Maldonado Rodriguez et al v. Hospital San Lucas II et al

Filing 91

OPINION AND ORDER granting 65 motion for summary judgment. Judgment shall be entered accordingly. Signed by Judge Juan M Perez-Gimenez on 4/22/2013. (PMA)

UNITED STATES DISTRICT COURT FOR THE
DISTRICT OF PUERTO RICO
MAYELA MALDONADO-RODRIGUEZ, ET AL,
Plaintiffs,
v.

CIV. NO. 10-1362 (PG)

ST. LUKE’S MEMORIAL HOSPITAL, INC.,
ET AL,
Defendants.

OPINION AND ORDER
Pending before the Court is co-defendant St. Luke’s Memorial Hospital,
Inc. motion for summary judgment (Docket No. 65). For the reasons set forth
below, the Court GRANTS the co-defendant’s motion.
I. BACKGROUND
On April 30, 2010, plaintiffs Mayela Maldonado-Rodriguez, Jorge PerezLugo,

Jorge

M.

Perez-Maldonado,

and

Marieli

Maldonado

(hereinafter

collectively referred to as “Plaintiffs”) filed the above-captioned claim
against

defendants

St.

Luke’s

Memorial

Hospital,

Inc.,

d/b/a

Hospital

Episcopal San Lucas (“HESL” or “the Hospital” or “the Defendant”), Dr. Jaime
A. Reyes-Cardona1 (“Dr. Reyes”), Dr. Hector Javier Acosta-Tapia (“Dr. Acosta”)
and Sindicato de Aseguradores de Imperica Medica (“SIMED”) and other unknown
defendants for the failure to screen, treat, stabilize and transfer patient
Christian Perez-Maldonado (“the Patient”) in violation of the Emergency
Medical Treatment and Active Labor Act (“EMTALA”), 42 U.S.C. § 1395dd.
Included in the complaint is also a supplemental cause of action for medical
malpractice pursuant to Article 1802 of the Puerto Rico Civil Code, P.R. LAWS
ANN. tit. 31, § 5141 (“Article 1802”).
Plaintiffs allege that on May 3, 2009, at approximately 1:21p.m., the
Patient suffered serious injuries when the All Terrain Vehicle (“ATV”) he was
operating in Ponce, Puerto Rico collided with an SUV. See Docket No. 15 at
¶ 24. The paramedics that arrived at the scene of the accident took the
Patient to HESL. See id. at ¶¶ 30, 34. Dr. Acosta and Dr. Reyes were both

1
The court entered partial judgment dismissing all claims against Dr. Reyes and SIMED
in its capacity as insurer for this party on March 21st, 2011. See Docket No. 39.

CIV. NO. 10-1362 (PG)

Page 2

emergency room doctors at the Hospital at the time the Patient was admitted.
See Amended Complaint, Docket No. 15. The Plaintiffs allege that the Hospital
lacked the necessary staff and medical equipment to treat the Patient’s
injuries, and violated EMTALA in their treatment and failure to properly
transfer him to a trauma center. See id. at ¶¶ 45-46. The Plaintiffs also
allege that the Hospital and its staff and doctors incurred in medical
malpractice resulting in the Patient’s death. See Amended Complaint, Docket
No. 15. The Patient was declared dead at 6:02p.m., id. at ¶ 78, a little over
four hours after the accident.
It is uncontested that the Hospital is subject to the provisions of
EMTALA, see Docket No. 65-1, however, it now moves the court to dismiss the
Plaintiffs’

EMTALA

claims

with

prejudice

and

their

state

law

medical

malpractice claims without prejudice. See Docket No. 65. The Hospital contends
that it complied with its obligations to screen, treat, attempt to stabilize,
and transfer the Patient to a trauma center in accordance with the statute.
Therefore, this claim, which gives rise to federal jurisdiction, should be
dismissed. See id. In light of the Plaintiffs’ failure to timely file a
response, the court already ruled that this motion shall be deemed unopposed.
See Docket No. 77.
II. STANDARD OF REVIEW
A motion for summary judgment is governed by Rule 56(c) of the Federal
Rules of Civil Procedure, which allows disposition of a case if “the
pleadings, depositions, answers to interrogatories, and admissions on file,
together with the affidavits, if any, show that there is no genuine issue as
to any material fact and that the moving party is entitled to a judgment as
a matter of law.” See Sands v. Ridefilm Corp., 212 F.3d 657, 660 (1st
Cir.2000). A factual dispute is “genuine” if it could be resolved in favor of
either party, and “material” if it potentially affects the outcome of the
case. See Calero-Cerezo v. U.S. Dep’t of Justice, 355 F.3d 6, 19 (1st
Cir.2004).
To be successful in its attempt, the moving party must demonstrate the
absence of a genuine issue as to any outcome-determinative fact in the record,
see DeNovellis v. Shalala, 124 F.3d 298, 306 (1st Cir.1997), through definite
and competent evidence. See Maldonado-Denis v. Castillo Rodriguez, 23 F.3d
576, 581 (1st Cir.1994). Once the movant has averred that there is an absence
of evidence to support the non-moving party’s case, the burden shifts to the
non-movant to establish the existence of at least one fact in issue that is

CIV. NO. 10-1362 (PG)

Page 3

both genuine and material. See Garside v. Osco Drug, Inc., 895 F.2d 46, 48
(1st Cir.1990) (citations omitted). If the non-movant generates uncertainty
as to the true state of any material fact, the movant’s efforts should be
deemed unavailing. See Suarez v. Pueblo Int’l, 229 F.3d 49, 53 (1st Cir.2000).
Nonetheless, the mere existence of “some alleged factual dispute between the
parties will not affect an otherwise properly supported motion for summary
judgment.” Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 247-48 (1986).
However, “summary judgment may be appropriate if the nonmoving party rests
merely upon conclusory allegations, improbable inferences, and unsupported
speculation.” Medina-Muñoz v. R.J. Reynolds Tobacco Co., 896 F.2d 5, 8 (1st
Cir.1990).
At the summary judgment juncture, the Court must examine the facts in the
light most favorable to the non-movant, indulging that party with all possible
inferences to be derived from the facts. See Rochester Ford Sales, Inc. v.
Ford Motor Co., 287 F.3d 32, 38 (1st Cir.2002). The Court must review the
record “taken as a whole,” and “may not make credibility determinations or
weigh the evidence.” Reeves v. Sanderson Plumbing Products, Inc., 530 U.S.
133, 135 (2000). This is so, because credibility determinations, the weighing
of the evidence, and the drawing of legitimate inferences from the facts are
jury functions, not those of a judge. Id.
III. FINDINGS OF FACT
Before setting forth the facts found by this Court to be undisputed and
relevant to the matter at hand, we must first address several compliance
issues noted by the Court when reviewing the Hospital’s statements of facts
and supporting evidence.
“Documents supporting or opposing summary judgment must be properly
authenticated.” Carmona v. Toledo, 215 F.3d 124, 131 (1st Cir.2000) (citing
FED.R.CIV.P. Rule 56(e)). To be admissible at the summary judgment stage,
documents must be authenticated by and attached to an affidavit that meets the
requirements of Rule 56(e). See 10A WRIGHT, MILLER & KANE, FEDERAL PRACTICE & PROCEDURE
§ 2722 (3d ed.1998). “Under Federal Rule of Civil Procedure 56(e), on summary
judgment, the parties in their supporting affidavits shall set forth such
facts as would be admissible in evidence, and shall show affirmatively that
the affiant is competent to testify to the matters stated therein.” Hoffman
v. Applicators Sales And Service, Inc., 439 F.3d 9, 14 (1st Cir.2006). “Sworn
or certified copies of all papers or parts thereof referred to in an affidavit
shall

be

attached

thereto

or

served

therewith.”

Id.

“The

failure

to

CIV. NO. 10-1362 (PG)

Page 4

authenticate a document properly precludes its consideration on a motion for
summary judgment.” Robinson v. Bodoff, 355 F. Supp. 2d 578, 582 (D.Mass.2005)
(striking all exhibits that were submitted without affidavits).
Moreover, a party must not “[overlook] the crucial point that documents
do not automatically become a part of the record simply because they are the
products of discovery.” Hoffman, 439 F.3d at 15. “If a party wishes the court
to consider matters disclosed during discovery, he must take appropriate steps
to have them included in the record: merely citing to pages of discovery
materials not of record does not suffice.” Id.
After a careful review of the record, we find that some of the materials
submitted by the Hospital are inadmissible for the purposes of summary
judgment because an exhibit attached in support of its statements of fact
lacks an authenticating affidavit or fails to indicate whether they stem from
discovery materials on file. To wit, the Hospital attached the Patient’s
medical records (Docket No. 65-2) without an authenticating affidavit and must
be thus disregarded.2 As a result, the Court did not consider the proposed
factual statements that were not properly supported by the record on file.
As per the foregoing discussion, the Court found the following relevant
facts were undisputed and supported by the record citations:
1.

Hospital is subject to the provisions of the EMTALA.

2.

On May 3, 2009, at approximately 1:21pm, the Patient suffered
serious injuries when the All Terrain Vehicle (“ATV”) he was
operating in Ponce, Puerto Rico collided at an intersection with
an SUV driven by a resident of the Commonwealth of Puerto Rico.

3.

Ambulance personnel arrived at the scene of the accident at
approximately 1:48pm, at which time, paramedics found the Patient
prone on the ground complaining of pain in his legs.

4.

The Patient arrived at HESL at 2:09 p.m., according to the
ambulance record, 48 minutes after the call to the ambulance
dispatch.

5.

Upon arrival, the Patient was attended by Dr. Acosta, HESL’s board
certified emergency room doctor.

2
Moreover, part of the medical record is in the Spanish language in contravention
with the First Circuit’s ruling in Puerto Ricans For Puerto Rico Party v. Dalmau, 544 F.3d
58 (1st Cir.2008) (holding defendants were required to provide certified English language
translation of documents). Specifically, a document titled “Forma para Transferencia de
Pacientes” is part of the medical record attached and, because it is not in the English
language, the court cannot consider the same.

CIV. NO. 10-1362 (PG)

6.

Page 5

Dr. Acosta found that the Patient had suffered acute trauma and had
a serious medical condition. See Docket No. 65-5 at page 78.

7.

The HESL nurse staff, Dr. Acosta and Dr. Liv Cuyar, a medical
resident, performed the Patient’s medical assessment, ordered and
administered several medications and ordered and performed tests
and laboratories, including X-Rays. See Docket No. 65-5 at pages
146-178.

8.

Dr. Acosta stabilized the Patient’s pelvis.

9.

The Patient was given blood transfusions.

10.

Dr. Acosta ordered and authorized the Patient’s transfer to Centro
Medico (trauma center) even when he was unstable because the
benefits outweighed the potential risk of the transfer. See Docket
No. 65–5 at pages 210-211.

11.

Due to the Patient’s condition, arrangements were made to transfer
him to Centro Medico, the trauma center in San Juan. See Docket
No 65-1 ¶ 11; Docket No. 65-7 at pages 48-49.

12.

Dr. Jones from Centro Medico accepted the transfer.

13.

Aeromed was contacted to transfer the Patient by air to Centro
Medico. See Docket No. 65-5 at pages 190-191; Docket No. 65-6 at
page 50.

14.

Plaintiff Mayela Maldonado, the Patient’s mother, authorized the
transfer. See Docket No. 52 at page 52.

15.

The Patient died before the transfer could take place.
IV. DISCUSSION

A. EMTALA Claims
“Congress enacted EMTALA in 1996 in response to claims that hospital
emergency rooms were refusing to treat patients with emergency conditions but
no medical insurance. … EMTALA therefore “is a limited anti-dumping statute,
not a federal malpractice statute.”” Ramos-Cruz v. Centro Medico del Turabo
642 F.3d 17, 18 (1st Cir.2011) (citing Reynolds v. MaineGeneral Health, 218
F.3d 78, 83 (1st Cir.2000)). “To this end, EMTALA imposes duties on covered
facilities to: (a) provide an “appropriate medical screening examination” for
those who come to an emergency room seeking treatment, and (b) provide, in
certain situations, “such further medical examination and such treatment as
may be required to stabilize the medical condition.”” Alvarez–Torres v. Ryder
Memorial Hosp., Inc., 582 F.3d 47, 51 (1st Cir.2009) (citing 42 U.S.C.

CIV. NO. 10-1362 (PG)

Page 6

§ 1395dd(a), (b)(1)(A); López-Soto v. Hawayek, 175 F.3d 170, 172-73 (1st
Cir.1999)). To establish an EMTALA violation, a plaintiff must show that:
(1) the hospital is a participating hospital, covered
by EMTALA, that operates an emergency department (or an
equivalent facility); (2) the patient arrived at the
facility seeking treatment; and (3) the hospital either
(a) did not afford the patient an appropriate screening
in order to determine if she had an emergency medical
condition, or (b) bade farewell to the patient (whether
by turning her away, discharging her, or improvidently
transferring her) without first stabilizing the
emergency medical condition.
Correa v. Hospital San Francisco, 69 F.3d 1184, 1190 (1st Cir.1995) (internal
citations omitted). In the case at hand, the first and second elements are not
at issue. That is, the Patient arrived at the emergency room of the Hospital,
a participating EMTALA facility, seeking medical care. The Plaintiffs’ claims
turn on the third prong.
1. Duty to Screen
In the complaint, the Plaintiffs allege, in essence, that the Hospital
failed to provide the Patient with the immediate, prompt, appropriate and
necessary medical screening that was required under EMTALA in light of his
medical condition. See Docket No. 15, ¶¶ 3, 93.

According to the Plaintiffs,

the physical examination the Patient received “was at best cursory … .” Id.
at ¶ 52.3 The Defendant requests that this claim be dismissed. See Docket
No. 65.
With regards to a participating hospital’s medical screening requirement
under EMTALA, subsection (a) of the statute establishes that:
In the case of a hospital that has a hospital emergency
department, if any individual … comes to the emergency
department 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
emergency
department,
including
ancillary services routinely available to the emergency
department, to determine whether or not an emergency
medical condition … exists.
42 U.S.C.A. § 1395dd(a). “EMTALA does not define the term “appropriate medical
screening examination.” However, it does indicate that the purpose of the

3
However, pursuant to the Plaintiffs’ own allegations in the complaint, the Patient’s
heart rate and blood pressure were taken, id. at ¶¶ 49-50; x-rays were performed which
revealed fractures, id. at ¶ 53; the hospital staff, at the request of Dr. Acosta, tested the
Patient’s arterial blood gases to determine if he was perfusing properly and to determine
whether or not he was developing acidosis, id. at ¶ 54; blood transfusions were ordered and
performed, id. at ¶ 68; and, the Patient was intubated, id. at ¶ 75, all prior to his death.

CIV. NO. 10-1362 (PG)

Page 7

screening is to identify an “emergency medical condition.”” del Carmen
Guadalupe v. Negron Agosto, 299 F.3d 15, 19 (1st Cir.2002). The statute
defines the term “emergency medical condition” as:
(A) a medical condition manifesting itself by acute
symptoms of sufficient severity (including severe pain)
such that the absence of immediate medical attention
could reasonably be expected to result in-(i) placing the health of the individual
(or, with respect to a pregnant woman, the
health of the woman or her unborn child) in
serious jeopardy,
(ii)
serious
impairment
to
bodily
functions, or
(iii) serious dysfunction of any bodily
organ or part[.]
42 U.S.C. § 1395dd(e)(1)(A).
It is an uncontested fact that Dr. Acosta, the emergency medicine
specialist that first attended to the Patient, ordered and performed a series
of tests, and found that the Patient had suffered acute trauma and was in a
serious medical condition. See Statements of Fact #6-7. If the statute imposes
a duty to screen upon participating hospitals just so that a determination can
be made as to whether or not an emergency medical condition exists, and here,
the fact that the emergency room physician made that determination is not in
question, it follows then that the Hospital complied with its duty to screen
the Patient as per the language of the statute. In other words, a strict
reading of the statute forces this court to conclude that the Hospital
complied with its duty to screen under EMTALA inasmuch as the emergency room
doctor admits to have identified that the Patient was in fact suffering from
an emergency medical condition.
“Moreover, whereas malpractice liability usually attaches when a health
care provider fails to adhere to a “general professional standard” of care,
… , EMTALA only requires an appropriate medical screening examination within
the capability of the hospital’s emergency department.” del Carmen Guadalupe,
299 F.3d at 21 (internal citation and quotation marks omitted). “A claim of
inappropriate medical screening based on a failure to

provide certain

diagnostic tests must at least address whether the hospital was capable of
performing such tests.” Id. at 22. Although in the complaint the Plaintiffs
criticize the Hospital for failing to provide the Patient with the appropriate
and necessary medical screening and treatment, see Docket No. 15 at ¶ 93,
Plaintiffs have offered no evidence indicating that the tests and treatment
that the Patient needed were in fact within the Hospital’s capability.

CIV. NO. 10-1362 (PG)

Page 8

Therefore, summary judgment dismissing the Plaintiffs’ claims that the
Hospital failed to fulfill the medical screening requirement under EMTALA is
appropriate for more than one reason in this case.4
2. Duty to Stabilize
In their complaint, the Plaintiffs allege that the Hospital failed to
stabilize the Patient in light of the serious medical condition he arrived in.
See Docket No. 15 at ¶¶ 102-106. The Defendant now seeks to have this claim
dismissed. See Docket No. 65.
“As a corollary to the right to be appropriately screened, EMTALA
guarantees patients the right, if an emergency medical condition is determined
to exist, to have that condition stabilized before discharge or transfer to
another hospital.” Reynolds v. MaineGeneral Health, 218 F.3d 78, 84 (1st
Cir.2000). To that effect, the statute provides, in relevant part, that:
If any individual … comes to a hospital and the
hospital determines that the individual has an
emergency medical condition, the hospital must provide
either(A) within the staff and facilities available at the
hospital, for such further medical examination and such
treatment as may be required to stabilize the medical
condition, or
(B) for transfer of the individual to another medical
facility … .
42 U.S.C. § 1395dd(b)(1). Therefore, “the duty to stabilize is only triggered
when it has been determined that the patient is suffering from an emergency

4
The court also notes that the Plaintiffs fail to properly allege a cause of action
under subsection (a) of EMTALA. “A hospital fulfills its statutory duty to screen patients
in its emergency room if it provides for a screening examination reasonably calculated to
identify critical medical conditions that may be afflicting symptomatic patients and
provides that level of screening uniformly to all those who present substantially similar
complaints.” Correa v. Hospital San Francisco, 69 F.3d 1184, 1192 (1st Cir.1995) (internal
citations omitted). “The essence of this requirement is that there be some screening
procedure, and that it be administered even-handedly.” Id.

In the complaint, the Plaintiffs categorize the screening as faulty and untimely. See
Docket No. 15. However, they do not allege either one of the two scenarios for which EMTALA
provides a cause of action under Section 1395dd(a), to wit, that the Hospital refused to
screen the Patient or that the screening that the Hospital provided was inconsistent with
regular screening procedures for similarly-situated patients. See Vazquez-Rivera v. Hospital
Episcopal San Lucas, Inc., 620 F.Supp.2d 264, 269 (D.P.R. 2009) (citing Correa, 69 F.3d at
1192-93). “EMTALA does not create a cause of action for medical malpractice,” Correa, 69 F.3d
at 1192, and thus, “faulty screening, … as opposed to disparate screening or refusing to
screen at all, does not contravene the statute,” id. at 1192-1193 (emphasis ours). Because the
Plaintiffs do not allege, or submit any evidence for that matter, that the Patient was denied
screening or received different treatment than other patients perceived to have the same
medical condition, they fail to properly set forth a claim under EMTALA that the Hospital
failed to fulfill its medical screening requirement. See del Carmen Guadalupe, 299 F.3d at 22
(affirming summary judgment of EMTALA’s duty to screen violation claim inasmuch as plaintiffs
failed to raise a genuine question of material fact on the issue of differential treatment by
submitting no testimony regarding the baseline of care which the hospital provides).

CIV. NO. 10-1362 (PG)

Page 9

medical condition.” Vazquez-Rivera, 620 F.Supp.2d at 269. Here, there is no
question that the Patient was in fact suffering from an emergency medical
condition.
Now, EMTALA defines the term “to stabilize” as “to provide such medical
treatment of the condition as may be necessary to assure, within reasonable
medical probability, that no material deterioration of the condition is likely
to result from or occur during the transfer of the individual from a facility
… .” 42 U.S.C. § 1395dd(e)(3)(A)(emphasis ours). Therefore, “[t]he duty to
stabilize under EMTALA “does not impose a standard of care prescribing how
physicians must treat a critical patient’s condition while he remains in the
hospital, but merely prescribes a precondition the hospital must satisfy
before it may undertake to transfer the patient.”” Alvarez-Torres v. Ryder
Memorial Hosp., Inc., 582 F.3d 47, 51 (1st Cir.2009) (citing Fraticelli-Torres
v. Hosp. Hermanos, 300 Fed.Appx. 1, 4 (1st Cir.2008) (unpublished)). Thus, the
First Circuit Court of Appeals in Alvarez-Torres reasoned that, taking into
account EMTALA’s definition of the term “to stabilize,” “a hospital cannot
violate

the

duty

to

stabilize

unless

it

transfers

a

patient

…

.”

Alvarez-Torres, 582 F.3d at 51-52 (citing Correa, 69 F.3d at 1190 (to
establish a violation of the duty to stabilize, the plaintiff must prove,
inter alia, that the hospital “bade farewell” to the patient)). According to
the First Circuit, this interpretation is consistent with EMTALA’s antidumping purpose. See Alvarez-Torres, 582 F.3d at 52 (“Interpreting the
stabilization provision to apply where transfer occurs is therefore fully
consistent with EMTALA’s statutory purpose.”).
Much like in Alvarez-Torres, “[i]n this case, [the hospital] did not
violate

the

stabilization

provision

because

[the

patient]

was

never

transferred.” Alvarez-Torres, 582 F.3d at 52. It stems from the uncontested
facts of this case that the Patient never left the Hospital’s facility and in
fact, died in the Hospital hours after being admitted, but before Aeromed
could perform the transfer. See Statements of Fact #13, 15. Because no
transfer

occurred,

the

Plaintiffs

are

simply

unable

to

establish

a

stabilization claim under EMTALA, and thus, this cause of action must also
dismissed.
3. Duty to Transfer
In the complaint, the Plaintiffs allege a cause of action under EMTALA
against the Hospital for failure to transfer the Patient. According to the
Plaintiffs, the Hospital “failed to timely transfer [the Patient] and this was

CIV. NO. 10-1362 (PG)

Page 10

a substantial contributing cause and proximate cause of his untimely death
… .” Docket No. 15 at ¶ 112.
The statute defines “transfer” as “the movement (including the discharge)
of an individual outside a hospital’s facilities at the direction of any
person employed by (or affiliated or associated, directly or indirectly, with)
the hospital.” 42 U.S.C. § 1395dd(e)(4). Pursuant to EMTALA, if a patient’s
medical condition has not been stabilized, “the hospital may not transfer a
patient to another medical facility unless (1) the patient or her proxy
requests

a

transfer

in

writing,

or

(2)

a

physician

or

other

medical

professional certifies that the medical benefits available at the other
facility outweigh the risks of transfer.” Fraticelli-Torres, 300 Fed.Appx. at
5 n. 2 (1st Cir.2008) (citing Baker v. Adventist Health, Inc., 260 F.3d 987,
993 (9th Cir.2001)). Now, “EMTALA merely restricts the conditions under which
a hospital may transfer an unstabilized critical patient. …

A hospital’s

negligent medical decision not to transfer a critical patient promptly to
another hospital to receive necessary treatment might trigger state-law
medical

malpractice

liability,

but

it

could

not

constitute

an

EMTALA

anti-dumping violation.” Fraticelli-Torres, 300 Fed.Appx. at 7.
As a result, whether or not the decision and the arrangements to transfer
the Patient were prompt and timely does not give rise to an EMTALA claim as
alleged by the Plaintiffs. Therefore, this court is forced to grant the
Defendant’s request for the dismissal of the Plaintiffs’ claim under EMTALA
against the Hospital for its alleged failure to comply with its duty to
transfer the Patient.
B. Supplemental Claims
Since the federal claims have been dismissed against the appearing
defendant, namely, the Hospital, and no other grounds for jurisdiction exists,
the court declines to exercise supplemental jurisdiction over the Plaintiffs’
remaining state-law medical malpractice claims. See Carnegie–Mellon Univ. v.
Cohill, 484 U.S. 343, 349, 108 S.Ct. 614, 98 L.Ed.2d 720 (1988) (explaining
that the exercise of pendent jurisdiction is a matter of the federal court’s
discretion and not one of plaintiff’s rights); United Mine Workers v. Gibbs,
383 U.S. 715, 725, 86 S.Ct. 1130, 16 L.Ed.2d 218 (1966) (stating “if the
federal claims are dismissed before trial, … the state law claims should be
dismissed as well.”). Accordingly, the Plaintiffs’ claims brought pursuant to
Commonwealth law are hereby DISMISSED WITHOUT PREJUDICE.

CIV. NO. 10-1362 (PG)

Page 11

V. CONCLUSION
For the reasons stated above, this Court hereby GRANTS the Hospital’s
motion for summary judgment (Docket No. 65). The claims pursuant to EMTALA are
hereby DISMISSED WITH PREJUDICE and the remaining state-law claims are
DISMISSED WITHOUT PREJUDICE. Judgment shall be entered accordingly.
IT IS SO ORDERED.
In San Juan, Puerto Rico, April 22, 2013.
S/ JUAN M. PEREZ-GIMENEZ
JUAN M. PEREZ-GIMENEZ
SENIOR U.S. DISTRICT JUDGE