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Oxford v. Northwest Medical Center - Springdale

United States District Court, W.D. Arkansas, Fayetteville Division

August 31, 2016

PATSY ANN OXFORD, individually and as administrator of the estate of James R. Oxford, deceased; and JAMES T. OXFORD PLAINTFFS



         Before 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.[1] 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.

         I. Analysis

         A. Multiple Motions to Dismiss

         As an 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.[2] “[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).

         B. Motion for Judgment on the Pleadings

         The 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).

         The 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.

         NWMC 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.

         The 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.

         The 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.

         The 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 action.

         C. John Doe Emergency Medical Service and John and Jane Doe Medical Staff

         The 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 ...

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