Alicea Martinez v. Hosp. Menonita de Cayey,
No. 99-1656 (D.P.R. July 26, 2001)

A patient presented to an emergency room complaining of difficulty swallowing and breathing after he had swallowed a small turkey bone. A physician examined the patient, ordered a Barium Swallow x-ray and diagnosed the patient with dysphagia, or difficulty swallowing. He prescribed a muscle relaxant and discharged the patient. The next day the patient again reported to the emergency room with similar symptoms. This time he was examined, given a Barium Swallow x-ray and the second physician diagnosed the patient with a perforated esophagus and performed surgery.

The patient sued the first physician under EMTALA. The physician moved for summary judgment claiming that the case was an ordinary medical malpractice claim which did not fall under EMTALA. The magistrate recommended that summary judgment be granted. The United States District Court, Puerto Rico accepted the magistrate's recommendation. The court held that EMTALA could only be violated if a physician fails to follow a customary screening procedure, and that the patient had the burden of proving that the screening procedure had not been followed. The court concluded that the patient could not show that the screening procedure had not been followed and that the case was a standard medical malpractice claim which could not be argued under EMTALA.