Cervantes v. El Paso Healthcare Sys., Ltd.

645 S.W.3d 843

Consuelo CERVANTES, Appellant,

v.EL PASO HEALTHCARE SYSTEM, LTD., d/b/a Del Sol Medical Center, Appellee.

No. 08-20-00227-CV

Court of Appeals of Texas, El Paso.

April 8, 2022

ATTORNEY FOR APPELLANT: John Grost, 8001 N. Mesa St., Sute #, El Paso, TX 79932.

ATTORNEY FOR APPELLEE: Joseph L. Hood Jr., Windle, Hood, Norton, Brittain & Jay, LLP, 201 East Main Drive, Suite 1350, El Paso, TX 79901.

Before Rodriguez, C.J., Palafox, and Marion, C.J. (Ret.)

OPINION

YVONNE T. RODRIGUEZ, Chief Justice

Appellant, Consuelo Cervantes, brought an action against El Paso Healthcare System, Ltd. d/b/a/ Del Sol Medical Center, Appellee (Del Sol), for violations of 42 U.S.C. § 1395dd, also known as the Emergency Medical Treatment and Active Labor Act (EMTALA). In a single issue, Appellant challenges the trial court's grant of Del Sol's motion for summary judgment. We affirm.

BACKGROUND

Factual Background

According to Cervantes’ petition, on April 9, 2016, at 7:12 p.m., Cervantes’ medical records reveal she sought emergency care for abdominal pain at Del Sol. Cervantes was seen by Dr. Shariq Khan. Cervantes was physically examined and laboratory tests were ordered to include a CT scan of her abdomen. The CT scan revealed Cervantes had a recurrent ventral hernia containing bowel loops. Cervantes was treated with Valium and an intravenous solution of Sodium Chloride and Hydromorphone. It was determined Cervantes’ condition was stable and improved. Cervantes was then discharged April 9th from Del Sol at 9:46 p.m. with prescriptions for Tramadol and Zofran.

In her petition, Cervantes alleged she returned to Del Sol's emergency department, a little over four hours later, at 1:49 a.m. on April 10th complaining of abdominal pain. Her medical records indicate her pain level was nine out of ten and the prescribed medications were not working. Dr. Khan reviewed her prior laboratory tests and CT scan and screened Cervantes again. Based on his second screening, Dr. Khan ruled out an impression of an incarcerated umbilical hernia. Cervantes’ family requested her transfer to Sierra Providence East, the hospital where Dr. Jaime Gomez, the surgeon who performed her prior hernia repair, could see her. Finding Cervantes’ condition stable, Del Sol attempted to arrange the transfer, but it was denied. On April 10^th Cervantes was released from Del Sol at 6:32 a.m. with instructions to see Dr. Gomez at Sierra Providence upon discharge.

Cervantes’ petition alleges she arrived at Sierra Providence at 6:59 a.m. on April 10th. She further alleges she was suffering from shock and sepsis. Cervantes states she was eventually admitted to the intensive care unit at Sierra Providence and underwent surgery due to a perforated bowel. Lastly, she alleges she was hospitalized until May 19, 2016, and then transferred to a rehabilitation hospital where she remained until July 2016.

Procedural Background

On December 1, 2017, Cervantes filed suit in the El Paso County Court at Law Number Three asserting Del Sol violated the EMTALA on April 10, 2016. On April 2, 2018, Cervantes also filed a lawsuit in the United States District Court for the Western District of Texas asserting Del Sol violated the EMTALA on April 9, 2016.

On May 2, 2019, the federal lawsuit was dismissed. Cervantes appealed and on November 21, 2019, the United States Court of Appeals, Fifth Circuit, affirmed the dismissal, finding no EMTALA violation for the April 9, 2016, emergency room visit.

On May 7, 2020, in the trial court below, Del Sol filed its motion for summary judgment pursuant to Rule 166a asserting res judicata barred Cervantes’ claims. The motion for summary judgment was granted on September 15, 2020, by the trial court. Cervantes filed a motion for new trial on October 15, 2020. On November 12, 2020, this appeal followed.

Procedural Decisions

The issue before both the United States District Court for the Western District of Texas and the United States Court of Appeals, Fifth Circuit, was whether the EMTALA was violated by Del Sol's alleged inappropriate medical screening examination and wrongful discharge of Cervantes. See Cervantes v. El Paso Healthcare Sys. Ltd. , No. EP-18-CV-111-PRM, 2019 WL 1865285 at *1 (W.D. Tex. Apr. 25, 2019) ; Cervantes v. El Paso Healthcare System , 791 F. Appx. 470, 471-72 (5th Cir. 2019). Cervantes alleged she had an emergency medical condition and the EMTALA requires hospitals to conduct appropriate medical screening examinations to determine whether patients are suffering a medical emergency before discharge, therefore, Del Sol violated the EMTALA. See 42 U.S.C. § 1395dd(a).¹

The federal trial court granted Del Sol's motion for summary judgment finding Cervantes cited to no evidence suggesting her screening failed to comply with Del Sol's standard screening procedure, was different than screenings patients with similar symptoms received, or was so cursory it amounted to no screening at all. Cervantes , 2019 WL 1865285 at *10. The Fifth Circuit Court of Appeals affirmed on the same basis, holding the trial court correctly determined Del Sol did not violate the EMTALA because "[a] physician's misdiagnosis, even if it could constitute negligence or medical malpractice, does not create an EMTALA claim." Cervantes , 791 F. Appx. at 473.

DISCUSSION

Issue

On appeal, Cervantes asserts the trial court erred in granting Del Sol's motion for summary judgment. The crux of the issue on appeal is whether Cervantes’ state court lawsuit is barred by res judicata as the result of the federal court judgment.

Standard of Review and Applicable Law

We review the trial court's summary judgment de novo. Ferguson v. Bldg. Materials Corp. of Am. , 295 S.W.3d 642, 644 (Tex. 2009) (per curiam). To be entitled to summary judgment under Rule 166a, a movant must establish there is no genuine issue of material fact so that the movant is entitled to judgment as a matter of law. TEX.R.CIV.P. 166a(c) ; Mann Frankfort Stein & Lipp Advisors, Inc. v. Fielding , 289 S.W.3d 844, 848 (Tex. 2009).

Res judicata is an affirmative defense. A defendant moving for summary judgment on its affirmative defense must conclusively prove each element of that defense. See Shah v. Moss , 67 S.W.3d 836, 842 (Tex. 2001). Federal law controls the determination of whether the federal court's judgment should bar Cervantes’ state court suit. See San Antonio Indep. Sch. Dist. v. McKinney , 936 S.W.2d 279, 281 (Tex. 1996) (noting that because the first suit was decided in federal court, federal res judicata law controls); Eagle Props., Ltd. v. Scharbauer , 807 S.W.2d 714, 718 (Tex. 1990) (same). "The res judicata effect of a prior judgment is a question of law that we review de novo." Oreck Direct, LLC v. Dyson, Inc. , 560 F.3d 398, 401 (5th Cir. 2009) (quoting Davis v. Dallas Area Rapid Transit , 383 F.3d 309, 313 (5th Cir. 2004) ).

"Under federal law, the doctrine of res judicata will apply if: (1) the parties are identical in both suits; (2) the prior judgment is rendered by a court of competent jurisdiction; (3) there is a final judgment on the merits; and (4) the same cause of action is involved in both cases." Eagle Props. , 807 S.W.2d at 718 (citing Nilsen v. City of Moss Point , 701 F.2d 556, 559 (5th Cir. 1983) ); Clear Lake Ctr., L.P. v. Garden Ridge, L.P. , 416 S.W.3d 527, 540-41 (Tex.App.—Houston [14th Dist.] 2013, no pet.). "Res judicata ‘bars all claims that were or could have been advanced in support of the cause of action on the occasion of its former adjudication, ... not merely those that were adjudicated.’ " In re Howe , 913 F.2d 1138, 1144 (5th Cir. 1990) (quoting Nilsen , 701 F.2d at 560 ).

In determining whether two lawsuits involve the same claim or cause of action, federal courts utilize what is known as the transactional test. See Test Masters Educational Services, Inc., v. Singh , 428 F.3d 559, 571 (5th Cir. 2005). "Under the transactional test, a prior judgment's preclusive effect extends to all rights of the plaintiff with respect to all or any part of the transaction, or series of connected transactions, out of which the original action arose." Id. The critical question is whether the plaintiff bases the two actions on the "same nucleus of operative facts." Id. (quoting New York Life Ins. Co. v. Gillispie , 203 F.3d 384, 387 (5th Cir. 2000) ).

Analysis

The parties are identical in both lawsuits against Del Sol, the prior judgment was rendered by a court of competent jurisdiction, and the prior action was concluded by a final judgment on the merits. See Test Masters Educ. Servs., Inc. , 428 F.3d at 571. Thus, only one of the four federal res judicata elements is at issue; the contested inquiry here is whether the same claim or cause of action is involved in both lawsuits. See id.

In her First Amended Petition, Cervantes alleged as follows:

• Plaintiff brings this suit pursuant to 42 U.S.C. § 1395dd, also known as the Federal Emergency Medical Treatment and Active Labor Act (hereinafter referred to an "EMTALA").

• Del Sol Medical Center is a participating hospital within the meaning of 42 U.S.C. § 1395dd (e) and all times material to the allegation in this Petition had a hospital emergency department.

• On April 9, 2016, at 7:12 p.m., Consuelo Cervantes sought emergency care at Del Sol's emergency department [for] abdominal pain. She was found to have a recurrent ventral hernia containing loops.

• Plaintiff was discharged from the emergency department at 9:46 pm still in pain.

• On April 10, 2016, at 1:49 a.m., Consuelo Cervantes sought emergency care at Del Sol's emergency department [for] abdominal pain. At that time she reported her pain level to be 9 out of 10. She was found to have a non-reducible supraumbilical hernia.

• On April 10, 2016, Plaintiff was not provided with an appropriate medical screening examination at Del Sol to determine if she had an emergency medical condition.

• Plaintiff was advised to seek care at another hospital where her surgeon had privileges. She was discharged at 6:32

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