Delgado-Caraballo v. Hospital Pavia Hato Rey, Inc.

United States Court of Appeals
For the First Circuit
No. 17-1654
YOMAYRA DELGADO-CARABALLO; JUAN RAMÓN DELGADO-CARABALLO;
B.O.G.D., minor; M.G.D., minor,
Plaintiffs, Appellants,
v.
HOSPITAL PAVÍA HATO REY, INC., d/b/a Hospital Pavía Hato Rey;
APS HEALTHCARE PUERTO RICO, INC.; MARJORIE ACOSTA-GUILLOT;
NILSA LÓPEZ,
Defendants, Appellees.
APPEAL FROM THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF PUERTO RICO
[Hon. Daniel R. Domínguez, U.S. District Judge]
Before
Howard, Chief Judge,
Thompson, and Barron, Circuit Judges.
Hatuey Infante Castellanos, with whom Hatuey Infante Law
Offices, P.S.C., and Wilbert Méndez Marrero were on brief, for
appellants.
Gloria M. De Corral, with whom De Corral & De Mier was on
brief, for appellee Hospital Pavía Hato Rey, Inc., d/b/a Hospital
Pavía Hato Rey.
Harry Anduze Montaño, with whom José A. Morales Boscio was on
brief, for appellee APS Healthcare of Puerto Rico, Inc.
Juan J. Vilella-Janeiro and Vilella-Janeiro Attorneys &
Counselors at law for appellee Nilsa Lopéz.
May 7, 2018
THOMPSON, Circuit Judge. We write today to undo errors
made by the district judge in granting defendants summary judgment
in this case.
Stage-Setting1
Parties
Juan and Yomayra Delgado-Caraballo, brother and sister,
have been through quite a lot. So have Yomayra's minor children,
referred to pseudonymously as "B.O.G.D." and "M.G.D."2 At least
that is what the record before us reveals when visualized in the
light most favorable to them, as we must. Just consider the
following.
Back on October 1, 2012, Juan and Yomayra had to rush
their mother, Natividad Caraballo-Caraballo, to the psychiatric
stabilization unit at Hospital Pavía Hato Rey ("Hospital Pavía")
after Juan found her in a nervous state (the hospital's cumbersome
official name is listed in the caption).3 Natividad — who had
1 Because the case is here on a summary judgment for
defendants, we present the facts in the light most favorable to
plaintiffs, together with the inferences rationally drawable from
them (whether plaintiffs can prove these facts at trial remains to
be seen, however). See, e.g., Rivera–Corraliza v. Morales, 794
F.3d 208, 214 (1st Cir. 2015) (discussing what the summary-judgment
standard demands).
2 For purposes of clarity, we occasionally use first names
throughout this opinion. We mean no disrespect.
3All the events mentioned in this part of our opinion occurred
in 2012.
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tried to kill herself sometime the year before — was not taking
meds her psychiatrist had prescribed. A triage nurse at Hospital
Pavía described Natividad as "alert" but "anxious" and
"disoriented." Performing a medical-screening exam, Dr. Marjorie
Acosta-Guillot noted that Natividad's psychiatric history included
a "suicide attempt 1 year ago" and that she had "poor compliance
or commitment to treatment, exacerbations of depressive symptoms
which included anxiety, isolation." Natividad's language and
psychomotor skills were somewhat diminished, Dr. Acosta-Guillot
added. Ultimately, Dr. Acosta-Guillot diagnosed her with "major
depression," though the doctor said she showed good hygiene,
demonstrated logical thought processes, and exhibited no suicidal
or homicidal inclinations. Convinced that Natividad did not meet
the criteria for admission to the stabilization unit, Dr. Acosta-
Guillot discharged her with instructions that she take her meds
and attend an appointment at an outpatient clinic with APS
Healthcare of Puerto Rico ("APS") scheduled for October 3.
On the day of her appointment, Natividad's mother-in-
law — someone she was close to — died of cancer and diabetes.
Natividad still went to APS, accompanied by Yomayra. Dr. Nilsa
López evaluated her there, asked her to continue taking her meds,
and scheduled some follow-up appointments. Sadly, Natividad
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committed suicide the very next day, October 4. She was 52 years
old.
Lawsuit
Nearly two years later, on September 30, 2014, Juan and
Yomayra sued Hospital Pavía, APS, Dr. Acosta-Guillot, and Dr. López
in federal court. Yomayra sued on her own behalf and on behalf of
her minor children, B.O.G.D. and M.G.D. They alleged that Hospital
Pavía and APS had violated the Emergency Medical Treatment and
Active Labor Act ("EMTALA"), see 42 U.S.C. § 1395dd, by failing to
give Natividad an appropriate screening exam, stabilize her, or
transfer her if she could not be stabilized.4 And they claimed
that each defendant had committed medical malpractice in violation
of Puerto Rico law. See P.R. Laws Ann. tit. 31, §§ 5141-42.5 They
premised the court's jurisdiction on statutes creating federal-
4
Stripped to its essentials, the EMTALA "requires that a
participating hospital" examine everyone who arrives in its
emergency room seeking treatment. And if that exam shows the
patient has "an emergency medical condition . . . , the
participating hospital must render the services that are necessary
to stabilize the patient's condition" — "unless transferring the
patient to another facility is medically indicated and can be
accomplished with relative safety." See Correa v. Hosp. S.F., 69
F.3d 1184, 1190 (1st Cir. 1995) (internal citations to the EMTALA
omitted).
5
Plaintiffs also sought recovery from defendants' insurers
under P.R. Laws Ann. tit. 26, § 2003 — a statute that says "[a]ny
individual sustaining damages and losses" may sue an insurance
company directly without joining the named insured, provided the
suit is pursued in Puerto Rico.
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question jurisdiction, see 28 U.S.C. § 1331, diversity
jurisdiction, see id. § 1332, and supplemental jurisdiction, see
id. § 1367(a).
Challenged Ruling
After discovery, the district judge granted defendants
summary judgment. The key parts of the judge's ruling are easily
summarized.
Kicking things off, the judge called the EMTALA claim a
"survivorship EMTALA action."6 See Caraballo v. Hosp. Pavía Hato
Rey, Inc., Civil No. 14-1738 (DRD), 2017 WL 1247872, at *2 (D.P.R.
Mar. 31, 2017). And he reasoned that because the EMTALA "'applies
only to participating hospitals with emergency departments'" and
because "[p]laintiffs concede[] that 'APS . . . is not a hospital
and not subject to the EMTALA provisions,'" he had to jettison the
EMTALA claim against APS with prejudice. See id. at *4-5 (emphases
removed) (quoting Rodríguez v. Am. Int'l Ins. Co. of P.R., 402
F.3d 45, 48 (1st Cir. 2005)).
6 As the Supreme Court recognized in a different context, a
survivorship action, generally speaking, is a suit by the
decedent's estate to recover on claims the decedent herself could
have recovered on but for her death. See Sea-Land Servs., Inc. v.
Gaudet, 414 U.S. 573, 575 n.2 (1974) (touching on the topic),
superseded by statute on other grounds as recognized in Miles v.
Apex Marine Corp., 498 U.S. 19, 30 n.1 (1990).
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As for the EMTALA claim against Hospital Pavía, the judge
recognized (at least implicitly) that the EMTALA tells courts to
look to state law — defined to include Puerto Rico — regarding the
availability of damages. See 42 U.S.C. §§ 410(h), 1395dd(d)(2)(A).
Next, the judge read Puerto Rico law as holding that "for an estate
to be able to . . . substitute a deceased plaintiff, all members
of the estate must be brought to the suit." See Caraballo, 2017
WL 1247872, at *6 (quoting Vilanova v. Vilanova, 184 P.R. Dec.
824, 839-40 (2012)). Natividad's estate, the judge then wrote,
includes not only Juan and Yomayra but also "Vanessa Delgado
Caraballo[] and widower Juan Delgado Gonzalez." See id. at *5.
So the judge considered the latter two "necessary part[ies]" under
Fed. R. Civ. P. 19(a), saying, for example, that he thought "the
absent heirs['] interest might be affected or prejudiced by the
decision" on the EMTALA-survivorship claim against Hospital Pavía.7
7 Rule 19(a) reads:
(a) Persons Required to Be Joined if Feasible.
(1) Required Party. A person who is subject to
service of process and whose joinder will not deprive
the court of subject-matter jurisdiction must be
joined as a party if:
(A) in that person's absence, the court cannot
accord complete relief among existing parties; or
(B) that person claims an interest relating to the
subject of the action and is so situated that
disposing of the action in the person's absence
may:
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See Caraballo, 2017 WL 1247872, at *5-6 (internal quotation marks
omitted). Sort of echoing the words of Fed. R. Civ. P. 19(b), the
judge suggested — without any explanation or analysis — that the
missing heirs could not "be feasibly joined."8 See Caraballo, 2017
(i) as a practical matter impair or impede the
person's ability to protect the interest; or
(ii) leave an existing party subject to a
substantial risk of incurring double, multiple,
or otherwise inconsistent obligations because of
the interest.
(2) Joinder by Court Order. If a person has not been
joined as required, the court must order that the
person be made a party. A person who refuses to join
as a plaintiff may be made either a defendant or, in
a proper case, an involuntary plaintiff.
(3) Venue. If a joined party objects to venue and
the joinder would make venue improper, the court must
dismiss that party.
The word "necessary" once appeared in Rule 19(a). See Republic of
Phil. v. Pimentel, 553 U.S. 851, 855 (2008). But "required"
replaced "necessary," thanks to an amendment to the rule. See id.
8 Rule 19(b) relevantly reads:
(b) When Joinder Is Not Feasible. If a person who is
required to be joined if feasible cannot be joined,
the court must determine whether, in equity and good
conscience, the action should proceed among the
existing parties or should be dismissed. The factors
for the court to consider include:
(1) the extent to which a judgment rendered in the
person's absence might prejudice that person or the
existing parties;
(2) the extent to which any prejudice could be
lessened or avoided by:
(A) protective provisions in the judgment;
- 8 -
WL 1247872, at *6 (internal quotation marks omitted). And he then
concluded that the action could not in "'equity and good
conscience'" proceed without them, principally because "[i]f the
survivorship claim is dismissed with prejudice, the absent heirs
would not be able to bring their own federal claim representing
the estate against the same particular defendant." Id. at *6-7.
Which is why he dismissed the EMTALA-survivorship claim against
Hospital Pavía without prejudice. Id. at *7.
Emphasizing that diversity jurisdiction requires
complete diversity of citizenship of each plaintiff from each
defendant, the judge found that requirement not met here because
Juan and Yomayra "are both from Puerto Rico," just like the four
defendants. Id. (relying on Gabriel v. Preble, 396 F.3d 10, 13
(1st Cir. 2005), which in turn relied on Strawbridge v. Curtiss,
7 U.S. (3 Cranch) 267, 267 (1806)). Having dismissed the federal-
EMTALA claim and having concluded no diversity jurisdiction
exists, the judge then declined to exercise supplemental
(B) shaping the relief; or
(C) other measures;
(3) whether a judgment rendered in the person's
absence would be adequate; and
(4) whether the plaintiff would have an adequate
remedy if the action were dismissed for
nonjoinder. . . .
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jurisdiction over the local-law claims and dismissed them without
prejudice as well. Id. at *8.
Plaintiffs later asked the judge to reconsider his
decision to dismiss their EMTALA-survivorship claim against
Hospital Pavía. But the judge would not budge. And this appeal
followed.9
Federal-EMTALA Claim
Standard of Review
Our analysis necessarily starts with the standard of
review, which is a little tricky because the judge partly relied
on Rule 19 in granting defendants summary judgment. We typically
review Rule-19 decisions for abuse of discretion, see Maldonado-
Viñas v. Nat'l W. Life Ins. Co., 862 F.3d 118, 121 (1st Cir. 2017),
knowing that an error of law is always an abuse of discretion, see
Koon v. United States, 518 U.S. 81, 100 (1996); see also United
States ex rel. D'Agostino v. Ev3, Inc., 802 F.3d 188, 192 (1st
Cir. 2015) (stressing that a judge abuses his discretion if he
"adopts and applies the wrong legal rule"). And we normally review
summary-judgment decisions with fresh eyes ("de novo," in law-
speak), see Rivera–Corraliza, 794 F.3d at 214, asking whether the
9 A quick aside: Dr. Acosta-Guillot did not file an appellate
brief. As a penalty, she could "not be heard at oral argument"
without our authorization. See Fed. R. App. P. 31(c). She did
not ask for permission and did not present oral argument.
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summary-judgment winners (here, defendants) are "entitled to
judgment as a matter of law" because "there is no genuine dispute
as to any material fact," see Fed. R. Civ. P. 56(a) — even after
taking all facts and inferences in the light most flattering to
the summary-judgment losers (here, plaintiffs), see Rivera-
Corraliza, 794 F.3d at 210, 214. In the present case, these
standards come together like this: if the judge abused his
discretion by making an error of law in his Rule-19 analysis, and
if that error sabotaged his summary-judgment ruling, then we must
vacate that ruling — if not, then we must affirm. See generally
United States v. San Juan Bay Marina, 239 F.3d 400, 403, 405-08
(1st Cir. 2001) (reviewing a summary-judgment ruling driven in
part by a Rule-19(b) analysis).
Plaintiffs' Take10
Plaintiffs do not contest the judge's dismissal of the
EMTALA claim against APS. They challenge only his dismissal of
the EMTALA claim against Hospital Pavía. So naturally we confine
our attention to that claim.
Importantly too, plaintiffs do not quarrel with the
judge's conclusion that Puerto Rico law requires the "joinder of
all heirs to a survivorship claim." See Caraballo, 2017 WL
10 Plaintiffs filed an opening brief but no reply brief.
- 11 -
1247872, at *5. And they essentially concede that, given this
reading of Puerto Rico law, the absent heirs are (in Rule-19 lingo)
"required part[ies]" to the EMTALA-survivorship action and so must
be joined "if feasible." Obviously, given plaintiffs' briefing
strategy, we need not — and thus do not — decide whether the
judge's reading of Commonwealth law is correct (the ultimate
resolution of that question must await another day).
Turning, then, to the EMTALA-survivorship claim,
plaintiffs essentially contend that the judge erred in two ways.
Quoting Rule 19(a)(2) — which, again, says (emphasis added) that
"[i]f a person has not been joined as required," then the judge
"must order that the person be made a party" — plaintiffs first
argue that the judge botched matters by not ordering the missing
heirs joined to this suit. They next argue that he gaffed things
by assuming, with no analysis, that the absent heirs could not
feasibly be joined. To hear them tell it, nothing made joinder
"unfeasible" — they premised jurisdiction on the presence of a
federal question (through the EMTALA claim), not diversity, they
remind us; so joinder would not wreck the jurisdictional predicate
for their suit. Ultimately, the judge's off-base assumption, they
add, led him to examine what "equity and good conscience" required
(a process that involved his weighing the parties' and the absent
heirs' interests), which in turn caused him to wrongly dismiss the
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EMTALA-survivorship claim against Hospital Pavía. See Caraballo,
2017 WL 1247872, at *6 (quoting Rule 19(b)).
Staying with the EMTALA claim, plaintiffs argue that
they can sue not only for Natividad's pain and suffering but also
for their own. To back up their argument, they cite to our Correa
opinion. There we noted that the EMTALA says:
Any individual who suffers personal harm as a direct
result of a participating hospital's violation of a
requirement of this section may, in a civil action
against the participating hospital, obtain those damages
available for personal injury under the law of the State
in which the hospital is located . . . .
69 F.3d at 1196 (quoting 42 U.S.C. § 1395dd(d)(2)). We then said
that this language supports "two possible" but conflicting
interpretations. Id. One is that "the words 'individual' and
'direct' . . . denot[e] the patient herself, and no one else."
Id. The other is that the statute "permit[s] an individual who
has a special relationship with another — say, a . . . bereaved
relative — to sue when she is harmed in direct consequence of an
EMTALA violation inflicted upon such other," and "[w]hen death
results," we added, "this reading would naturally extend the
statutory prerogative to individuals who are eligible to bring
survivors' actions under local law." Id. Because we found "both
readings . . . superficially plausible," we could not say that the
judge plainly erred in thinking that persons other than patients
(or those suing on the patient's behalf) can recover EMTALA
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damages. Id. at 1196-97. And from this plaintiffs intuit that the
EMTALA unquestionably allows persons "other than a patient" to
bring "EMTALA claim[s] against a hospital" — they say this even
though "a no-plain-error holding does not constitute a 'ruling on
the merits.'" See Rodríguez-Miranda v. Benin, 829 F.3d 29, 44
(1st Cir. 2016) (quoting United States v. Caraballo–Rodriguez, 480
F.3d 62, 70 (1st Cir. 2007)).
Hospital Pavía's Take
Tackling the EMTALA-survivorship-claim issue first,
Hospital Pavía counters that plaintiffs' summary-judgment papers
never argued that the judge defied Rule 19(a)(2)'s mandatory
directive by not ordering the absent heirs' joinder.11 Thus,
Hospital Pavía protests, plaintiffs cannot make that argument
here. Cf. generally DiMarco-Zappa v. Cabanillas, 238 F.3d 25, 34-
35 (1st Cir. 2001) (discussing the "'raise-or-waive' rule" and
some of its exceptions). Shifting to the merits, Hospital Pavía
seconds the judge's view that, under Puerto Rico law, all heirs
must be joined in a survivorship claim (plaintiffs have no beef
with that view, don't forget, at least at this point — so, again,
the correctness of that theory is not before us). Leaning on Rule
11
We repeat that Rule 19(a) declares that "[i]f a person has
not been joined as required," then the judge "must order that the
person be made a party . . . ."
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19(b), Hospital Pavía argues from there that because plaintiffs
failed to join the missing heirs and because the judge rightly
held the action could not proceed without them, the judge had to
dismiss the EMTALA-survivorship claim. Not until later in its
brief does Hospital Pavía argue that joinder is "unfeasible." And
its sole theory is that because (as it sees things) the statute-
of-limitations period for the EMTALA-survivorship claim has
already expired, the absent heirs cannot be made parties anyway.
As for plaintiffs' suggestion that they can recover
damages under the EMTALA for their own pain and suffering, Hospital
Pavía says that they "waived" this issue by not raising it at the
summary-judgment stage. Waiver aside, Hospital Pavía argues that
the EMTALA's "clear language" allows only the patient (and those
suing on her behalf) to recover damages under the statute. In
other words, Hospital Pavía believes that plaintiffs cannot bring
a private cause of action under the EMTALA because "such actions
are not contemplated in the statute." And Hospital Pavía pooh-
poohs Correa, calling its plain-error holding "dictum."
Our Take
Following the parties' lead, we start with the EMTALA-
survivorship issue. To understand who is right and who is wrong
here, one needs to know how Rule 19 works.
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Rule 19 distinguishes between two types of absentees:
"those whose joinder is feasible and those whose joinder is not
feasible, because it would defeat subject-matter jurisdiction, or
the [absentee] is beyond the personal jurisdiction of the court,
or the [absentee] has and makes a valid objection to venue." Askew
v. Sheriff of Cook Cty, Ill., 568 F.3d 632, 634-35 (7th Cir. 2009).
We know this in part because Rule 19(a) talks about "persons
required to be joined if feasible," and Rule 19(b) talks about
what judges must do "when joinder is not feasible" (excess
capitalization omitted, by the way — something we'll do for the
remainder of the opinion). See Askew, 568 F.3d at 635.
Rule 19 lays out a two-step process. Starting with Rule
19(a), the judge first decides whether, if the absentees can be
joined, they must be joined (absentees cannot be joined if, for
example, service-of-process or subject-matter-jurisdiction
problems exist). See Fed. R. Civ. P. 19(a)(1). One scenario in
which the judge ought to join them (if they can be joined) is if
he cannot "accord complete relief among existing parties" without
their joinder.12 Absentees that meet the Rule-19(a)(1) standard
are called "required part[ies]" (once called "necessary parties"
in days gone by, see Pimentel, 553 U.S. at 855). And if the judge
12
For the other examples, check out footnote 7 above, which
quotes Rule 19(a)(1)(A) and (B).
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identifies such parties, he then looks to Rule 19(a)(2) — a rule
that says that if they have "not been joined as required, the
[judge] must order that [they] be made . . . part[ies]." See
Askew, 568 F.3d at 635 (quoting Rule 19(a)(2)). As one prominent
treatise pithily puts it, if an absentee's joinder is "feasible"
and required "for a just adjudication," the judge "must order"
joinder since he "has no discretion at this point because of" Rule
19(a)(2)'s "mandatory language." 7 Charles Alan Wright, Arthur R.
Miller & Mary Kay Kane, Federal Practice and Procedure § 1611, at
158-62 (3d ed. 2001) (footnotes omitted).
If (and only if) the absentees are required parties but
cannot feasibly be joined does the judge, at the second step, pull
up Rule 19(b) and see if the suit can proceed without them. See
Askew, 568 F.3d at 635; see also Provident Tradesmens Bank & Tr.
Co. v. Patterson, 390 U.S. 102, 108-09 (1968). To aid in this
effort, the judge looks at various factors — like "the extent to
which a judgment rendered in [their] absence might prejudice [them]
or the existing parties" — through the lens of "equity and good
conscience,"13 ever mindful that the caselaw generally prefers
that judges not dismiss suits. See 4 Richard D. Freer, Moore's
Federal Practice — Civil § 19.02[3][c] & n.54 (3d ed. 2017)
13 Flip back to footnote 8 for the other listed Rule-19(b)
factors.
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(quoting a case saying that "the phrase 'good conscience,' in
19(b), contemplates that very few cases should be terminated due
to the absence of non-diverse parties unless there has been a
reasoned determination that their nonjoinder makes just resolution
of the action impossible").
Measured against these benchmarks, the judge's analysis
cannot be sustained. Buckle in as we explain.
As we previously noted, the judge — after examining the
factors in Rule 19(a)(1)(A) and (B) — essentially held that the
missing heirs are required parties. See Caraballo, 2017 WL
1247872, at *5. Then he basically concluded that their joinder
was not feasible. We know this to be true, given his laser-like
focus on Rule 19(b), see id. at *5-6 — a prescript (we've been at
pains to stress, hopefully without becoming tedious) that
instructs judges on how to handle situations where (emphasis ours)
"joinder is not feasible," because of, say, nondiversity.
Regrettably, though, the judge never explained why the absent heirs
cannot be joined. See id. at *5-7.
Again, by our reading, plaintiffs push two big arguments
on the joinder issue. The first (remember) is that after deeming
the absent heirs required parties, the judge should have ordered
them joined right then and there, as required by the must-order-
joinder language in Rule 19(a)(2). Hospital Pavía's comeback is
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that because plaintiffs did not develop their "must order" theory
in their summary-judgment submissions, they cannot peddle it on
appeal. We need not referee this dispute, because plaintiffs'
other argument is a winner for them.
The second argument (remember too) is that the judge
gave no reason to back up his joinder-is-not-feasible intimation.
So true — the judge said nothing (as in zero, zip, zilch) to
explain why joinder cannot occur, and Hospital Pavía makes no
effort to convince us we are wrong about that point. Critically
too, Hospital Pavía offers no raise-or-waive objection in response
to plaintiffs' second contention — which undoubtedly waives any
waiver argument in that direction that it might have had. See,
e.g., In re San Juan Dupont Plaza Hotel Fire Litig., 45 F.3d 569,
574 (1st Cir. 1995).
Thus freed to weigh in, we easily conclude that the
judge's inadequate Rule-19 analysis is reversible error. After
all, our Rule-19 precedent makes plain that a judge abuses his
discretion by not offering a "reasoned analysis" or by pushing an
"incomplete and inadequate" analysis. Bacardí Int'l Ltd. v. V.
Suárez & Co., 719 F.3d 1, 9 (1st Cir. 2013). This describes our
situation to a T. And because the judge's legal misstep skewed
and undermined his summary-judgment ruling, we must vacate and
remand for further proceedings consistent with our analysis above.
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See generally Maldonado-Viñas, 862 F.3d at 122-23 (vacating and
remanding where the district court did not reach a Rule-19 issue
that it should have); Bacardí Int'l Ltd., 719 F.3d at 9 (citing a
case vacating and remanding where the district court did not give
enough reasoning for its Rule-19 decision); Delgado v. Plaza Las
Americas, Inc., 139 F.3d 1, 2 (1st Cir. 1998) (per curiam)
(vacating and remanding where the district court used an incorrect
Rule-19 analysis).
Now on to what Hospital Pavía thinks is its ace up the
sleeve — that we (supposedly) can, as an alternative basis for
affirmance, fill the hole in the judge's analysis by deeming
joinder "unfeasible" because the EMTALA's limitations period has
already lapsed (a "Ctrl-f" search for "feasib" in Hospital Pavía's
brief reveals this is the only argument it makes for why joinder
is not feasible14). But unfortunately for Hospital Pavía, its
argument does not do the trick here, for a simple reason. The
judge did not address the statute-of-limitations theory. And so
we need not either. See Foley v. Wells Fargo Bank, N.A., 772 F.3d
14 For the IT-challenged, Ctrl-f is a keyboard shortcut for
the "find command" that lets one find words or phrases in, say, a
pdf document. Pressing the "Ctrl" and "F" buttons brings up a
search box. We did that here, after pulling up Hospital Pavía's
brief. And then we typed in "feas" so that we could capture words
like "feasible," "feasibility," and "unfeasible."
- 20 -
63, 75 (1st Cir. 2014) (collecting cases holding that we can
decline to affirm a decision on a ground not relied on by the
judge); Lucia v. Prospect St. High Income Portfolio, Inc., 36 F.3d
170, 177 (1st Cir. 1994) (noting, among other things, how the
district court did not rule on a statute-of-limitations issue, and
so we needed to leave the matter "to be determined in the first
instance" by that court). The litigants and the judge can delve
into the statute-of-limitations matter on remand. See Tutor Perini
Corp. v. Banc of Am. Sec. LLC, 842 F.3d 71, 96 (1st Cir. 2016).
We, of course, express no opinion as to the ultimate resolution of
this question.
That leaves one last EMTALA issue over which
disagreement lingers — whether plaintiffs can sue Hospital Pavía
for their "personal damages" under that statute. The judge did
not address that issue either. And consistent with the just-cited
cases, we decline to address it here, leaving it instead for
determination on remand. See, e.g., id.; Foley, 772 F.3d at 75;
P.R. Am. Ins. Co. v. Rivera-Vázquez, 603 F.3d 125, 134 (1st Cir.
2010). Yes, we know Hospital Pavía thinks plaintiffs waived the
personal-damages issue by not presenting it in their summary-
judgment papers — though, for what it's worth, their memo opposing
summary judgment seemingly hints that they are pursuing
survivorship and personal claims. But the parties can duke out
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their personal-damages dispute in the district court. As before,
we intimate no view about how the judge should rule on this issue.
Recap
To summarize our EMTALA-claim conclusions: We do not
disturb the grant of summary judgment for APS, because plaintiffs
do not attack that piece of the judge's decision. But we vacate
the entry of summary judgment for Hospital Pavía so the principals
can focus on the outstanding matters discussed above, like helping
the judge rework the Rule-19 analysis with the right considerations
in mind and determine if plaintiffs can and should recover for
their personal damages under the EMTALA.
Local-Law Claims
As we explained above, because the judge found no
federal-question or diversity jurisdiction existed, he renounced
supplemental jurisdiction over the local-law claims without
analyzing them. Our vacating part of the judge's summary-judgment
ruling on the federal-EMTALA claim undercuts the analysis behind
his supplemental-jurisdiction decision. That being so, and in
line with past practice, we vacate that aspect of the judge's order
declining supplemental jurisdiction and instruct the judge to
reinstate the local-law claims. If the judge again tosses out the
EMTALA claim before trial, he can reconsider the supplemental-
jurisdiction question. See, e.g., Rivera-Corraliza, 794 F.3d at
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227 (citing Rodríguez v. Municipality of San Juan, 659 F.3d 168,
181-82 (1st Cir. 2011)).
Not so fast, APS and Dr. López insist. The local-law
claims face a statute-of-limitations problem. Or so they believe.
And, they argue (APS, explicitly; Dr. López, implicitly), that
given this problem, we must hold that the judge should have
dismissed the local-law claims with prejudice instead of without
prejudice. But the judge did not reach this issue. And we see no
reason to reach it either. See, e.g., Foley, 772 F.3d at 75;
Lucia, 36 F.3d at 177. The parties can litigate this statute-of-
limitations issue on remand. Like with the other unexplored
issues, we take no position on who should win this fight.15
Final Words
Our bottom line: We let the summary judgment for APS on
the EMTALA claim stand (because plaintiffs don't attack it). But
15On top of all this, because neither APS nor Dr. López filed
any cross-appeal, we could not explore their statute-of-
limitations issue even if we wanted to. See Figueroa v. Rivera,
147 F.3d 77, 81 (1st Cir. 1998). True, "[a]n appellee who does
not take a cross-appeal may 'urge in support of a decree any matter
appearing before the record, although his argument may involve an
attack upon the reasoning of the lower court.'" See Jennings v.
Stephens, 135 S. Ct. 793, 798 (2015) (quoting United States v. Am.
Ry. Express Co., 265 U.S. 425, 435 (1924)). But "an appellee who
does not cross-appeal may not 'attack the decree with a view either
to enlarging his own rights thereunder or of lessening the rights
of his adversary.'" See id. (quoting Am. Ry. Express Co., 265
U.S. at 435); see also Haley v. City of Boston, 657 F.3d 39, 53
(1st Cir. 2011) (emphasizing that "even though an appellee can
argue in support of a lower court's ruling in his favor on any
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we vacate the summary judgment for Hospital Pavía on the EMTALA
claim, leaving it to the parties and the judge to work through the
joinder and personal-damages issues. And we also vacate the
dismissal of the local-law claims, leaving it to the principals to
puzzle out any and all questions related to those claims.
Vacated in part and remanded for further proceedings
consistent with this opinion. Costs on appeal to plaintiffs.
ground made manifest in the record (including grounds not relied
on by the lower court), he cannot, without a cross-appeal, argue
against a judgment in his favor" to get us to "expand his rights
or to diminish the appellant's rights"). Dismissing plaintiffs'
local-law claims on statute-of-limitations grounds would be a
dismissal with (rather than without) prejudice, see generally
Hilton Int'l Co. v. Unión De Trabajadores De La Industria
Gastronomica De Puerto Rico, 833 F.2d 10, 11 (1st Cir. 1987)
(noting that a "dismissal by the court . . . , even though labelled
'without prejudice,' is, in fact, with prejudice if the statute of
limitations has run") — a result that would lessen their rights.
So APS and Dr. López's argument is not properly before us. See
Hadar v. Broward Cty., 692 F. App'x 618, 624 n.6 (11th Cir. 2017).
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