the Appellants in this case pleaded alternative theories of liability
for a single injury-wrongful death. The jury had to find causation in order to
find liability, and here the jury found liability under all three theories. This
amounted to a finding that any of the three tortious acts was a sufficient cause
of the wrongful death, and the damages that flowed from that injury.
As to the loss of consortium, the directed verdict on the EMTALA statute
also has no effect because wrongful death could be established by either of the
two theories that were not appealed, and the finding of the wrongful death of
Mrs. Shreve was an element of proof of the loss of consortium claim. Either of
the surviving findings of liability is sufficient to support the loss of consortium
Therefore, this Court concludes that while the failure to give a directed
verdict on the EMTALA claim in this case was error, it was harmless as to the
damages award returned by the jury under the policy and procedures claim or
the general negligence claim, which were not appealed .
Kentucky's loss of consortium statute, KRS 411.145, is compensatory in
nature, and creates an independent cause of action for the spouse of an
injured or deceased person . The statute is silent as to the duration of any
damages from the loss, and this Court will not provide a term that is missing
by limiting recovery only up to the time of death. On this ground, the Court of
Appeals is reversed, and the judgment of the trial court is reinstated on the
loss of consortium claim.
The Appellee hospital in this case was entitled to a directed verdict on the
EMTALA claim because there is no dispute that it performed the required
elements of the statute which is designed to prevent hospitals from "dumping"
patients who cannot pay for their care . The statute imposes absolute liability
on a hospital if it fails in conforming to the statute, but there is no liability if it
has, which is the case here. However, because the jury verdict found liability
for wrongful death on all three theories of causation, this error is harmless
because the damages claimed and proven were for the same personal injury.
Thus the Court of Appeals is affirmed to the extent it held that a directed
verdict was required but its judgment is reversed on this ground because the
verdict of the jury and judgment of the trial court are otherwise sustainable.
For the forgoing reasons, the decision of the Court of Appeals is reversed
and the judgment of the Ohio Circuit Court is reinstated in its entirety.
All sitting. All concur.