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Wrongful Death, EMTALA, and Sovereign Immunity in Texas

Bansal v. University of Texas MD Anderson Cancer Center is a wrongful death and survival action that arose out of the death of a stage IV colon cancer patient. The decedent was brought into the cancer center at the University of Texas with various symptoms, and he died a week later.

The decedent’s father and wife sued the center. They alleged that the center didn’t stabilize the decedent or relieve his pain after the oncologist determined chemotherapy hadn’t worked. The decedent died less than 24 hours after the center reduced its care. The plaintiffs claimed negligence, negligence per se, breach of contract, and a violation of the federal Emergency Medical Treatment and Active Labor Act (EMTALA).

Under EMTALA, if someone comes to a hospital, and it determines that the person has an emergency medical condition, the hospital needs to provide further examination and treatment to stabilize the patient or transfer him to another facility with certain conditions. When a hospital participates in receiving Medicare payments, someone harmed by the hospital’s violation of EMTALA can sue the hospital and receive personal injury damages that are available under state law.

The center argued that it was entitled to sovereign immunity from suit and filed a plea to the jurisdiction. The plaintiffs amended their petition and agreed they would not try to obtain further discovery in order to establish the trial court’s jurisdiction over the matter. The center then filed a brief supporting its jurisdictional plea. It argued that the claims didn’t fall within the waiver of sovereign immunity found in the Texas Tort Claims Act (“the TTCA”). The plaintiffs responded that EMTALA preempted sovereign immunity.

The trial court granted the plea to the jurisdiction. The claims were dismissed with prejudice. The plaintiffs appealed. On appeal, they asked the appellate court to review whether the trial court had erred in deciding the center was entitled to sovereign immunity from their EMTALA claim.

The appellate court explained that unless the Legislature waives or abrogates sovereign immunity, the state is protected against a lawsuit for damages. In responding to the appeal, the center claimed, for the first time, that it was entitled to sovereign immunity under the Eleventh Amendment. The plaintiff disagreed, claiming that in the Rule 11 agreement between the parties, the center had waived its right to raise new sovereign immunity arguments.

The appellate court explained that the Rule 11 agreement didn’t affect its duty to hear arguments that implicate subject matter jurisdiction and that the agreement didn’t address the scope of the arguments the center could make when asserting sovereign immunity.

The Eleventh Amendment provides sovereign immunity for federal claims against the State. States maintain immunity from private suit in their own courts, such that states cannot be sued in their own courts for federal law claims (like EMTALA) without their consent or waiver of sovereign immunity.

In this case, the center was an arm of the State. Accordingly, the appellate court found it had immunity from the EMTALA claim unless it had voluntarily waived that immunity, or Congress had abrogated it. In the language of EMTALA, Congress hadn’t expressed an intent to abrogate Eleventh Amendment immunity, and Texas had not voluntarily waived it. The court also found that amending the pleadings given these particular facts wouldn’t bring the claims within the scope of the TTCA waiver of immunity. Accordingly, the lower court’s ruling was affirmed.

If a loved one dies as a result of someone else’s negligence, the San Antonio wrongful death attorneys at Carabin Shaw may be able to represent you and develop a sound strategy for handling your case. Call our office for more information at 1-800-862-1260.

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