Opinion
NO. 99-3734
July 18, 2001
ORDER REASONS
Pending before the Court is Defendant's Motion to Dismiss Pursuant to Federal Rules of Civil Procedure 12(b)1 and 12(b)6. For the following reasons, the motion is GRANTED and this matter is dismissed pursuant to Federal Rule of Civil Procedure 12(b)(1).
Plaintiff seeks to recover damages under the Emergency Medical Treatment and Labor Act, 42 U.S.C. § 1395dd ("EMTALA") stemming from the suicide of Mr. Michael Thomason shortly after he was treated at Charity Hospital and Medical Center of Louisiana at New Orleans ("Charity Hospital"). Plaintiff's complaint states that this Court has jurisdiction in this matter under both 28 U.S.C. § 1331 (federal question) and under 28 U.S.C. § 1332 (diversity). Defendant argues that this Court lacks jurisdiction in this case because the Defendant enjoys immunity from suit under the Eleventh Amendment to the United States Constitution.
The Defendant is identified as Medical Center of Louisiana at New Orleans in the complaint. In 1992 the Medical Center of Louisiana at New Orleans was redesignated as the Charity Hospital and Medical Center of Louisiana at New Orleans. See La. R.S. § 2002.5
ANALYSIS
The Eleventh Amendment provides immunity to an unconsenting state from suits brought in federal courts by her own citizens as well as by citizens of another state. Edelman v. Jordan, 415 U.S. 651, 662-63 (1974). This immunity extends to suits by private citizens against state agencies. See Pennhurst State School Hosp. v. Halderman, 465 U.S. 89, 100 (1984).
An exception to the Eleventh Amendment immunity arises if Congress legislatively abrogates the state's immunity. The EMTALA does not contain such an expression of intent to abrogate the state's immunity. See Drew v. University of Tenn. Reg'l Med. Ctr. Hosp., 2000 WL 572064 (6th Cir. 2000) ( citing Ward v. Presbyterian Healthcare Servs., 72 F. Supp.2d 1285 (D.N.M. 1999), Lebron v. Ashford Presbyterian Cmty. Hosp., 975 F. Supp. 407 (D.P.R. 1997)). A second exception arises if the state waives its Eleventh Amendment immunity. Louisiana has expressly refused to waive its immunity to suit in Federal Court. See, e.g., Edelman v. Jordan, 655 F. Supp. 560, 564 (M.D. La. 1985). A third exception arises if a public entity is so independent from the state that it cannot be characterized as the "alter ego" of the state itself. The inquiry in this case is whether Charity Hospital is an alter ego of the state causing the state to be the real party in interest in the lawsuit.
In Tradigrain, Inc. v. Mississippi State Port Auth., 701 F.2d 1131 (1983), the Fifth Circuit set out the test to determine when an entity is entitled to Eleventh Amendment immunity. The process involves weighing several factors to determine whether the state is the real party in interest in the lawsuit nominally brought against the agency. Id. The Court should consider:
(1) Whether state statutes and case law characterize the agency as an arm of the state;
(2) The source of entity funding;
(3) The degree of local autonomy;
(4) Whether the entity is concerned primarily with local, as opposed to statewide problems;
(5) The authority to sue and be sued in its own name; and
(6) The right to hold and use property.
Id. at 1059.
In Darlak v. Bobear, the Fifth Circuit found Charity Hospital — at that time a part of the Louisiana Department of Health and Human Resources — was entitled to Eleventh Amendment immunity. See 814 F.2d 1055 (5th Cir. 1987). Since the Darlak decision, Charity Hospital has been placed under the authority of the Board of Supervisors of Louisiana State University and Agricultural and Mechanical College (the "Board"). See La. R.S. § 17:1519.1. Despite this change, under the six factor Tradigrain analysis Charity Hospital still enjoys Eleventh Amendment immunity.
The Board is not named as a defendant in this case, however, because its status is relevant to Charity Hospital's Eleventh Amendment status, both entities are addressed in the analysis.
The first factor, whether state statutes and case law characterize the agency as an arm of the state, points toward eleventh amendment immunity for Charity Hospital. The Board was established under the State Constitution in Article 8 section 7; Louisiana Revised Statute 17:1519.1 placed Charity Hospital under its authority. Case law confirms that the Board and Charity are entitled to Eleventh Amendment immunity. See, e.g., Darlak, 814 F.2d at 1060 (finding Charity Hospital, as part of the Department of Health and Hospitals, is entitled to Eleventh amendment immunity); Boston v. Tanner, 29 F. Supp.2d 743 (W.D. La. 1998) (holding that the Board was entitled to Eleventh Amendment immunity); Schuth v. Louisiana Sate University Medical Center, 1989 WL 65566 (E.D. La. 1989) (finding the Board and the Louisiana State University Medical Center were state agencies for Eleventh Amendment purposes).
The second factor, the source of entity funding, is of critical importance to the Eleventh Amendment analysis. See Darlak, 814 F.2d at 1059. Charity is funded, to the extent possible, through patient care revenue. See La. R.S. 17:1519.4. However, the state legislature appropriates money to the Board to operate its hospitals and "any Medicaid and uncompensated care cost payments in excess of the appropriated amount . . . shall be transferred by the board to the Department of Health and Hospitals." See La. R.S. 17:1519.4(B)(1). Moreover, while the Board has the power to issue bonds, it is the State that is ultimately responsible for the payment of a judgment against the Board. Any judgment against the Board would be payable out of funds appropriated by the State legislature for that purpose. See La.R.S. 13:5109B(2); Boston v. Tanner, 29 F. Supp.2d 743, 747 (W.D.La. 1998). After weighing Charity's sources of funding and ultimate responsibility, the balance is in favor of Eleventh Amendment immunity.
The third factor, the degree of local autonomy, also points to immunity. Charity Hospital is "under the immediate direction and control of the Louisiana State University Health Sciences Center, subject to the overall direction, supervision and management of the [Board of Supervisors of Louisiana State University]." La. R.S. 17:1519.2(A). Two of the three members of Charity's local administrative board, which is composed of members from Tulane University Medical Center, the Louisiana State University Health Sciences Center and the Department of Health and Hospitals, are representatives of state entities. See La. R.S. § 17:1519.6. As Charity is both managed and administered by state entities, it cannot be characterized as an autonomous entity.
The fourth, fifth and sixth factors point against a finding of eleventh amendment immunity, as they did in Darlak. See 814 F.2d at 1060. But these factors are not controlling when the other factors point to immunity. See id. The fourth factor considers whether an entity is concerned primarily with local as opposed to state-wide problems. Charity is concerned with the administration of the hospital, and in that regard is primarily focused on local as opposed to state-wide problems. See id. However, the Board supervises and administers institutions throughout the State. See La. R.S. § 17:3215. As for the fifth factor, the statutes creating Charity Hospital do not explicitly authorize it to sue and be sued in its own name. However, numerous cases exist where Charity has been named in a lawsuit. See, e.g., Reimer v. Medical Center of Louisiana at New Orleans, 688 So.2d 165 (La.App. 4 Cir. 1997). Finally, Charity Hospital holds and uses property in its day to day operations.
CONCLUSION
After balancing the factors under the Tradigrain analysis, the Court concludes that the state of Louisiana is the real party in interest in this suit and, therefore, the Eleventh Amendment to the United States Constitution bars this action. For the foregoing reasons, Defendant's Motion to Dismiss is GRANTED.