Keitz v. Commonwealth Of Virginia et al

Filing 5

MEMORANDUM OPINION. Signed by District Judge Glen E. Conrad on 10/5/11. (hnw)

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CLERKS OFF/ E U,. sT O URT S Dl . AT ROANOKE, VA - s i'2' F*91 i' 1 4 5 ' I THE U N I N TED STATES D I STRI COU RT CT FOR THE W ESTERN DI STRI OF VI CT RGW I A CH A RLOTTESVI LLE D I I ON V SI J ULI . DR D B >o &- ' k C ERK c k MI CHA EL J M ES KEI A TZ, Ci lA c i N o. 11 c 00061 vi ton 3: - vPl ntf , ai if M EM O R AN D U M O PI I N N O COM M ON W EA LTH O F V I NI ,e al, RGI A t . By:Hon. e E.Conr d Gln a Chi fUnie St t sDiti tJ e e td a e src udg D e e nt . f nda s Thepr K pli if M iha lJ m e Ket ,fl dt sa ton on Se e be 7,2011 l o antf, c e a s iz ie hi c i ptm r , nami a de e ng s f ndan st Com monwe 1h ofVigi a t Uni r iy ofVigi a, heUni r iy t he at r ni , he ve st r ni t ve st ofVigi aM edialCe er a t Re t randViio soft Uni r iy ofVigi a Thec ' r ni c nt , nd he c o st r he ve st r ni . oul t grntdt pli ifsc e a e he antf ontmporne l fldmoto t pr ce dt f a ousy ie in o o e q onnapa i,purua t upers s nt o 28U. C.j1 ()1 .Afe c S. 915a( ) tr onduci a i ta s re ngoft co anthowe r t tng n niil ce ni he mpli , ve ,he cou tc l st ti mus bedimis dpurua t 28U. C.j 1 5()2)B) r oncude ha t t s se s nt o S. 91 e( ( . FactualBackzround Acc di t t c pli t t pli ifr s or ng o he om a n , he antf e ponde i lt s me 2009t r di d n a e um r o a o a r i e e sa a i d t pa tci t i a m edi a sudy a t Uni er iy ofV igi a' dve ts m nt nd pple o r i pa e n cl t t he v st r ni s Ce e frAddito Reeac a Educ ton( ntr o cin s rh nd ai UVA Cae)2 ( oc tN o 2a 1) UVA Cae r . D ke t. r . a e edt pl n ifsap i ai a i tuce t pli ift thewoul sa f ni da i cc pt he aitf plc ton nd nsr td he antf ha d t y or ne ys n UVA Caedurngt a nitai oft sudy.((,a 2. Aspa toft sudy,hepl ntf r i he dmi srton he t L1 t ) r he t t ai if woul i s tze d esoft dr Topia t a s e nty, d beij ce wih d nget lre os he ug rmae nd, ubs que l woul n e td t l I i unce w he e ty t plitf fl hi c plit Howe ,ase ai d be ow,i r not 7, he t s lar n xacl he an if ied s om an . ver xpl ne l nfa e t c ta s our sumest tt c ha he ompl ntwa fl on Se e r7, l1. ai s ied ptmbe 20 2 Thi ca ea i sfom t s m ef t o i nt ts r a t ebassf as pa aecompl ntfl byt s s rse r he a acual rgi ha eved s h i or e r t ai ied he i tntpl ntft Ket v.Unna ed Spons r ofCocaneRes a c S ud Ci lAci N o.3: 1cvnsa ai if iz m os i e r h t y, vi ton l - 00054,2 11 0 W L 38 9 8( . Va S p . , 1. 7 51 W D. . e t 1 201 ) c c iet ts To in t ' efc o ad u u e' d sr f rc c i .(d) Afe i etn te o an o e t pr maes fe t n r g s rs e ie o o ane I . tr ng sig h frtdos ofTo r m ae,t pli ife re e s ve epani a dicomf q a t r fe is e pia t he antf xpei nc d e r c nd s or nd he eal r rf s dt ermani d s so t ed u .(d) eu e h e i ng o e f h r g 1 . UVA Ca edic r d t pli ifni da lt r f r s ngt pli ifwih m it n r s ha ge he antf ne ys a e , u nihi he antf t te i t u tonst r por i medit l t t e e ge y r m i t eve t thee re ed nsr c i o e t m a ey o he m r nc oo n he nt ha xpe inc ç ni lkes oms. (d. Se alda a trhi r e s ,t plitf s fr das veepa c t c i ympt ' I ) ver ys fe s ela e he anif ufe e e r ni ma ' a tc a wa ta pored by a ta k nd s r ns t mbul et t e e g y r anc o he m r enc oom a t Uni r iy ofVigi a t he ve st r ni Media Ce e ( c l ntr UVA ER) (#. . J )Uponhi a valt t UVA ER,hepl ntf wastke t t s ni o he t ai if a n o he a s sme t r a wh r h rp re hsp riiaini teTo rmaesud (d) Th UVA se s n a e , ee e e o td i a t p to n h pia t t y. I . e c ER safte die tdtepli tf t l g ri t lb yi ln i apa i. (d) Du i h swat tf h n rce h anif o i e n he o b t o e n nc' I . rng i i n a ' i telb y,h panifSellu a l t b e t , l, t. ndE s ta maie E t n h o b t e litf t l n b e o rahe wak ec a wa ) r u tz d t ) f t ha nogonewl d)hel hi s i ashow t yc usdi vi t e rme .'(d. l oul p m eeng he a e t a he xpei nt' I ) A fe t ur ' ofw aii a wom a s m one t pl i ift a w i ow w he e he s t r t s' ho tng, n um d he a ntf o nd r poke wihtewo na o th swata dh sc n iin (d. t3) S b e u n t t sc n es to te t h ma b u i i n i o dto . I a . u s q e t o hi o v rain,h pli tf wasuna et wal ba k t hi s ta c lps d ont foo i fontoft wi a n if bl o k c o s ea nd ola e he l r n r he ndow. (d. Th wo nt wh m t epanifs o eC id if lyif nngd hm (h t heta tst l ) e ma o o h litf p k t s an u l n o e ) i t a) c n' i d (j ee' (d) W h l t epanifrmane c la sd o t efo r as c n n repa sdte th r.' 1 . ie h litf e i d olp e n h lo , e o d u s se h ' pli ifa c antf nd omme e t anohe pes t tt pli ifwa dcaz ' (d. Noonepr de ntd o t r ron ha he antf s ir y. l ) ' ovi d t plitf wihanya ssa ewhiehewa c lps ont foorne t wi he anif t sitnc l s ola ed he l ar he ndow.(#. J) t nal a t holr ea elj'UVA ER saf 1dt pli ift ta ioltda e outof t ly, fer zs lps d s Fi ' t f e he antf o dn s ae r a ge rlle rhotoft ot rpaint,' r t pli ifrmanedaone.(d. Thepli if ne la a s he he te s'whee he antf e i l l) antf camst hec dhavebe na te att stmet t dulysafdps h uni. (d. li hat oul e dmitd hi i o he t l tfe yc t' 1 ) f ' W hie t pl i ifw a t d,hi G a c sa e '1 d hi t be i vet thi û ye ve n' wasca i l he a ntf ie s s ni t t ' e m o le ha s l m e i' usng hss fe ig (d) Th plitf rp re ti s l- ig o i, ihhed s rb sa çu a y't i ufrn . 1 . e an if e o td hs efda n ss wh c e c ie s s n c , o l ' t ee doc or who ar i i t pl i if sr hz t s rved n he a ntf ' oom a alo c m m uni t d t t m hi pa tc pa i nd s o ca e o he s r i i ton i t dl sudy.(d. The et e docor de e tdt pli iff a he pr o edpe i n he ' t ug I ) s hr e t s s re he antf or not r olng rod b f r an ree tr dt ep an ifsr o E ciga t o ht e f g lp an if( s j s a eo e u s nee h litf o m,d tn s h ug h y el litf wa l u t a t t r ousne1y.' (d. Thi nurea nitrdonedos ofvail a t nçsnl!(he ne v l '' I ) s s dmi see e ltm nd he se t t panif it ten g l ' (d. i sn l d s o v lu t plitf alg s fie t lit j n o h iht.' I )Th s ig e o e f aim,he an if le e , ald o f l sa lzehi r a ont To rmaea fie t prve hi c to fom deei ai (d. tbii s e di o pia t nd ald o e nt s ondiin r trortng. l ) Theens ngf z ortve da ,a or ng t t pli if we e t lvi hel'off a and ui olr i ys cc di o he antf, r $ i ng l' e r a hal i tons (d. Durngt stmepei t pli ifc ace UVA Caesve a tme , lucnai . I ) i hi i rod,he antf ont td r e r li s buthi c s omm t c tonsc us t UVA Ca esa ft dit et ms l sfo t pli if mia i a ed he r t f o sanc he eve r m he antf e nf rher (#) ve u t . J= The pl ntf t n boa de a bus a t a le t Fl i t tt e ns hi s l of ai if he r d nd r ve l d o orda o çcl a e' m e f ç e n .' (d a 4. Ho v r b fr j u n yn t Flrd ,hepan ifrc ie atlp n d mo s' I . t ) we e, eo e o r e ig o o ia t litf e ev d ee ho e ' c lfom atveyne v 'UVA Caedocort who t pli ifrporedhi detnai (d al r t r r ous' r t o m he antf e t s si ton. L=) UVA Car ma nof t rate st c a tt pli ifdurnghi t ei Fl i .(d. e de urhe tmpt o ontc he antf i s enur n orda L=) Onemonhltr t pli ifee e t la Fl i a ta t Ne Yor (d.a 4. Beor t ae,he antf lctd o e ve orda nd rvelo w k. 1 t ) f e e c i hi plns t pl n ift l ne t s meUVA Ca edocort i r whehe t xe utng s a , he aitf eepho d he a r t o nquie t r he docorwihedt vii wiht plitf.(d. trt dodorr ponde i t ne tve,he t s o st t he anif 1 )Afe he es d n he gai t pli ifta l t New Yor (d. W hiei Ne Yor t pli ifs frdfom ç r ve antf rveled o k. 1 ) l n w k,he antf ufee r t a g i er it ntpa c a t c ' a e r e ed tr c l c i nsofodd i e r tona a pe t oft nt m te ni ta ks ' nd xpe i nc ûe ole to nt r oga i l s c s he ( UVA Caesud hewa i ' (d Thepli ifrpore t eme c lis t UVA Cae, r t y) s n.' L=) antf e td hes dia sues o r whihc e ie s hr ci a c c atgorz d uc ea tons s ommonpl e.(#za 5. Afe s frngfom apa tc al ac J . t ) tr ufei r riulry s ve e pa c a t ck,t pl i ifc m it d hi s l t aN ew Yor hos t ' e e ge y r , e r ni ta he a ntf om te m e f o k pials m r nc oom wheeh r c ie c rans d tv s (d) Th p anifalg st t et o tn e t t i d yt r e e ev d e ti e aie . l . e litf l e ha h t n iu s o hs a o e c sr ggl wihpani atc t tweenonle sen p i t hi patcpai i t ( tu e t c ta ks ha r lxit t ror o s rii ton n he UVA Cae r sudyl' (d. t - l) ' St andard ofR e ew vi Unde 28U. C.j 1 5,whihgovensL f mapa rspr e ngs t c tbe sa r S. 91 c r q or upei oce di ,he our ar ma d tr d t t sr e i ta fl g .Erln Co v J h s n, 40F.d65 5 ( t Ci. 0 6 . n ao y uy o ce n ni l ii s iie . . o n o 4 3 6-7 4h r2 0 ) i n Specfc ly,; diti tc t us dim isan a ton t tt cou tfndst be fi ousor ii al t src our m t s s a ci ha he r i o rvol malcousort fist saeacli ' Miha v. reson Cnt , 4 F.d 7 7 ( hCi. ii hat al o tt am.' c u Chal t y.43 3 25, 28 4t r 2006)(ii 28U. C.j1 ()2)B). ctng S. 915e( ( ) Thesa r ofr viw f am o i t dimi sund rFede a Rul ofCi lPr e e t nda d e e or ton o s s e rl e vi oc dur 1 ( )6 as a pist ad s sa f rfi et saeacam u d rj1 5 e( )B) Ne o 2 b () lo p le o imis l o al o tt li n e 91 ()2 ( . ws me ur v EEOC, 01F.d2 7, 31( t Ci. 0 2 .Th ,nrv e ngac mpli t n e t ssaue . 3 3 2 2 5h r 2 0 ) us i e iwi o an u d r hi tt t, t co tmus t c pta tu al we lplade al gai ns' nd c tuet e al gai i t he ur t ç e s r e 1 l- e d le to 'a onsr hos le tons n he ac lg mos fvorbl t t pl ntf.Myln La .I v. aka i7F. 11 11 ( hCi. iht t a a e o he ai if a bssnc. M t r, 3d 30, 34 4t r 1 .A c an ne notasetdealdfcualalgai , mus co anEmor t 993) omplit ed s r tie a t le tons but t nti t e han l bel and c l i ,a a f m ul c r cia i oft el m e s o a c us o a ton wilnot a s onc usons nd or ai e t ton he e nt f a e f c i l do. BelAt.Co p.v.Twombl 55 U. 544,555( ) Furhe mor,ev a s mi t ' l l r ' y, 0 S. 2007 . t r e en s u ng he f cuala lga i i t c a t le tons n he ompli a etu t y C tbee ant r r e, he t mus noug t r ie arghtt r i a h o a s i o elef bove t s c a i lvel' l he pe ultve e .' d. Di c s o s us i n Thepli ifa nc si hi c pli tt ca esofaci n agans t de e ntantf dva e n s om a n wo us to i t he f nda s f r t a f de alc ai f a vi a i oft Em e g nc M e c lTr a m e a A c i La rA c i s , e r l m or ol ton he r e y di a e t nt nd tve bo t ( EMTALA)42U. C.j 1 , S. 395dd()( ,a s c amedia ne iencecai unde Vigi a a-b) nd, e ond, c l glg lm r r ni 4 lw. l pe f ngiss r e ng f to wih r pec t t e cai s t c tbiur aesis a n ronni t c e ni unci n t es t o hes l m , he our f c t t a ys sand co i r tr tt EM TA LA c a m a t n t ne i nc cl m . nal i ns de s i s he l i nd he he glge e ai 3 EM TA LA Cong es e t EM TALA a a û nt- um pi ' t t t ,t lm ie pur eofwhi r s naced s n ç id a ng'sa u e he i t d pos ch l st g tpai nt i ot s t m who mi hto he wiegounte t d a be l twihoutar m e s o e te s nt he yse i g t r s r a e nd ef t e dy be us t a tona m e c lm al a tc l w a f dsno c ai f f iur t te t' Br n v. ca e r dii l di a pr c i e a f or l m or a l e o r a . ya ' Re t r & Viio so Unv. f .9 F.d3 , 51(t Ci. 9 6 .He c , litfsma n t co s str f i o Va, 5 3 49 3 4h r 1 9 ) n e panif y o utlz EM TALA asa s tt e f r sa e 1 w m a pr c i e ac i ns Pow e v. lnMt H os ii e ubs iut o t t a l a tc to . r Ar i on p. As' , 2F.d8 , 5 ( t Ci.1 9 ) Br o v Md. n Hos .l c, 96F.d7 8 71 - 3 sn 4 3 51 8 6 4h r 9 4 ; o ks . Ge . p. n .9 2 0 , 0 1 (t Ci.1 .l ta EM TALA s r esadif rn pur e. 4h r 993) nse d, ev fee t pos i tons i s, t EM TALA i pos sonpa tcpa i hos t l4t prncpaloblga i . C rt i m e ri i tng pias wo i i Fi r quiest twhe a i vi e r ha n n ndi duals kst e t e a a hos t l se e ge r ,çhe hos t l ee r a m nt t pia ' m r ncy oom t pia m us pr vi f a a opra e m e c s e ni e m i ton ...t de e m i w he he ornot t o de or n ppr i t di al cr e ng xa na i o t r ne t r a e e ge y medialc to e ss' Vike sv. s Ge Hos .l ,78 F. 1 1 n m r nc c ondii n' xit.' c r Na h n. p. nc. 3d 39, 42 ( t Ci. 9 6 ( u tng4 U. C.j1 9 d ().t e o d it esr e i e a n to rv as 4h r 1 9 ) q oi 2 S. 3 5 da ) s c n ,f h ce nng x miain e e l s t pr e e ofa e e genc m e c lc ton, he hos t lor na iy m us çt bii t he es nc n m r y di a ondii t pia di rl t s a lze he me ca c ton'bef etanse ngordichagi t paint' 1 ( i 42U. C.j di l ondii or r fni s r ng he te .' d. quotng S. 1 9 d ( )1) 3 5 d b ( ). The g lofEM TA LA ' s r e ng r q r m e ( s t de e m i w he he a pa i ntw ih oa S c e ni e uie nt t o t r ne i t r te t a ut o s ve e s pt shasa lf t ea e ng o s r o m edi alc ton. Ba rv. os c e r e r ym om ie hr t ni r e i us c ondii ' be H p. ' 3 Theco tnotsi taly t tt pl ntf hasna eda ad e tt U ni r iyofV igi aM e c ur e nii l ha he ai if m s efndan he ve st r ni dial Ce tr( dcl ne) Be a s teMe ia Ce triadvso o teRe tra dVii r o teUnv ri o ne Me ia Ce tr. c u e h dc l ne s iiin fh co n st s f h iest f o y Vi n a M ilrv Unv. f . e . r, 8Va Ci. 4 ( . r Ct 2 0 ) t eM e c l n e i a i o e r i, l . i o Va M d Ct.5 . r 2 0 Va Ci. . 0 2 , h dia Ce tr s n mpr p r gi e d fn a t J h o v Un v o Va M e . r, v l . 0 c 0 61 2 0 W L 1 71 1 a * ( . Va J n 1 , e e d n . o ns n . i . f . d Ct.Ci i No 3:6 v 00 , 0 7 3 1 , t 4 W D. . a . 7 20) 0 7. 4 A Pa tcpai hos tli de i asat pialt thase eedi oapr de a e m en unde s ci rii tng pia s fned ç t ha hos ntr nt ovi r gr e t r e ton 1 9 c o ti tl. 4 U.. j1 9 d ()2 . 3 5 c f hs ie' 2 SC. 3 5 de() t ' Co . fAm.9 7F. 8 2, 7 (t Ci.1 9 ) Toa he et i g a,h sauete ur sa p o , 7 2d 7 8 9 4h r 9 2 . c iv hs o lt e tt t s q ie r hos t t de l a s r ni pr dur de i d t i en iy s h c ii lco tonst te s pial o ve op c ee ng oce e s gne o d tf uc rtca ndii ha xi t i s pt a i pa i nt and t a y t ts r e ng pr dur unior l t a lpatent wih n ym om tc te s o ppl ha c e ni oce e f m y o 1 i s t smi rc mpans' l . f onoeo te ) s eas i a 8 1(tW ) h l t a ah s ia i l o lit. d (o t t mitd ; e lo d. t 8 t e o d h t o ptl a ' ( s tsis( aife EMTALA' s re n rq ie nji issa d r s re i pr c dlei a pid S ce nig e ur me t f t tn ad ce nng o e t s p le r unionnl t a1paint i smia me c lcrumsa e .) f y o 1 te s n i lr dia ic tnc s'.Howe r at hEMTALA ' ve , lhoug oblgaeshos t e ge r m de rme st a y unior l issa r s r eni i t pial mer ncy oo pa t nt o ppl f m y t t nda d c e ng pr e e, TA LA i no a m e c m al a tc sa u e a t , oc dur EM s t di al pr c i e t t t nd, hus doesnotgua a e t tt r nt e ha he s r e ng exa i ton wilyi l a c r c di gnos s l a 879. c e ni m na i l e d or e t a i . d. t l t ss r e ng pr es r s t i a di gnos st tt pa i nthasa em e ge y m e ca f hi c e ni oc s e uls n a i ha he te n r nc di l c ton,5EM TALA r quie t e e ge y r ondii e r s he m r nc oom pe s r onne t pr de s h a tona l o ovi uc ddii l e xami ton a team e a i ne esar t sa lz 6t ec dii . Vi ke s 78F. a 1 na i nd r t nt s s c s y o t biie h on ton c r, 3d t 45 ( i 42U. C.j1395 b)1 ) EM TALA ta t a t dignossa agi n, y quotng S. dd( (). t kes he cual a i s ve onl t oblgai hos tl t sabiiecondii t tt ya t lydee t' 1 (uoi Ba r 977 i tng pias o t lz tons ha he cual tc.' d. q tng be , F. a 883) I ohe wor ,EM TALA tdoe nothol hos tl a countbl f f lngt 2d t . n t r ds t s d pias c a e or aii o sa lzec tonsofwhi h t y a eno a r ore n c tonsofwhih t y s d ha tbii ondii c he r t wa e, ve ondii c he houl ve be na r ' ( 'ALA woul ot r s bec coe e i wihmal a tcecai fr e wae' ; f - EM d hewie ome xtnsve t prci l ms o ne i entte m ent' l glg r at . d. ' 5 EM TA LA defne a t m e ge m e c co ton' f l : i s n d r ncy dial ndii 'as olows e ( me ia c n iin ma fsig isl b aue s mptms o s fiin sv rt (n ldng AJ dc l o dt o niet tef y c t y o f u fce t e ei icu i n y sv r p i)sc ta tea e c o i daeme ia atninc udra o a l bee p ce t e ee an u h h t h bsn e f mme it dc l te to o l e s n by x e td o rs li--iplcn t eh at ofh i iiu l . i sro s e pad (is ro si i e to eut n t) a ig h elh te ndvd a . .n eiu j o ry,i eiu mpann n t ) bo l fncin , r(i sro sd fn to o a yb dl og no p r . . di u t s o i) eiu ysu cin f n o i ra r at . . y o i y 42U. C. 1 9 d ()l( . S. j 3 5 de( )A) 6 EM TALA pr vi t tço sa lz ' ea to pr des h medialr t entoft c to a m a be o des ha ç tbiie'm ns G ovi uc t t c team he ondiin s y ne es ayt a s e, ihi r as bl m e c pr biiy,ha no m aei dee i ai oft c to i lkel t c s r o s ur w t n e ona e dial oba l t t t tral trorton he ondiin s i y o rs lfo o o c rd rn teta se o teidiiu lfo afcly' 4 U. C. l 9 d ()3( . eut rm r c u u ig h rn fr f h n vd a r m a it. 2 S. j 3 5 d e( )A) i ' 6 Appl ngt sl t t f c si t i t ntca eyil t c l i t tt pl ntf yi hi aw o he a t n he nsa s eds he oncuson ha he ai if hasf ie t s a e a c a m f a EM TA LA vi a i 7 l ta l , t pl i if s EM TA LA c a m a l d o t t l i or n ol ton. nii ly he a ntf li f l be a et de e ais c us he f ndan sa ei munefom s t J on v. v. Va M e Ct.Ci l t r m r ui. ohns Uni of . d. r, vi No. 3:6 v 0 6 , 0 7W L 1 5 5 5 a * ( . Va Ma 2 , 0 7 (o cu igt a t 0 c0 0 12 0 5 6 5 , t 7 W D. . y 4 2 0 ) c n ldn h the Com m o alh ofV igi a a t Re t r a V i ior oft U ni r iy ofV igi a a a a m nwe t r ni nd he c o nd st s he ve st r ni , s n r oft Com m onwea t a e i m une fom EM TALA s t bec us Congr se es e i he 1h, r m r uis a e es xpr s d n EM TALA not qui lco e t a oga eVig ni si me voca ns nt o br t r i a' mmuniy a bec us t t nd a e he Commo 1hdi nots eq nl waveisi nweat d ubs ue ty i t mmuniy) afd, F. x625( hCi. t , f 260 App' 4t r 2008) . l a e nt t pli ifsEM TALA cli f l f ra mor s t ntver s n.As n ny ve , he antf am ais o e ubsa i ea o m en i d a ve,EM TA LA ' co e pur e a m sa a r i di pa a e t e t e . V i ke s 78 tone bo S r pos i t ve tng s r t r a m nt c r , F. a 1 Br 3d t 43; ooks 996 F. a 71 Ba r 977 F. d a 881 8 The pl i ifa l gest tt , 2d t 3; be , 2 t - 2. a ntf le ha he UVA ER pe s nne f l t s r e hi a qua ey be us t y f l t muse t i d ul r o l aied o c e n m de t l ca e he aied o tr her ç l f r s u c s'oe au t a te thm u nh sarva t teUVA ER.( c e No. a 56. e o re 't v lae nd ra i po i ri lo h Do k t 2 t - ) H o e , he pl ntf f ist a l ge t the S ec i dif r ntt e t e t n ot rpa i nt w ver t ai i f a l o le ha é e ved fe e r a m nt ha he te s r pe c ve t ha t s e m e ca co ton. i ke s 78 F. a 1 Fort sr as n, he r ei d o ve he am di l ndii ' c r , 'V 3d t 45. hi e o t pl niffist saeacli ofi ppr it s re ngunde EMTALA.Seege r lvt. aitf al o tt am na oprae ce ni r ne al ts t (fimi t dititcour' dimis loft pli ifsEM TALA cai f i p o it afr ng he src ts s sa he antf l ms or na prprae s r e ng a f l et s a lze, t r i ng t ts h c ai s pr s nt d a l ga i m or c e ni nd aiur o t bii de e m ni ha uc l m e e e le tons e prpel br o ry oughti saecour asmal a tc a to ) s ealoBabe,977F. a 881 n tt t prcie cins; e s r 2d t 1 Theco tnotst tEM TALA i pos at ye lm ia i pe i i whi aci m us bebr ur e ha m es wo- ar i ttons rod n ch tons t ought 42 . U.. j1 9 d ()2( .Th panifalg si hsc mpan ta ter lva t ve t o c re s mei i tae SC. 3 5 dd ()C) e litf le e n i o lith t h ee n e ns c u rd o t n t t me l smme 2 0 . ( c t 2a 1)Th qlitftldhscmpan n erirh nSpe e 7 2 1tedt h u r 0 9' DokeNo. t . e anifie i o lit o al ta etmb r , 01,h ae e * e sg e tec mplit n ma h v plcdli teprsnmal jsse Co rdv. r, vl to No. 1ind h o an a d y a e ae tn h io iï ytm. na Akes CiiAcin 7:0 n c -0 6 , 01 W L38 7 7 a * ( D. . g 3 , 01 )(ligHo tnv La k 4 7U. 2 6(98 :. v0 5 0 2 1 4 01 , t 5 W. Va Au . 0 2 1 ct n uso . c , 8 S. 6 1 8 Be a s ii t la fo tefcua a srin i tec mplit eh rh glitf fldt ss twi ntet cu e t smcer rm h at l set s n h o an wh te te anif i hi ui t h wo o e hi ye rlm ia i pe i t c twilnotr l on t s a u e ofIm ia i i dl mi s ng t pl ntf ' EM TALA a i t tons rod, he our l e y he t t t i t tons n s s i he ai if s cl m . ai (fimigted src c u tsg a to s mma yj d me ta dc n ld n ta teplitf afr n h itit o r' rn f u r u g n n o cu i g h t h an if of e e no e de e ofdi pa a e tea m e t s po t s i ppr i t s r ni cl i u e frd vi nc s r t r t nt o up r hi na opra e c ee ng a m nd r EM TALA) . The pl ntf scl i t tt d e nt vi a e EM TA LA t ough negl c i t ai i f a m ha he ef nda s ol t d hr e tng o s a lzehi c ton lkewi e m us f i. The f c t tt UV A ER s a fm i have f ie i t bii s ondii i s t al a t ha he t f ght a l d, n a t lt t sa lzehi a l edr a ton t Topin t i ir lva underEM TALA. l t d, c uaiy, o t bii s leg e c i o r mae s ree nt nsea t o y r e nti r unde EM TALA' sa lz ton r quie e i whehe t UVA ER he nl elva nquiy r S t biia i e r m nt s t r he pe s nelpr ry sa lz t co ton fom whih t y per e ve t pl n ifass f rng. r on ope l t biied he ndii r c he c i d he aitf ufe i SeeVike s 78F. at1 (1 isf e,( c r, 3d 45 6On t ac EMTALA' sa lz tonqpr sont st a t l S tbiiai ovii ake he cua di gnos s a a gi n,o y oblg i hos t l t s a lz co to t tt a t ly a i s ve nl i atng pia s o t bii e ndii ns ha hey c ua l deec ... ( TALAJdoesnothol hos tl a c a ef fii t sa lzec tonsof t t . EM d pias c ountbl or alng o tbii ondii whiht a enota r ore nco tonsofwhiht ys ul ha be nawa e' .Unde c hey r wae, ve ndii c he ho d ve e r .' ) r t f t a a l ge by t pl ntf , he s r e ng pr d e r s t d i t UV A ER s a f s he ac s s le d he ai i f t c e ni oce ur e ule n he tf pec ptont tt pli ifwa at v nel ' ( ke No. a 3. te tt speceve re i ha he antf s d ous ly.' Doc t 2 t )To ra hi r i d ner c ton,hepli ifalges t UVA ER safa nitr donedos ofvalum.(d. He e, ondii t antf le ,he tf dmi se e e i l ) nc unde t f t a a l ge i t com pl nt t pl i if sc a m f a vi a i ofEM TALA ' r he ac s s le d n he ai , he a ntf l i or ol ton S sa lz ton r quieme f isbot be a et UVA ER saf di notpe c i t pli ifa t biia i e r nt a l h c us he t f d r eve he antf s s frngfo a e r nc me c lc ndiin,seBa ,97 F. a 883(oncudi t t ufei r m n mege y dia o to e ber 7 2d t c l ng ha EM TA LA ' s a lza i n r r m e ti nott i r d unl s a hos t la t ly de e m i t ta S t bii to equie n s r gge e es pia c ua l t r nes ha paints fr fom ane r nc me ca c tona t str i dei byt saut) a te ufe s r mege y di l ondii s hi em s fned he tt e , nd be a e i a e nt t saf pr vi d t pli ifwihvalum t sa lzet pl n ifs c us , n ny ve , he t f o de he antf t i o t bii he aitf pec i dne v ne s Se Vikes 78F. a 1 ( tr ni t tahos tlsdignoss reve r ous s . e c r, 3d t 45 deemi ng ha pia' a i m us be accept atf val f pur esofan EM TA LA anal sand concl ng t t ed ace ue or pos ysi udi hat 8 hos t l ma behel la eunde EM TALA' sa lzai pr son o y f f ii t sa lze pia s y d ibl r S tbii ton ovii nl or a lng o tbii c tonsofwhiht yaea r) ondii c he r wae . A s dic s d a s us e bove t c r c ne soft U VA ER ' di nos sasa r ul oft , he or e t s he s ag i es t he s re igp o e si ir lv n f rp r s so tealg dEMTALA v oain .Th ti as b e t c e nn r c s s ree a t o upo e f h l e e i lto s a s u j c f rasae1 mapr tc cai Se i a 1 (oncudi t tt pl ntf salegainsof o tt aw l acie l m. e d. t 43 c l ng ha he ai if l to i ppr it s e ni a f llet sa lz ( tm ae ypr e c na opra e cr e ng nd aitr o t biie t i tl es nt onve i lc ge of ul ntona har s midignoss'prpel br ug a cai ofmaprcieunde saelw) He e,f t ras s a i' o ry o ht s l ms l a tc r tt a . nc or he e ons sae a tt d bove, hepl ntf ha f ie t sa eacli f EM TALA vi a i nsupon whih r i t ai if s al d o tt am or olto c elef m a be gr nt d. Acc di y,t t e e t tt pl i ifs e t r ove f om t de e n s y a e or ngl o he xt nt ha he a ntf e ks o ec r r he f nda t bas d on a l e EM TA LA vi a i ,t pl i ifs c pl i m us be di m i s pur ua t 28 e leg d ol tons he a ntf om a nt t s s ed s nt o U. C. 1 5e( )B) S. j 91 ()2 ( . M e c ne i nc di al clae e A sdi c s d a s us e bove, he pl i i fa s s kst r ove f om t def nda sunde a t a ntf l o ee o ec r r he e nt r neg i nc t or H ow e r t pl ntf ne i e c a m f l bas d on pr e a r s ns lge e he y. ve , he ai ips glg nce l i ais e oc dur l ea o . l ta l t pl i iff ie t fl t sa ton wihi t one- rlm ia i pe i pr dedby niily, he antf a ld o ie hi c i t n he yea i t tons rod ovi t Vigi a To tCl m s A c .8 Va. he r ni r ai t CodeAl j8. - 95. ( es 2011. m. 011 7 W t ) l a e nt e n i t pli iffl hi neg i nc cam wihi t lm ia i pe i n ny ve , ve f he antf ied s lge e li t n he i ttons rod, t cl m silc dno gof wad.l Vigni,t Vigi aM e ca M aprcieAc ( MA) he ai tl oul t or r n r i a he r ni di l l a tc t VM r quiesa pa t a l gi ne i n m ed c lc r t obt i a e r ce ttc ton ofm e i pr o e r ny r y le ng glge t i a a e o a n n xpe t rii a i rt i r t s r i pr es upont dee nt Va. o e vng oc s he fnda . CodeAl j8. - 1.Thef l et c ywih m. 0120. aiur o ompl t t sc riiaton r uie e g ve rs t gr hi e tfc i eq r m nt i s ie o oundsf dimis l d.Br or s s a .I ; embr v. t d Stt s y Unie ae , B Thepl ntf algesi hi c ai if le n s ompl ntt t e nt gi ng rs t hi ne i ncecl m oc redi ilt ai hat he ve s vi ie o s glge ai cu r n tae s mme 2 0 . ( c t 2a 1)Asdsu sda o e hsc mpan c udh v b e fldn e rirta u r 0 9' Do ke No. t . ' ic se b v , i o lit o l a e e n i o al h n e e Se embe 7, 11.Suor noe7.He t pl n iff l t fl hi ne i ncecli w ihi t oneye r pt r 20 a t nce,he aitf aied o ie s glge am t n he - a lm ia i pe i i t tons r od. 9 No. :0c 38 , 01 W L 1 7 , t* ( . Va Jn. 3, 01 ) Dea e v. a s , v l 7 1 -v- 8 2 1 21 41 a 7 W D. . a 1 2 1 ; ln v M rh Cii Aci No.7: c 00465 201 W L 1 256 a *3n. ( . Va Mar 25,201 .The ton 08-v, 0 21 9, t 6 W D. . . 0) V M M A a hor z s e us oft c r ii a i r quie e onl w he e t pl i if û n g ut i e xc al he e tfc ton e r m nt y r he a ntf , t ood i f ih,al sam e c lmal a tc a tont tas e t at r ofla lt whe ee r at lege di a pr c ie ci ha s rs heo y ibiiy r xpe t t tm o i unnec s a y be us t al d a tofneg i nc cea l le wihi t r e o esi ny s e s r ca e he lege c lge e l ry is t n he ang f t j y' c he ur s ommonkno e ande re e' Va. wldge xpeinc .' CodeAnn.j8. - 1 Vigni co t 0120.. r i a urs ha obs r d t ti t nc s e usng t c r ii a i r qui e e w ilbe ( a e. Be r y ve e ve ha ns a e xc i he e tfc ton e r m nt l t r ' ve l r ' Entr .va v. c s 441S. 2d 1 3( .1 4) e s- . Nihol, E. , Va 99 . H e e t pl ntf scom pl nta t a t c d doc e t a e de d ofa r e e e t r , he ai i f ai nd he ta he um n s r voi ny ef r nc o t V M M A and t t e r c r ii a i r qui e e . The c tfndsi pr ri t si t nc he o he xpe t e tfc ton e r m nt our i m ope n hi ns a e t e aloft cettc tonr uie t Vigi aprce n cla l e tbls st t Gll he xcus he rii ai eq rmen. r ni e de t e ry sa ihe ha: tln mo tisa c s e pet etmo yi rq ie t a ss tej r Ex e te tmo yi o dnaiy s n tn e , x r tsi n s e u rd o sit h u y. p r tsi n s r i rl nec s a yt e t bls t a opra esa r ofc r a de a i fom t tsa r a t t e s r o sa ih he ppr it t nda d a e, viton r ha t nda d, nd ha s h de a i n w ast pr m a e c us ofda ag . I i igi a co t ha alow e uc vi to he oxi t a e m es' d. i r ni ur s ve l d ' v pli if t pr e d wihoute rsi me c lne i nc c s sonl i st tonswhe e a antfs o oc e t xpe t n dia glge e a e y n iua i r l y r on w oul know t r qui ie s a r ofc r wihouta s s a e.' Br m br 2011 W L a pe s d he e st t nda d ae t s it nc ' e y, 1 741 a *8( tngBe ryEntr.va.441S. 2da 3) s ealos c.Cosonv.Bi M e 21 , t cii vel es- , E. t ; e s e. , t o- d. Applc tonsofVa.l ,654S. 2d5 562( .2008 ( tr ni t te r t tmony iai , nc. E. 60, Va ) deemi ng ha xpetesi w a t ne e s r whe e t pl ntf aleg t tt de e nt se pl s t i e pl ce he i a s m c s ay r he ai if l ed ha he f nda ' m oyee w c a d r n de e tvec i,c usnghe t fl a srket grundbot tme) Dike s v. thi 48 f ci har a i r o al nd ti he o h i s; c ron Fae , 4 S. 2d880,882( 1 97 (xpl ni t te r tsi E. Va. 9 ) e ai ng ha xpet etmonywa ur c s r wheet s me esa y r he plitf aleg t taphysca l tane ei he ne k f l ngs geyl Bevel Entr. anif l ed ha iin ef edl n r c olowi ur r ; rv es- Va,4 S. 2da 3(i ngexpe tetmo t c s r ont is whehe t dee nts . 41 E. t fndi r tsi ny mne esay he sue t r he fnda ' 10 e oyee we ene i nti l vi atay off wih apa intwho wasunabl t fed he s l mpl s r glge n ea ng r ood t te eo e r ef a whoprvi l ha s ro c ngi i nt) J fronHos .l v.VanLe r 41S. 2d nd e ousy d eius hoki ncde s; efes p. nc. a , E. 441 44 43( 1 ( e mi ngt te r tsi nywa ul c sr wheet pl ntf , 2- Va. 947) detr ni ha xpe tetmo s me esay r he ai if a l ge t tnur esdel ye t r y m i e i r s le d ha s a d hi t nut s n e pondi t a c l f om a e de l be rdde ng o a l r n l r y, d- i n paintwhoprvi l hadde etdhi be wihoutmsitnc . te e ousy s re s d t ssa e) l tec s a b r i i n t t i tec mmo k o e g a de peinc o aj r t n h a e t a,t s o wihn h o n n wld e n x re e f u y o dee m i whehe t UVA ER pe s tr ne t r he ronnels tsi d t sa r ofc r i t i di gnossoft a ife he t nda d a e n her a i he pl i if sco ton a i t i s l ton o t e t e pur uantt t tdi gnos s l e a ntf ndii nd n he r e ec i f r a m nt s o ha a i . nde d, as rai ngt exa tsa r ofca ei t st ton al d by t pli ifi a exe c s ce t ni he c t nda d r n he iua i lege he antf s n r ie o ti eo a u y' o dn r c mp e e in.Th s tec u t id t t hsc s fist q aiya u sd f j r s r iay o rh nso u ,h o r fn s ha t i a e al o u l s f one oft r r i t nc i whi h t di pe e w ih t VM M A ' expe t r ii aton he a e ns a es n c o s ns t he S r ce tfc i r ui e e . A c or ngl be aus t pl ntf f l d t o ai s h a c r ii ato t c t eq r m nt c di y, c e he ai if aie o bt n uc e tfc i n, he our concude t tt pl i ifhasf ld t saeacl m onwhih r le ma begr nt The l s ha he antf aie o tt ai c ei f y a ed. pli ifscli f me c negi nc t rf emus bedimis puruan t 28U. C.j antf am or dial lge e heeor t s sed s t o S. 1 5()2)B) 91 e( ( . Concl on usi Fort f e ng r s , he c t nc ude t tt pl ntf scl i s m us be he or goi ea ons t our co l s ha he ai i f a m t dimis dpurua tt 28U. C.j 1 5( ( ( .TheClr i die tdt s ndacetfe c s se s n o S. 91 e)2)B) ek s rce o e riid opy oft sme or hi m andum opi on a t a co nyi or rt t pli tf. ni nd he c mpa ng de o he a n if ENTER:Ths . i da of i 5x y œ m Be ' xk , , , 2 1 01 . 1 > *- Chi Unied St esD i t ctJudge ef t at sri

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