United States District Court, W.D. Arkansas, Fayetteville Division
PATSY ANN OXFORD, individually and as administrator of the estate of James R. Oxford, deceased; and JAMES T. OXFORD PLAINTFFS
NORTHWEST MEDICAL CENTER - SPRINGDALE; NORTHWEST HEALTH SYSTEM; MADISON COUNTY SHERIFF'S OFFICE; SHERIFF PHILLIP MORGAN, in his official capacity as Madison County Sheriff; MR. ANDY MITCHELL, Individually and in his official capacity as a deputy in the Madison County Sheriff's Office; JOHN DOE INSURANCE COMPANIES I-V; JOHN AND JANE DOE PHYSICIANS AND MEDICAL STAFF FOR NORTHWEST MEDICAL CENTER - SPRINGDALE; and JOHN DOE EMERGENCY MEDICAL SERVICE DEFENDANTS
OPINION AND ORDER
HOLMES, III DISTRICT JUDGE
the Court are Defendant Northwest Medical Center -
Springdale's (“NWMC”) motion to dismiss (Doc.
14) and second motion to dismiss (Doc. 16). NWMC has filed
briefs in support. The motion to dismiss seeks dismissal on
statute of limitations grounds and the second motion to
dismiss argues that the Court lacks personal jurisdiction and
service of process was insufficient. Plaintiffs Patsy Ann
Oxford and James T. Oxford have filed responses (Docs. 21,
23). NWMC has filed a reply (Doc. 25) with respect to its
first motion to dismiss on statute of limitations
grounds. The reply was filed without leave of Court
and so has not been considered. See W.D. Ark. R.
7.2(b) (indicating that the only reply that may be filed as a
matter of course is a reply to a response to a motion for
summary judgment). Also pending is a motion to dismiss (Doc.
29) Northwest Health System filed by the Oxfords.
Multiple Motions to Dismiss
initial matter, NWMC's overzealous approach to
document-filing has created a procedural issue in this
lawsuit that must be addressed. The Oxfords correctly argue
that the second motion to dismiss (Doc. 16) must be
denied. “[A] party that makes a motion under
[Rule 12] must not make another motion under this rule
raising a defense or objection that was available to the
party but omitted from its earlier motion.”
Fed.R.Civ.P. 12(g)(2). The exceptions to this general
prohibition do not apply to this motion, and it is
appropriately denied because it is disallowed by the Rules.
This leaves for consideration the Rule 12(b)(6) motion to
dismiss (Doc. 14) on statute of limitations grounds, which
suffers from a similar procedural weakness. NWMC filed an
answer (Doc. 13) prior to filing its Rule 12 motions. Any
Rule 12 motion asserting a 12(b) defense “must be made
before pleading if a responsive pleading is
allowed.” Fed.R.Civ.P. 12(b) (emphasis added). An
answer is a responsive pleading. Fed.R.Civ.P. 7(a)(2).
NWMC's Rule 12(b)(6) motion to dismiss was filed after
its responsive pleading. If this motion had been filed on a
different Rule 12(b) basis, the Court would deny it as
disallowed, just as it is required to do with NWMC's
other motion. However, failure to state a claim upon which
relief can be granted is also a basis for relief under Rule
12(c), which allows a post-answer motion for judgment on the
pleadings. Because the grounds for dismissal set out in that
motion have merit, the Court will construe the motion to
dismiss on statute of limitations grounds as a Rule 12(c)
motion. Cf. Albers v. Bd. of Cnty. Comm'rs of
Jefferson Cnty., Colo., 771 F.3d 697, 703-04 (10th Cir.
2014) (adopting Third Circuit approach of overlooking any
error in a district court's treatment of Rule 12(b)(6)
motion as Rule 12(c) motion because decision not to require
defendants to technically comply with the Rules and file a
new motion did not affect substantive rights of the parties).
Motion for Judgment on the Pleadings
standards for a Rule 12(b)(6) motion for failure to state a
claim apply to a Rule 12(c) motion for judgment on the
pleadings. Mickelson v. Cnty. of Ramsey, 823 F.3d
918, 923 (8th Cir. 2016). “[W]hen it appears from the
face of the complaint itself that the limitations period has
run, a limitations defense may properly be asserted through a
12(b)(6) motion to dismiss.” Wycoff v. Menke,
773 F.2d 983, 984-85 (8th Cir. 1985) (quotation omitted);
see also Thach v. Tiger Corp., 609 F.3d 955 (8th
Cir. 2010) (affirming judgment on the pleadings where statute
of limitations expired). In reviewing the complaint on a
12(b)(6) motion, the Court “accept[s] as true all facts
pleaded by the non-moving party and grant[s] all reasonable
inferences from the pleadings in favor of the non-moving
party.” Gallagher v. City of Clayton, 699 F.3d
1013, 1016 (8th Cir. 2012) (quotation omitted).
“Federal courts apply the law of the forum to determine
statutes of limitation.” Harris v. Mortg.
Prof'ls, Inc., 781 F.3d 946, 948 (8th Cir. 2015);
accord Metro. Wholesale Supply, Inc. v. M/V Royal
Rainbow, 12 F.3d 58, 61-62 (5th Cir. 1994) (applying
Louisiana statute of limitations to state law claims over
which the court exercised supplemental jurisdiction).
Oxfords allege that on February 1, 2014, James R. Oxford
(“Mr. Oxford”) made suicidal comments to his son
and to Madison County Sheriff's deputies. The deputies
called emergency medical services and directed them to
transfer Mr. Oxford to NWMC for a 72-hour hold. Mr. Oxford
had previously been a patient of NWMC and had been treated
for depression, anxiety, and other medical issues. He was
transported and admitted to the emergency room at NWMC for
depression, suicidal ideation, and alcohol intoxication. He
was admitted at 11:06 pm on February 1, and was released and
discharged at 11:39 pm that same day. NWMC called his family
to have him picked up, and was informed that Mr. Oxford was
supposed to be on a 72-hour hold. Mr. Oxford was allowed to
leave the hospital in a taxi cab. On February 2, Mr.
Oxford's family was able to contact him, and discovered
that he was in a hotel in Springdale, Arkansas. On February
3, Mr. Oxford's family brought his truck and travel
trailer to an RV park in Springdale and arranged for him to
be brought to the trailer. Later that day, Mr. Oxford's
son visited the RV park, and both Mr. Oxford and his truck
were not there. On February 4, Arkansas State Police informed
Mr. Oxford's family that he had been in an automobile
accident and was in the intensive care unit at Washington
Regional Medical Center in Fayetteville, Arkansas. Mr. Oxford
died on February 5, 2014. This action was filed on February
3, 2016. The Oxfords assert a medical negligence claim
against NWMC. In particular, the Oxfords allege that by
discharging an inebriated and suicidal Mr. Oxford instead of
holding him for 72-hours, NWMC and its personnel fell below
the standard of care.
argues in support of its motion to dismiss that this is a
medical malpractice action for “medical injury.”
Ark. Code Ann. § 16-114-201(e) (broadly defining
“medical injury” as “any adverse
consequences arising out of . . . professional services being
rendered by a medical care provider to a patient . . .
whether resulting from negligence . . . or from premature
abandonment of a patient or of a course of treatment . . . or
otherwise arising out of or sustained in the course of such
services”). Actions for medical injury accrue on
“the date of the wrongful act complained of and no
other time.” Ark. Code Ann. § 16-114-203(b). They
must be commenced within two years after the date of accrual.
Id. § 16-114-203(a). NWMC argues that any
wrongful act on its part occurred at the latest on February
1, 2014, when it discharged Mr. Oxford rather than holding
him for 72 hours.
Oxfords respond that NWMC's duty of care extended through
the entire 72-hour hold period and the cause of action did
not accrue until the end of that period, on February 4, 2014.
In support, they cite to Fleming v. Vest, 475 S.W.3d
576 (Ark. Ct. App. 2015). Fleming discussed the
“continuous-course-of-treatment” exception, which
tolls the statute of limitations “in
medical-malpractice cases where there is medical negligence
followed by a continuing course of treatment for the malady
which was the object of the negligent treatment or
act.” Fleming, 475 S.W.3d at 581 (quotation
omitted); see also Lane v. Lane, 752 S.W.2d 25 (Ark.
1988) (recognizing soundness of this exception to the statute
of limitations). The Oxfords argue that because Mr. Oxford
suffered his fatal injury during the 72-hour period during
which he should have been admitted to NWMC, the statute of
limitations for claims against NWMC did not begin to run
until his death.
negligent act alleged by the Oxfords is NWMC's discharge
of Mr. Oxford on February 1, 2014. Following that act, the
Oxfords' allegations make abundantly clear that there was
no course of treatment from NWMC. Therefore, the
continuing-course-of-treatment exception does not apply, and
the cause of action accrued on February 1, 2014. Because the
two-year limitations period expired prior to the filing of
the complaint, the Oxfords' action against NWMC is
time-barred and must be dismissed.
Oxfords attempt to overcome this issue by arguing for the
first time in their response to the motion to dismiss that
they have a claim under the Emergency Medical Treatment and
Active Labor Act (“EMTALA”), 42 U.S.C. §
1395dd. The Oxfords did not identify this claim in their
complaint, but a complaint is tested on its factual
allegations, and not on express invocations of the law or
detailed exposition of legal theory. Johnson v. City of
Shelby, Miss., --U.S.--, 135 S.Ct. 346 (2014);
Skinner v. Switzer, 562 U.S. 521, 530 (2011).
However, an action under EMTALA requires a plaintiff to show
that a hospital did not apply the same screening procedures
to him that it applies to similarly situated patients, and
that this has had a disparate impact on the plaintiff.
Summers v. Baptist Med. Ctr. Arkadelphia, 91 F.3d
1132, 1138 (8th Cir. 1996) (reiterating that “EMTALA is
not a federal malpractice statute and it does not set a
national emergency health standard; claims of misdiagnosis or
inadequate treatment are left to the state malpractice
arena.”). The Oxfords have not alleged that NWMC failed
to follow the same screening procedures it applies to all
patients, nor have they pleaded facts that support even an
inference of disparate impact. The Oxfords have not pleaded
an EMTALA claim. Even if they had, an EMTALA claim is subject
to a two-year statute of limitations. 42 U.S.C. §
1395dd(d)(2)(C). As set forth above, the Oxfords did not file
their case against NWMC within two years of the
allegedly-wrongful act, and their hypothetical EMTALA claim
would be subject to dismissal the same as their malpractice
John Doe Emergency Medical Service and John and Jane Doe
complaint names multiple John and Jane Doe defendants. Among
them are various physicians and medical staff at NWMC. To the
extent that any NWMC employees owed a duty of care to Mr.
Oxford such that a malpractice claim could plausibly be
raised against those employees, any medical injury that they
might have caused would have happened at the latest when Mr.
Oxford was discharged from NWMC. The statute of limitations
has expired for any claim against them, and the action
against them will be dismissed. John Doe Emergency Medical
Service is also named as a defendant, but no specific
allegations are made against it. However, because the
complaint does not allege any tortious acts occurred
following Mr. Oxford's February 4, 2014, automobile
accident, the only reasonable inference to be made from the
complaint is that John Doe Emergency Medical Service is ...