Sample GALEX Report — Pamela Rogers ED Cardiology

EMTALA — 42 U.S.C. §1395dd

Federal requirement that Medicare-participating hospitals provide an appropriate medical screening examination and stabilise emergency medical conditions. Chest pain may constitute an emergency medical condition. Note: EMTALA is a screening-and-stabilisation statute, not a federal malpractice cause of action; disparate screening is the typical theory. Private EMTALA actions have their own limitations period, distinct from state malpractice deadlines.

Roberts v. Galen of Virginia, Inc. — 525 U.S. 249 (1999)

Held that EMTALA’s stabilisation requirement does not require proof of improper motive. Important limit: the Court expressly did not decide whether an improper-motive showing is required for a screening claim. Describing Roberts as establishing strict liability for screening failures overstates the holding.

Helling v. Carey — 83 Wash.2d 514, 519 P.2d 981 (Wash. 1974)

Washington Supreme Court held that compliance with professional custom did not, on those facts, satisfy the standard of care. Important limits: the Washington legislature responded with RCW 4.24.290, which substantially narrowed the decision’s reach in that state, and Helling remains a minority position nationally. Most jurisdictions continue to treat professional custom as strong — often controlling — evidence of the standard of care. Do not present it as a general rule.

Washington v. Washington Hospital Center — 579 A.2d 177 (D.C. 1990)

Institutional liability and the national standard. A patient suffered catastrophic brain injury from oxygen deprivation after esophageal rather than tracheal intubation during general anaesthesia. The claim against the hospital was that it failed to supply a carbon dioxide monitoring device that would have permitted early detection. The D.C. Court of Appeals applied a national standard to institutions rather than a locality rule.

Relevance here is by analogy only — institutional responsibility for the diagnostic resources it makes available. This is not a chest-pain or emergency-triage case, and should not be cited as one.

Sullivan v. Edward Hospital — 806 N.E.2d 645 (Ill. 2004)

Expert witness competency. The Illinois Supreme Court held that a physician was not competent to testify to the nursing standard of care, affirming that an expert must generally be licensed in the school of medicine whose standard is at issue.

Relevance here: where a claim turns on nursing documentation or nursing conduct, plan for a nurse expert rather than assuming a physician can cover it. This is not a spoliation case and should not be cited for adverse-inference instructions.

Truman v. Thomas — 611 P.2d 902 (Cal. 1980)

California Supreme Court recognised a duty to inform a patient of the material risks of declining a recommended diagnostic test — the informed-refusal doctrine. Note: adoption and scope vary by state. Where a defence of patient refusal is anticipated, the absence of documented refusal may be significant, subject to the law of the governing jurisdiction.

Matsuyama v. Birnbaum — 890 N.E.2d 819 (Mass. 2008)

Massachusetts Supreme Judicial Court recognised loss of chance as compensable in medical malpractice. Critical limit: loss of chance is not a national doctrine. A substantial number of states have declined to adopt it, and among those that have, the formulations differ materially. Confirm its status in the governing jurisdiction before building a causation theory on it — particularly where the matter is framed under a state that has not adopted it.

Daubert v. Merrell Dow Pharmaceuticals — 509 U.S. 579 (1993)

Expert testimony must rest on reliable methodology. Note: Daubert governs in federal court and in states that have adopted it; other states apply Frye or a state-specific standard, and some have changed standard in recent years. Confirm which test governs before preparing expert disclosures.

False Claims Act — 31 U.S.C. §3729

Federal liability for false claims to government payers. Caution: an FCA theory requires a knowingly false claim — the absence of a test from a produced record does not, by itself, establish that the test was billed and not performed. Billing records are a separate production and a separate analysis.

State-Specific Provisions — Verify Currency Before Relying

Florida. Fla. Stat. §766.203 sets the presuit investigation and corroborating-affidavit requirement. §766.102 addresses the standard of care and expert qualification — these are distinct provisions and are frequently conflated. §766.106 governs presuit notice. Limitations and repose under §95.11(4)(b).

Texas. Tex. Civ. Prac. & Rem. Code §74.351 — expert report served within 120 days of each defendant’s answer; failure is typically fatal to the claim.

California. MICRA was substantially amended by AB 35, effective January 1, 2023. The non-economic damages cap is no longer a fixed figure; it escalates annually on a defined schedule and differs between wrongful-death and other actions. Any reference to the historic cap figure is obsolete — confirm the current applicable amount.

New York. CPLR 214-a — two years and six months, with the continuous treatment doctrine. Note also the discovery rule added for certain cancer claims.

Statutes are amended and periods are jurisdiction- and fact-specific. Nothing above should be used for calendaring without independent verification.