Pauly v. Stanford Health Care

Background

Makenzie Pauly moved under Federal Rule of Civil Procedure 12(f) to strike the entirety of Stanford Health Care’s answer. The case concerns five remaining claims under the Emergency Medical Treatment and Labor Act, or EMTALA. The claims allege that Stanford Health Care failed to accept Pauly’s transfer, provide an appropriate medical screening examination, provide on-call specialists, treat a known emergency medical condition, and properly transfer a patient with a known emergency medical condition.

Pauly challenged Stanford Health Care’s denials of the allegations and its 18 affirmative defenses. The defenses included comparative negligence, failure to mitigate damages, assumption of risk, consent, third-party fault, factual insufficiency, statutes of limitations, public policy, business necessity or legitimate business reasons, collateral-source offsets, preexisting conditions, and several California statutes concerning damages and liability.

Legal standard

Rule 12(f) permits a court to strike an insufficient defense or redundant, immaterial, impertinent, or scandalous matter from a pleading. The court explained that a motion to strike generally should be granted only when the challenged material could have no possible bearing on the litigation. Under Rule 8, an answer must state defenses in short and plain terms and admit or deny the opposing party’s allegations; denials must fairly respond to the substance of those allegations.

The court addressed a dispute over whether the heightened plausibility standard used for complaints under Bell Atlantic Corp. v. Twombly and Ashcroft v. Iqbal also applies to affirmative defenses. It held that the governing standard for these defenses was fair notice, not plausibility pleading. Under that standard, a defense must identify its legal theory in general terms, but need not include facts that make the defense plausible. Supporting facts may be obtained through discovery.

Analysis

The court found that Stanford Health Care’s 18 affirmative defenses adequately notified Pauly of the legal theories on which they were based. It held that the common-law defenses involving comparative negligence, failure to mitigate, assumption of risk, and consent were sufficiently alleged. The court also rejected Pauly’s argument that reliance on tort concepts made those defenses immaterial in an EMTALA case, explaining that EMTALA incorporates state-law principles concerning damages for personal injury and appropriate equitable relief.

The court found the third-party-fault defense sufficient to provide fair notice, even though Stanford Health Care did not identify the alleged third party in the answer. It also found the defenses based on factual insufficiency adequate. The court rejected Pauly’s issue-preclusion argument, explaining that its earlier ruling addressed whether the five claims were time-barred, not whether the claims were factually sufficient.

The court also found adequate the defenses based on California Civil Code sections 3333.1, 3333.2, and 1714.8, and California Code of Civil Procedure section 667.7. Pauly had not shown that those defenses could have no possible bearing on the litigation. The court likewise found sufficient the remaining defenses based on the statute of limitations, public policy, business necessity or legitimate business reasons, and collateral offsets for damages.

Finally, the court held that Stanford Health Care’s repeated denials of the allegations in the five causes of action fairly responded to the substance of those allegations. It rejected Pauly’s other arguments as unpersuasive.

Disposition

Judge Susan Illston denied Pauly’s Rule 12(f) motion to strike. The order did not decide the ultimate merits of Pauly’s EMTALA claims; it held only that Stanford Health Care’s answer and defenses should not be stricken at that stage.