Betty Miller, Individually and as Personal Representative of the Estate of John Allen Miller v. Laxeshkumar Patel, M.D.

FILED
Nov 30 2020, 9:31 am
CLERK
Indiana Supreme Court
Court of Appeals
and Tax Court
ATTORNEYS FOR APPELLANT ATTORNEYS FOR APPELLEES
Nicholas C. Deets COMMUNITY HOWARD1
Tyler J. Zipes Edna M. Koch
Hovde Dassow + Deets, LLC Joseph D. McPike, II
Indianapolis, Indiana Erin E. Meyers
Zeigler Cohen & Koch
Indianapolis, Indiana
IN THE
COURT OF APPEALS OF INDIANA
Betty Miller, Individually and as November 30, 2020
Personal Representative of the Court of Appeals Case No.
Estate of John Allen Miller, 20A-CT-1088
Appellant-Plaintiff, Appeal from the
Marion Superior Court
v. The Honorable
Heather A. Welch, Judge
Laxeshkumar Patel, M.D., John Trial Court Cause No.
Schiltz, M.D., Benjamin 49D01-1812-CT-49633
Coplan, M.D., Joseph Hill,
M.D., Erik Fossum, M.D.,
Bradford Hale, M.D., Christine
Tran, M.D., James Blickendorf,
M.D., Robert McAllister, M.D.,
1
Although they did not file a brief, Schultz & Pogue, LLP attorneys Jon M. Pinnick and Jeffrey M. Kraft
entered an appearance on July 10, 2020 on behalf of Medical Associates, LLP, Erick Fossum, M.D.,
Bradford Hale, M.D., James Blickendorf, M.D., Robert McAllister, M.D., Sara Koerwitz, M.D., and
Timothy Held, P.A. Odyssey.
Court of Appeals of Indiana | Opinion 20A-CT-1088 | November 30, 2020 Page 1 of 25
Sara Koerwitz, M.D., Timothy
Held, PA, Community Health
Network, Inc., d/b/a
Community Howard Regional
Health Hospital and
Community Howard Behavioral
Health, Community Physicians
of Indiana, Inc., d/b/a
Community Physician Network,
Community Howard Regional
Health, Inc., St. Joseph Hospital
& Health Center, Inc., St.
Vincent Health, Inc., Ascension
Health, Inc., and Medical
Associates, LLP,
Appellees-Defendants.2
Kirsch, Judge.
[1] In this discretionary interlocutory appeal, Betty Miller (“Miller”), individually
and as personal representative of the estate of John Allen Miller (“John”),
appeals the trial court’s denial of her motion to amend her complaint to add a
claim against Community Health Network, Inc., d/b/a Community Howard
Regional Health Hospital and Community Howard Behavioral Health, and
2
This interlocutory appeal involves only Community Health Network, Inc., d/b/a Community Howard
Regional Health Hospital and Community Howard Behavioral Health, and Community Howard Regional
Health, Inc.; however, we include the other named defendants because our Indiana Appellate Rules provide
that a party of record in the trial court shall be a party on appeal. Ind. Appellate Rule 17(A); Hoosier Outdoor
Adver. Corp. v. RBL Mgmt., Inc., 844 N.E.2d 157, 162 (Ind. Ct. App. 2006).
Court of Appeals of Indiana | Opinion 20A-CT-1088 | November 30, 2020 Page 2 of 25
Community Howard Regional Health, Inc. (“Community Howard”) under 42
U.S.C. § 1395dd, the federal Emergency Medical Treatment and Active Labor
Act, (“EMTALA”). On appeal, Miller contends that in denying her motion to
amend, the trial court erred by relying on this court’s opinion in Williams v.
Inglis, 142 N.E.3d 467 (Ind. Ct. App. 2020), trans. denied, which she asserts was
incorrectly decided and is in need of reexamination,. Finding that Williams was
correctly decided, we find no error in the trial court’s denial of Miller’s motion
to amend.
[2] We affirm.
Facts and Procedural History
[3] Miller filed a complaint on December 18, 2018, against Laxeshkumar Patel,
M.D., John Schiltz, M.D., Benjamin Coplan, M.D., Joseph Hill, M.D., Erik
Fossum, M.D., Bradford Hale, M.D., Christine Tran, M.D., James
Blickendorf, M.D., Robert McAllister, M.D., Sara Koerwitz, M.D., Timothy
Held, PA, Community Howard, St. Joseph Hospital & Health Center, Inc., St.
Vincent Health, Inc., Ascension Health, Inc., and Medical Associates, LLP
(collectively, the “Defendants”), in which she alleged that the Defendants were
negligent in their care and treatment of Zachary Miller (“Zachary”). Appellant’s
App. Vol. 2 at 33-38. In the complaint, Miller asserted that between December
9, 2016, through January 8, 2017, the Defendants treated Zachary for serious
mental illnesses that included suicidal ideations, major depression, drug abuse,
psychosis, anxiety, threats to his life and the lives of others, killing animals, and
Court of Appeals of Indiana | Opinion 20A-CT-1088 | November 30, 2020 Page 3 of 25
bipolar disorder. Id. at 35. Over the course of that thirty-day period, medical
personnel at Community Howard treated Zachary for these conditions on at
least five occasions. Id. The complaint further alleged that on January 8, 2017,
Zachary came to the emergency room at Community Howard Regional
Hospital requesting to be admitted due to his ongoing mental illness and
dangerous propensities, and that he was treated and discharged by hospital
physicians and a physician’s assistant. Id. Specifically, after his discharge, in
the overnight hours of January 8-9, 2017, Zachary returned to the home of his
grandparents, Miller and John, and killed John by beating him with a frying
pan and cutting John’s wrists because he heard voices telling him to do so. Id.
[4] On February 5, 2019, Community Howard filed an answer to the complaint, in
which it denied Miller’s allegations of negligence and the characterization of
Zachary’s presentations for medical treatment over the period spanning
December 9, 2016 through January 8, 2017. Appellee’s App. Vol. 2 at 2-8. On
January 31, 2020, Community Howard filed a motion for summary judgment
contending that Miller lacked standing to assert a negligence claim and that
Community Howard was immune from civil liability. Id. at 9-12.
[5] On February 14, 2020, Miller filed a motion for leave to amend the complaint
and the proposed amended complaint, which sought to add a claim under
EMTALA against Community Howard. Appellant’s App. Vol. 2 at 39-49. On
February 27, 2020, Community Howard objected to Miller’s motion for leave
to amend, arguing that the proposed amendment was barred by the two-year
statute of limitations that governs EMTALA claims. Id. at 50-56; see 42 U.S.C.
Court of Appeals of Indiana | Opinion 20A-CT-1088 | November 30, 2020 Page 4 of 25
§ 1395dd(d)(2)(C) (“No action may be brought under this paragraph more than
two years after the date of the violation with respect to which the action is
brought.”). Miller filed a reply on March 13, 2020, contending that her motion
for leave to amend the EMTALA claim was not barred by the two-year statute
of limitations because it arose out of the same conduct, transaction, or
occurrence set forth in her original complaint and should relate back to her
original complaint under Indiana Trial Rule 15(C), and that Williams was
incorrect in holding that EMTALA’s statute of limitations preempted Indiana
Trial Rule 15(C). Id. at 57-64. On March 27, 2020, the trial court denied
Miller’s motion for leave to amend the complaint to add a claim under
EMTALA. Id. at 65-69. In particular, the trial court’s order denied the motion
to amend on the basis of Williams and HCA Health Servs. of Ind., Inc. v. Gregory,
596 N.E.2d 974 (Ind. Ct. App. 1992), trans. denied, stating:
Thus, this Court finds that the Indiana Court of Appeals has held
that EMTALA preempts any state or local law that directly
conflicts with the 2-year statute of limitations. Since [Indiana
Trial Rule 15(C)] is in direct conflict, EMTALA preempts this
trial rule and mandates that the strict 2-year statute of
limitation[s] be imposed. Since [Miller] filed [her] Motion to
Amend Complaint on February 14, 2020, and the last date of
treatment was January 8, 2017, the Motion to Amend is in
violation of EMTALA’s 2-year statute of limitation[s] and is
futile because [Indiana Trial Rule 15(C)] is preempted by federal
law.
Court of Appeals of Indiana | Opinion 20A-CT-1088 | November 30, 2020 Page 5 of 25
Id. at 67-68.3
[6] On April 23, 2020, Miller filed a motion that sought to certify the denial of the
motion to amend for interlocutory appeal, arguing that Williams was
“incorrectly decided.” Id. at 71; 70-77. Over Community Howard’s objection,
the trial court certified Miller’s motion to certify the denial of the motion to
amend for interlocutory appeal. Id. at 89-90. On May 26, 2020, Miller filed
with this court a motion to accept interlocutory appeal. Id. at 91-106. Over
Community Howard’s objection, this court accepted jurisdiction over Miller’s
interlocutory appeal on June 18, 2020. Id. at 133-34. Miller now appeals.
Discussion and Decision
[7] Miller argues that the trial court abused its discretion by denying her motion to
amend because it erred in its application of Williams and HCA Health Servs. to
the denial, and that this court should “reexamine” Williams. Appellant’s Br. at
12. Indiana Trial Rule 15(A) governs amendments to pleadings and provides as
follows:
A party may amend his pleading once as a matter of course at
any time before a responsive pleading is served or, if the pleading
is one to which no responsive pleading is permitted, and the
action has not been placed upon the trial calendar, he may so
amend it at any time within thirty [30] days after it is served.
3
EMTALA’s express preemption provision specifies that “[t]he provisions of this section do not preempt any
State or local law requirement, except to the extent that the requirement directly conflicts with a requirement
of this section.” 42 U.S.C. § 1395dd(f).
Court of Appeals of Indiana | Opinion 20A-CT-1088 | November 30, 2020 Page 6 of 25
Otherwise a party may amend his pleading only by leave of court
or by written consent of the adverse party; and leave shall be
given when justice so requires. A party shall plead in response to
an amended pleading within the time remaining for response to
the original pleading or within twenty [20] days after service of
the amended pleading, whichever period may be the longer,
unless the court otherwise orders.
Amendments to pleadings are to be liberally allowed, but the trial court retains
broad discretion in granting or denying amendments. Hilliard v. Jacobs, 927
N.E.2d 393, 398 (Ind. Ct. App. 2010), trans. denied. We will reverse upon a
showing of only an abuse of that discretion. Id.[8] An abuse of discretion may occur if the trial court’s decision is clearly against
the logic and effect of the facts and circumstances before the court, or if the
court has misinterpreted the law. Id. We consider whether a trial court’s ruling
on a motion to amend is an abuse of discretion by evaluating a number of
factors, including “‘undue delay, bad faith, or dilatory motive on the part of the
movant, repeated failure to cure deficiency by amendment previously allowed,
undue prejudice to the opposing party by virtue of the amendment, and futility
of the amendment.’” Id. (quoting Palacios v. Kline, 566 N.E.2d 573, 575 (Ind.
Ct. App. 1991)). In reviewing a discretionary motion, we generally affirm if
there is any rational basis for the trial court action. Palacios, 566 N.E.2d at 575.
However, to the extent our analysis depends on whether Indiana Trial Rule
15(C) is preempted by EMTALA, we review that issue of law de novo. See
State v. Norfolk S. Ry. Co., 107 N.E.3d 468, 471 (Ind. 2018).
Court of Appeals of Indiana | Opinion 20A-CT-1088 | November 30, 2020 Page 7 of 25
[9] Indiana Trial Rule 15(C) governs relation back of amendments and provides, in
pertinent part, “[w]henever the claim or defense asserted in the amended
pleading arose out of the conduct, transaction, or occurrence set forth or
attempted to be set forth in the original pleading, the amendment relates back to
the date of the original pleading.” 4 “The purpose of the doctrine of relation
back is to allow a party who, through the course of discovery, realizes a new
claim or defense the opportunity to use this claim or defense despite the running
of the statute of limitations.” McCarty v. Hosp. Corp. of Am., 580 N.E.2d 228,
231 (Ind. 1991); see also Cinergy Corp. v. St. Paul Surplus Lines Ins. Co., 785 N.E.2d
586, 592 (Ind. Ct. App. 2003) (noting that “most cases discussing relation back
arise in the context of a statute of limitations problem” in discussing Indiana
Trial Rule 15(C), trans. denied. (citation omitted)).
[10] Miller’s principal contention is that Williams was “wrongly decided” because
the plaintiff in Williams made an “erroneous concession” that relation back
under Indiana Trial Rule 15(C) “directly conflicted with and was preempted”
by the two-year statute of limitations applicable to a claim under EMTALA.
Appellant’s Br. at 11. We reject Miller’s argument and conclude that Williams
guides our analysis in this case.
4
The federal counterpart to Indiana Trial Rule 15(C) is substantially identical to our state rule and provides,
in pertinent part, that an “amendment to a pleading relates back to the date of the original pleading when . . .
the amendment asserts a claim or defense that arose out of the conduct, transaction, or occurrence set out--or
attempted to be set out--in the original pleading . . . .” Fed. R. Civ. P. 15(c)(1)(B).
Court of Appeals of Indiana | Opinion 20A-CT-1088 | November 30, 2020 Page 8 of 25
[11] In Williams, Williams filed a proposed complaint with the Indiana Department
of Insurance (“IDOI”) in April 2014, alleging medical malpractice based on
treatment he received on December 2, 2012. 142 N.E.2d at 471. The IDOI
appointed a medical review panel. Id. On September 12, 2014, Williams filed a
complaint in state court alleging the same medical malpractice claim. Id. On
November 1, 2017, the medical review panel issued a unanimous opinion,
finding that the evidence did “not support the conclusion that the Defendants
[had] failed to meet the standard of care” and that “the conduct complained of
was not a factor of [Williams’s] resultant damages.” Id. On December 18,
2017, Williams filed a motion to amend his trial court complaint to identify the
anonymous defendants and to add a new, federal EMTALA claim. Id.
[12] The defendants objected to the amendment to add an EMTALA claim after the
expiration of EMTALA’s two-year statute of limitations. Id. at 471-72.
Williams filed a response to the defendants’ objection, contending that: (1) his
EMTALA claim was protected from a statute of limitations defense because he
filed his proposed medical malpractice complaint with the IDOI in April 2014
and his trial court complaint in September 2014; (2) the provisions of Indiana’s
medical malpractice act prohibited him from including an EMTALA claim in
his trial court complaint until after the statute of limitations had already passed;
(3) the EMTALA count that he sought to add to his original trial court
complaint was not time barred because Indiana Trial Rule 15(C) would allow
the claim to relate back to the original trial court complaint. Id. at 472. The
trial court denied Williams’ motion to amend to add the EMTALA claim. Id.
Court of Appeals of Indiana | Opinion 20A-CT-1088 | November 30, 2020 Page 9 of 25
[13] In our opinion affirming the trial court’s denial of Williams’s motion to amend,
we explained the purpose of EMTALA:
“EMTALA was enacted to address the problem of patient
‘dumping,’ in which hospitals would not provide the same
treatment to uninsured patients as to paying patients, either by
refusing care to the uninsured patients or by transferring them to
other facilities.” Beller v. Health & Hosp. Corp. of Marion Cty., Ind.,
703 F.3d 388, 390 (7th Cir. 2012). “EMTALA imposes two
duties on hospitals with respect to patients who come to their
emergency rooms: first, to provide medical screening for any
emergency condition; and second, as to any emergency
condition, to stabilize the patient prior to any transfer to another
facility.” Id. (citing 42 U.S.C. § 1395dd). See also HCA Health
Servs., 596 N.E.2d at 976 (explaining that “EMTALA operates to
restrict, among other things, the transfer, or ‘dumping,’ of
patients from hospitals until their conditions have stabilized”).
“EMTALA created a federal cause of action under federal law,
governed exclusively by the federal act, but that may be pursued
in federal or state fora.” Id. at 977. “This choice of forum in
which to pursue an EMTALA claim, however, does not indicate
that all state procedural requirements are encompassed when
maintaining an action based on the federal statute.” Id. The
statute of limitations for an EMTALA claim is two years from
the date of the alleged EMTALA violation. See 42 U.S.C. §
1395dd(d)(2)(C) (providing that “[n]o action may be brought
under this paragraph more than two years after the date of the
violation with respect to which the action is brought”). The
EMTALA statute also provides that “[t]he provisions of
[EMTALA] do not preempt any State or local law requirement,
except to the extent that the requirement directly conflicts with a
requirement of this section.” 42 U.S.C. § 1395dd(f).
Court of Appeals of Indiana | Opinion 20A-CT-1088 | November 30, 2020 Page 10 of 25
Williams, 142 N.E.2d at 474-75. We first addressed Williams’s motion to
amend his complaint under Indiana Trial 15(A) and concluded that his
proposed amendment would be futile, noting that “the two-year statute of
limitations for the EMTALA claim had already passed” by the time Williams
attempted to amend his complaint. Id. at 475.
[14] Williams also contended that his federal EMTALA claim was “not a new,
separate claim that he sought to add to his complaint” but “an expansion of his
malpractice and negligence claim in his original complaint filed in September
2014.” Id. He asserted that his proposed EMTALA claim would fall under the
state statute of limitations for negligence, which is also two years, and that this
claim would then be allowed to be added to his original complaint pursuant
Indiana Trial Rule 15(C). Id. We observed that, in arguing that the trial court
should have allowed him to include the alleged EMTALA claim in his
complaint despite the passing of the two-year statute of limitations, Williams
“[r]ecogniz[ed] the conflict between Indiana Trial Rule 15(C) and EMTALA’s
statute of limitations” and that he argued Indiana Trial Rule 15(C) would
“‘prevail’ and render EMTALA’s statute of limitations a ‘nullity.’” Id. at 476.
[15] We rejected Williams’s arguments concerning the application of relation back
under Indiana Trial Rule 15(C) to his proposed amended complaint and
reasoned as follows:
Here, Williams sought to add an EMTALA claim to his original
complaint. As such, it was a “federal cause of action under
federal law” and “governed exclusively by the federal act[.]”
Court of Appeals of Indiana | Opinion 20A-CT-1088 | November 30, 2020 Page 11 of 25
HCA Health Servs., 596 N.E.2d at 977. The fact that an
EMTALA claim may be brought in state court, “does not
indicate that all state procedural requirements are encompassed
when maintaining an action based on the federal statute.” Id.We acknowledge that “[i]t is a fundamental rule of law in
Indiana that in the event of a conflict between a procedural
statute and a procedural rule adopted by the supreme court, the
latter shall take precedence.” Bowyer v. Indiana Dep’t of Nat. Res.,
798 N.E.2d 912, 916 (Ind. Ct. App. 2003) (internal quotation
marks and citation omitted). See also Ritchie v. State, 809 N.E.2d
258, 268 (Ind. 2004) (“In general, if a statute conflicts with a
validly adopted Trial Rule, the rule prevails.”), reh’g denied, cert.
denied. However, the federal EMTALA regulation at issue
includes an express provision regarding preemption, which
provides that “[t]he provisions of [EMTALA] do not preempt
any State or local law requirement, except to the extent that the
requirement directly conflicts with a requirement of this section.” 42
U.S.C. § 1395dd(f) (emphasis added). See also Kennedy Tank &
Mfg. Co. v. Emmert Indus. Corp., 67 N.E.3d 1025, 1028 (Ind. 2017)
(explaining that “[e]xpress preemption exists when Congress
states the statute’s preemptive effect”). The EMTALA statute of
limitations, 42 U.S.C. § 1395dd(d)(2)(C), provides that “[n]o
action may be brought under this paragraph more than two years
after the date of the violation with respect to which the action is
brought.” (Emphasis added). Because the application of Indiana
Trial Rule 15(C) would directly conflict with the EMTALA two-
year statute of limitations, it is therefore preempted by
EMTALA.
Here, Williams attempted to file an EMTALA claim on
December 18, 2017, which was more than two years after the
date of the alleged violation of EMTALA on December 2, 2012.
Thus, Williams’[s] EMTALA claim was barred by EMTALA’s
two-year statute of limitations. Because his proposed
amendment to add this claim would have been futile, we
Court of Appeals of Indiana | Opinion 20A-CT-1088 | November 30, 2020 Page 12 of 25
conclude that the trial court did not abuse its discretion by
denying Williams’[s] motion to amend his complaint.[footnote omitted]
Id. at 476.
[16] Additionally, in HCA Health Servs., we addressed the interaction between
EMTALA and Indiana’s Medical Malpractice Act when determining whether a
plaintiff was barred from filing an EMTALA claim because she had not filed
the EMTALA claim within the two-year statute of limitations. 596 N.E.2d at
975-76. The plaintiff’s daughter was discharged from the hospital on November
13, 1987 and later died. Id. at 975. On February 10, 1989, the plaintiff filed a
proposed complaint with the IDOI, alleging medical malpractice and a federal
EMTALA claim but did not file the EMTALA claim in either state or federal
court. Id. After the expiration of the two-year EMTALA statute of limitations,
the defendant hospital filed a motion for summary judgment, which was
denied. Id. We observed that there was “no provision in EMTALA which
effectively toll[ed] the statute of limitations while awaiting a state procedural
prerequisite, such as an opinion from a medical review panel . . . .” Id. at 977.
This court held that EMTALA preempted Indiana’s Medical Malpractice Act
and that the plaintiff could not “shield her non-compliance with EMTALA’s
procedural mandates by asserting compliance with the [Indiana Medical
Malpractice] Act” nor “use the [Indiana Medical Malpractice] Act to foil
EMTALA’s statute of limitations.” Id. at 978.
[17] Here, the date of Zachary’s last treatment was January 8, 2017, Miller’s
complaint was filed on December 18, 2018, and her proposed amended
Court of Appeals of Indiana | Opinion 20A-CT-1088 | November 30, 2020 Page 13 of 25
complaint was filed on February 14, 2020 – beyond the two-year statute of
limitations for an EMTALA claim. Appellant’s App. Vol. 2 at 10, 23, 35, 39-49.
Similar to the proposed amended complaint in Williams, Miller’s proposed
amended complaint was futile because the attempt to amend the complaint
occurred outside EMTALA’s two-year statute of limitations, and applying
Indiana Trial Rule 15(C) would directly conflict with the EMTALA two-year
statute of limitations and is preempted by EMTALA. We find no error with
the trial court’s application of our precedent in Williams and HCA Health Servs.
in denying Miller’s motion to amend as futile because Indiana Trial Rule 15(C)
was preempted by EMTALA.5
[18] Contrary to Miller’s assertions that the plaintiff in Williams made an erroneous
concession that relation back under Indiana Trial Rule 15(C) directly conflicted
with and was preempted by EMTALA’s two-year statute of limitations, there is
no indication in Williams that Williams conceded, let alone made an erroneous
concession or admission, that Indiana Trial Rule 15(C) was in direct conflict
5
We acknowledge the state case law that Miller cites demonstrating the operation of relation back under
Indiana Trial Rule 15(C) in conjunction with various state statutes of limitations. Appellant’s Br. at 14-15, 22-
25, Appellant’s Reply Br. at 7-8. See McCarty v. Hosp. Corp. of Am., 580 N.E.2d 228, 231 (Ind. 1991) (concluding
that the plaintiff’s amendments related back to the original complaint despite the running of the statute of
limitations); Porter Cty. Sheriff Dep’t v. Guzorek, 857 N.E.2d 363, 366-68 (Ind. 2006) (allowing relation back of
an amendment to add an additional defendant after the statute of limitation had expired where the original
action was timely filed); Allied Mills, Inc. v. P.I.G., Inc., 454 N.E.2d 1240, 1242 (Ind. Ct. App. 1983) (rejecting
defendant’s argument that plaintiff’s motion to amend the complaint should not have been permitted because
it was filed after the statute of limitations had expired and concluding the plaintiff’s amendment related back
to the original pleading); Palacios v. Kline, 566 N.E.2d 573, 575 (Ind. Ct. App. 1991) (concluding the plaintiff’s
amended complaint related back to the original complaint even though the statute of limitations had
expired). However, in light of the holding of Williams, regarding preemption, we decline to apply the
rationale in those cases to the instant case.
Court of Appeals of Indiana | Opinion 20A-CT-1088 | November 30, 2020 Page 14 of 25
with and was preempted by the EMTALA statute of limitation. As previously
set forth, this court observed that Williams’s arguments were correct in
“recognizing the conflict between Indiana Trial Rule 15(C) and EMTALA’s
statute of limitations,” but we do not find this language in Williams to be
equivalent to a concession or an admission that Indiana Trial Rule 15(C)
directly conflicts with the EMTALA statute of limitations. Williams, 142
N.E.2d at 476 (emphasis added). We decline Miller’s request to reexamine
Williams on this basis.
[19] Miller also argues that “critical federal cases,” Appellant’s Br. at 20, which were
not cited to the court in Williams compel a different outcome here because they
show that “EMTALA and T.R. 15(C) do not directly conflict[,]” that the
federal cases demonstrate there is no direct conflict between EMTALA’s two-
year statute of limitations and relation back under Federal Rule of Civil
Procedure 15(C), and that EMTALA does not preempt Indiana Trial Rule
15(C). Appellant’s Reply Br. at 7. In support of her position, Miller directs us to
McCullum v. Silver Cross Hospital, No. 99 C 4327, 2001 WL 969076 (N.D. Ill.
Aug. 21, 2001) and Freedman v. Fisher, 89 F. Supp. 3d 716 (E.D. Pa. 2015),
federal trial court cases in which the plaintiffs were permitted to amend their
complaints to add an EMTALA claim after the two-year statute of limitations
had passed. Appellant’s Br. at 17. She also draws our attention to Lemons v.
Board of County Commissioners of Brown, No. CIV. A. 00-2297-CM, 2002 WL
370227 (D. Kan. Feb. 21, 2002) and Monrouzeau v. Asociacion del Maestro, 354 F.
Court of Appeals of Indiana | Opinion 20A-CT-1088 | November 30, 2020 Page 15 of 25
Supp. 2d 115 (D.P.R. 2005), which also discussed the application of Federal
Rule of Civil Procedure 15. Id.[20] In McCullum, which was an unreported federal district court decision, the
plaintiffs filed a complaint on July 11, 1999, to recover damages against the
defendants pursuant to 42 U.S.C. § 1981(a) for events occurring at the hospital
on July 5, 1997. 2001 WL 969076 at *1. On February 22, 2001, the plaintiffs
filed a second amended complaint adding a second count pursuant to
EMTALA. Id. Applying the concept of relation back pursuant to Federal Rule
of Civil Procedure 15, the federal district court permitted the plaintiffs to amend
their complaint to allege a violation of EMTALA because the EMTALA claim
was based on the same occurrence as the original complaint. Id. at *2.
[21] In Freedman, the plaintiffs filed a complaint in federal district court against the
defendant hospital for events occurring in the hospital emergency room on
February 22, 2012. 89 F. Supp. 3d at 720 n.4. The plaintiffs filed their original
complaint on June 7, 2013 and filed a motion to amend their original complaint
to plead an EMTALA claim, which was filed more than two years after the
statute of limitations had expired on April 15, 2014. Id. The motion to amend
was granted on May 6, 2014. Id. The defendant hospital moved for summary
judgment, arguing the EMTALA claim was barred by the statute of limitations.
Id. at 720. The federal district court determined that the EMTALA claim
related back under Federal Rule of Civil Procedure 15 because it was based on
the same occurrence as the original complaint and denied the defendant
hospital’s motion for summary judgment. Id.
Court of Appeals of Indiana | Opinion 20A-CT-1088 | November 30, 2020 Page 16 of 25
[22] In Lemons, which was an unreported federal district court decision, the plaintiffs
filed a complaint alleging violations of 42 U.S.C. § 1983, EMTALA, and raised
various state law claims. 2002 WL 370227 at *1. The defendants filed a
motion to dismiss, alleging that no named party had the capacity to sue when
the complaint originally was filed, which was based on Kansas law requiring
that a survival action be brought by the personal representative of the estate and
not the decedent’s heirs. Id. Acknowledging that, at the time the complaint
was originally filed, it was brought by the heirs and not the estate’s personal
representative, the federal district court noted that the plaintiffs had been
previously allowed to amend their complaint to name the personal
representative of the estate as an additional plaintiff. Id. at *1-2. In concluding
that the amended complaint related back and rejecting the defendants’
argument, the federal district court noted that relation back of an amendment to
a pleading that is filed in federal court is governed by the Federal Rules of Civil
Procedure. Id. at *2. It concluded that, based on Federal Rules of Civil
Procedure 15(c) and 17(a), the plaintiffs’ amendment adding the personal
representative of the estate as a party plaintiff was proper and denied the
defendants’ motion to dismiss. Id. at *3-4
[23] In Monrouzeau, the plaintiff filed a malpractice complaint in a Puerto Rico
commonwealth court on May 30, 2002 and an action in federal district court
alleging violations of EMTALA on October 7, 2002. 354 F. Supp. 2d at 117.
The malpractice complaint and the EMTALA action were both based on events
that occurred at the defendant’s hospital emergency room on July 14, 2000. Id.
Court of Appeals of Indiana | Opinion 20A-CT-1088 | November 30, 2020 Page 17 of 25
In opposition to the defendant’s motion for summary judgment, the plaintiff
argued that the ongoing malpractice action tolled the two-year EMTALA
limitations period or, in the alternative, that the term was extended under
principles of equitable tolling. Id. In rejecting the plaintiff’s arguments and
granting summary judgment for the defendant, the federal district court
observed that “[h]aving an ongoing suit would allow for additional claims to
‘relate back’ to the time the original pleading was filed pursuant to Rule 15(c)
Fed. R. Civ. P.,” but it ultimately determined that the plaintiff’s prior
proceedings instituted in commonwealth court within the two-year period,
which were ongoing, were of consequence in determining the timeliness of the
EMTALA claim filed in federal court. 6 Id. at 118-19.
[24] We do not find these federal cases require us to reexamine Williams as Miller
urges. We note that the reported and unreported federal district court cases
Miller cites are not controlling authority in this court. See U.S. Steel Corp. v. N.
Ind. Pub. Serv. Co., 951 N.E.2d 542, 558 (Ind. Ct. App. 2011) (citing Plaza Grp.
Props., LLC v. Spencer Cnty. Plan Comm’n, 877 N.E.2d 877, 894 (Ind. Ct. App.
2007), trans. denied (federal district court decisions are persuasive as opposed to
binding authority on state courts)). Moreover, each of the cases Miller cites
6
While the parties discuss the district court’s decision, we note that Monrouzeau was affirmed on appeal. See
Monrouzeau v. Asociacion Del Hosp. Del Maestro, Inc., 153 Fed. Appx. 7, 9 (1st Cir. 2005) (concluding that
equitable tolling did not apply to Monrouzeau’s alleged EMTALA violation even though Monrouzeau
“timely pleaded her federal claim in the Commonwealth court action . . . where she was allowed to have it
adjudicated . . . does not entitle her to replead it beyond the statutory window in this parallel federal lawsuit”
(citations omitted)).
Court of Appeals of Indiana | Opinion 20A-CT-1088 | November 30, 2020 Page 18 of 25
involves actions that were filed in federal court that address the application of
Federal Rule of Civil Procedure 15 to amendments to complaints filed in
federal court, and none involve preemption, which Miller recognizes.7 We
acknowledge, as Miller also observes, the similarity between relation back
under Indiana Trial Rule 15 and Federal Rule of Civil of Procedure 15 and that
we may refer to federal authority when interpreting similar provisions of the
Indiana Rules of Trial Procedure. See Guzorek, 857 N.E.2d at 367 (explaining
that as to the interpretation of Indiana Trial Rule 15(C) and Federal Rule of
Civil Procedure 15(C), it is “appropriate to consider federal authorities as
guidelines in interpreting and applying the Indiana rule.”); Crossroads Serv. Ctr.,
Inc. v. Coley, 842 N.E.2d 822, 825 (Ind. Ct. App. 2005) (noting that “because the
Indiana Trial Rules are based on the federal rules, it is appropriate to look to
federal decisions for guidance” regarding Indiana Trial Rule 15). We are
sympathetic to Miller for the loss she suffered; however, we decline to disturb
the dispositive holding in Williams that the “application of Indiana Trial Rule
15(C) would directly conflict with the EMTALA two-year statute of
limitations” and is “therefore preempted by EMTALA” to the instant case.
Williams, 142 N.E.2d at 476; see also In re Beck’s Superior Hybrids, Inc., 940
7
To the extent Miller also relies on Carodenuto v. New York City Health & Hosps. Corp., 156 Misc. 2d 361, 368-
69, 593 N.Y.S.2d 442, 447 (N.Y. Sup. Ct. 1992), in which a New York state court concluded that the
plaintiff’s amended complaint adding an EMTALA claim related back to the original timely-filed complaint
to support his position regarding relation back, we note that our state procedural rules, including Indiana
Trial Rule 15(C) have been preempted. See HCA Health Servs., 596 N.E.2d at 978-79; Williams, 142 N.E.2d at
476. We are not persuaded that the different conclusion regarding relation back and EMTALA under New
York state procedural law compels a different outcome in the instant case.
Court of Appeals of Indiana | Opinion 20A-CT-1088 | November 30, 2020 Page 19 of 25
N.E.2d 352, 368 (Ind. Ct. App. 2011) (holding that the use of Indiana Trial
Rule 28(E) to compel compliance with a subpoena duces tecum was preempted
by the Federal Arbitration Act, which required an arbitration panel to petition
the United States district court in which the panel sits to compel a nonparty to
appear before it or produce documents.) Therefore, we affirm the trial court’s
decision denying Miller’s motion to amend her complaint.
[25] Affirmed.
Pyle, J., concurs.
Tavitas, J., dissents with separate opinion.
Court of Appeals of Indiana | Opinion 20A-CT-1088 | November 30, 2020 Page 20 of 25
IN THE
COURT OF APPEALS OF INDIANA
Betty Miller, Individually and as Court of Appeals Case No.
Personal Representative of the 20A-CT-1088
Estate of John Allen Miller,
Appellant-Plaintiff,
v.
Laxeshkumar Patel, M.D., John
Schiltz, M.D., Benjamin
Coplan, M.D., Joseph Hill,
M.D., Erik Fossum, M.D.,
Bradford Hale, M.D., Christine
Tran, M.D., James Blickendorf,
M.D., Robert McAllister, M.D.,
Sara Koerwitz, M.D., Timothy
Held, PA, Community Health
Network, Inc., d/b/a
Community Howard Regional
Health Hospital and
Community Howard Behavioral
Health, Community Physicians
of Indiana, Inc., d/b/a
Community Physician Network,
Community Howard Regional
Health, Inc., St. Joseph Hospital
& Health Center, Inc., St.
Vincent Health, Inc., Ascension
Health, Inc., and Medical
Associates, LLP,
Appellees-Defendants.
Tavitas, Judge.
Court of Appeals of Indiana | Opinion 20A-CT-1088 | November 30, 2020 Page 21 of 25
[26] I respectfully dissent from the majority’s decision to affirm the denial of Miller’s
motion to amend her complaint. When analyzing whether the EMTALA
preempts Indiana Trial Rule 15(C), I reach a different result than the majority
and Williams v. Inglis, 142 N.E.3d 467 (Ind. Ct. App. 2020), trans. denied.
[27] The EMTALA provides that “[n]o action may be brought under this paragraph
more than two years after the date of the violation with respect to which the
action is brought.” 42 U.S.C. § 1395dd(d)(2)(C). The EMTALA also provides
that “[t]he provisions of [EMTALA] do not preempt any State or local law
requirement, except to the extent that the requirement directly conflicts with a
requirement of this section.” 42 U.S.C. § 1395dd(f).
[28] Indiana Trial Rule 15(C) governs relation back of amendments to pleadings and
provides, in pertinent part, “[w]henever the claim or defense asserted in the
amended pleading arose out of the conduct, transaction, or occurrence set forth
or attempted to be set forth in the original pleading, the amendment relates back
to the date of the original pleading.” Indiana Trial Rule 15(C) allows an
exception to the statute of limitations where the amendment is based on the
same conduct, transaction, or occurrence as pled in the complaint. Here, Miller
filed a motion to amend pursuant to Indiana Trial Rule 15(C) to add an
EMTALA claim. Williams and the majority hold that Trial Rule 15(C) conflicts
with the EMTALA statute of limitations and, thus, is preempted. I disagree.
[29] The majority relies, in part, on HCA Health Servs. of Ind., Inc. v. Gregory, 596
N.E.2d 974 (Ind. Ct. App. 1992), trans. denied. There, this Court addressed the
Court of Appeals of Indiana | Opinion 20A-CT-1088 | November 30, 2020 Page 22 of 25
trial court’s denial of a hospital’s motion for preliminary determination in a
medical malpractice action. The patient’s proposed complaint contained an
EMTALA claim, but the claim was never actually presented in a state or
federal action. During the medical review panel process, the two-year statute of
limitations expired. This Court held that Indiana’s Medical Malpractice Act’s
“provision requiring the filing of a proposed complaint with the Department,
and the ensuing indeterminate waiting period until a medical review panel
renders an opinion as a prerequisite to filing an action in court, directly conflicts
with the two-year statute of limitations contained in EMTALA.” HCA Health
Servs. of Ind., 596 N.E.2d at 977. This holding is consistent with other federal
cases regarding other similar state medical malpractice act provisions. See, e.g.,
Power v. Arlington Hosp. Ass’n, 42 F.3d 851, 866 (4th Cir. 1994) (holding that
“Virginia’s notice of claim provision, and its requirement that suits cannot be
filed until after they are reviewed by a malpractice review panel, directly
conflicts with EMTALA”); Cox v. Cabell Huntington Hosp., Inc., 863 F. Supp. 2d
568, 571 (S.D.W. Va. 2012) (holding that West Virginia’s medical malpractice
act “contains specific waiting periods, and therefore directly conflicts with
EMTALA’s statute of limitations.”).
[30] I do not, however, find HCA Health Servs. applicable or persuasive here with
regard to the application of Indiana Trial Rule 15(C). In HCA Health Servs., the
EMTALA two-year statute of limitations expired while the proposed complaint
was pending before the medical review panel. In the instant case, a complaint
was filed against appellees within the two-year statute of limitations, and Miller
Court of Appeals of Indiana | Opinion 20A-CT-1088 | November 30, 2020 Page 23 of 25
filed a motion to amend pursuant to Indiana Trial Rule 15(C) to add an
EMTALA theory purportedly arising out of the same conduct, transaction, or
occurrence pled in the original complaint.
[31] As the majority acknowledges in footnote 5, Indiana courts have routinely
recognized that a claim may relate back pursuant to Trial Rule 15(C) despite
the running of the statute of limitations. See, e.g. McCarty v. Hosp. Corp. of Am.,
580 N.E.2d 228, 231 (Ind. 1991) (holding that the plaintiff’s amendments
related back to the original complaint despite the running of the statute of
limitations); Porter Cty. Sheriff Dep’t v. Guzorek, 857 N.E.2d 363, 366 (Ind. 2006)
(holding that “on the facts of this case an amended complaint adding the
sheriffs’ department as a defendant relates back to the date of the original
complaint and is therefore not barred by the statute of limitations if the original
action was timely filed”). Moreover, as the majority also acknowledges, federal
courts have specifically held that an EMTALA claim may relate back pursuant
to Federal Rule of Civil Procedure 15(C), which is substantially similar to
Indiana Trial Rule 15(C). See, e.g., Freedman v. Fisher, 89 F. Supp. 3d 716, 720
(E.D. Pa. 2015) (holding that the patient’s EMTALA claim related back
pursuant to Federal Rule of Civil Procedure 15(C) and, therefore, the claim was
not barred by the statute of limitations).
[32] Under these circumstances, I do not find that Indiana Trial Rule 15(C) “directly
conflicts with” the EMTALA two-year statute of limitations. 42 U.S.C. §
1395dd(f). It is inconsistent to hold that Indiana Trial Rule 15(C) “directly
conflicts with” the EMTALA when federal courts have allowed relation back
Court of Appeals of Indiana | Opinion 20A-CT-1088 | November 30, 2020 Page 24 of 25
under the similar federal rule. Under the majority’s analysis and Williams,
Indiana Trial Rule 15(C) and the equivalent federal rule would be rendered
meaningless.
[33] While the trial court has discretion regarding whether to allow an amendment,
which we review under the abuse of discretion standard, our review of
conclusions of law is a de novo review. In a de novo review, I find that the trial
court misapplied the law. I conclude that the trial court incorrectly determined
that EMTALA’s two-year statute of limitations precluded Miller from
amending the complaint.
[34] Accordingly, I find that the relation back provision of Trial Rule 15(C) is not
preempted by the EMTALA’s two-year statute of limitations. I would remand
for the trial court to determine whether the EMTALA claim in the amended
complaint “arose out of the conduct, transaction, or occurrence set forth or
attempted to be set forth in the original pleading.” Ind. T.R. 15(C).
Court of Appeals of Indiana | Opinion 20A-CT-1088 | November 30, 2020 Page 25 of 25