On April 24, 2025, the U.S. Court of Appeals for the Seventh Circuit (the “Seventh Circuit” or “Court”) affirmed summary judgment in Partin v. Baptist Healthcare Sys., Inc., applying the McDonnell Douglas burden-shifting framework to Emergency Medical Treatment and Active Labor Act (“EMTALA”) retaliation claims.
Case Background
Plaintiff Dr. William Partin (“Partin”) was an employee of Floyd Associates (“Floyd”), a medical staffing company with whom Baptist Healthcare System, Inc. (“Baptist”) contracted for emergency department medical personnel. Partin resigned after forcibly treating a cogent patient without consent, despite hospital legal advice that the patient had the right to refuse the procedures.
Partin filed suit against Baptist and its President, Dr. Daniel Eichenberger (“Eichenberger”), in the District Court, alleging retaliation in violation of EMTALA. Partin also brought various Indiana state law claims, including defamation per se, breach of contract and tortious interference with contractual relations. The District Court granted summary judgment in favor of Baptist. Partin appealed.
The dispute centered around Partin’s treatment of a patient (“J.C.”) in Baptist’s emergency department. J.C. was brought by ambulance to Baptist after attempting to commit suicide. Upon arrival, J.C. was diagnosed with depression accompanied by suicidal ideation. Partin observed that J.C. was combative, exhibited signs of psychosis and admitted to illegal drug use. Given this, Partin successfully petitioned for a 72-hour medical hold.
Despite reassuring vital signs apart from a slightly elevated heart rate, Partin ordered IV fluids and a rectal temperature reading. When J.C. refused, Partin threatened restraints to gain compliance. The hospital staff refused, believing J.C. was alert, coherent and capable of refusing treatment. Moreover, J.C. was generally cooperative: J.C. agreed to a psychological consultation, voluntarily provided a urine sample and allowed the staff to draw blood, take her vitals (including her oral temperature) and administer an EKG. Despite this, and advice from Baptist’s legal department to the contrary, Partin persisted and obtained Eichenberger’s support to forcibly carry out the treatments. J.C. was then subsequently restrained, sedated with ketamine and the procedures were completed. The following day, a psychiatric consult found J.C. neither psychotic nor suicidal, and the hold was discontinued.
In the aftermath, formal complaints were lodged about Partin’s conduct, expressing dismay that a cogent patient was forcibly treated without consent despite their protestations. Due to the conflict, Eichenberger requested that Floyd immediately remove Partin from Baptist. Floyd’s Medical Director told Partin that he could either resign or be terminated.
Background of EMTALA
EMTALA was established to address the issue of hospitals refusing to treat patients who lack health insurance. EMTALA largely mandates that hospitals conduct appropriate medical screening examinations for all patients who present to the hospital’s dedicated emergency department to determine if an emergency medical condition exists. If such a condition exists, the hospital must, within the hospital’s capabilities, provide necessary stabilizing treatment before transferring or discharging the patient. EMTALA aims to ensure that patients receive equal treatment and are not discriminated against compared to other patients in similar situations.
In addition to protecting patients, EMTALA safeguards specific individuals, including physicians who refuse to transfer an unstabilized patient and hospital employees who report violations of EMTALA, from retaliation. This final point forms the basis of Partin’s EMTALA-related claim.
As affirmed by the Court, EMTALA was not enacted to provide a federal remedy for medical errors or negligence, which are appropriately addressed by state medical malpractice laws. Additionally, it does not offer a federal solution for professional disagreements related to patient care.
The Court’s Analysis of the EMTALA Retaliation Claim
The Seventh Circuit affirmed the District Court’s finding that Partin did not engage in EMTALA-protected activity. Partin claimed that Baptist violated EMTALA by retaliating against him for: (1) refusing to discharge J.C., even though the hospital wanted to do so before she was stable; and (2) reporting to Eichenberger that the hospital had failed to sufficiently examine J.C. to determine her condition before she was discharged.
For purposes of this appeal—absent direct evidence of retaliation—the Seventh Circuit assumed that the McDonnell Douglas burden-shifting framework utilized in Title VII cases applies to whistleblower claims under EMTALA. Under the McDonnell Douglas framework, a plaintiff must first establish a prima facie case of retaliation and, if successful, the burden shifts to the employer to articulate a legitimate reason for the adverse action. If the employer can do so, the burden shifts back to the plaintiff to prove that the employer’s proposed reason “is merely a pretext and that retaliatory animus motivated the adverse action.” Elkharwily v. Mayo Holding Co., 823 F.3d 462, 470 (8th Cir. 2016). To establish a prima facie case of retaliation, Partin must have shown that a reasonable jury could find that (1) he engaged in statutorily protected activity; (2) his employer subjected him to an adverse action; and (3) the first caused the second. See Gillispie v. RegionalCare Hosp. Partners Inc., 892 F.3d 585, 592 (3d Cir. 2018).
The Court found that Partin failed to present evidence that he refused to discharge J.C. amid pressure from the hospital staff, as no member of the staff discharged or attempted to discharge J.C. before Partin spoke with Eichenberger. Moreover, Partin’s arguments that the staff impeded him from performing the necessary assessment of J.C. by refusing to administer IV fluids and take her temperature rectally demonstrate a mere professional disagreement beyond the statute’s reach. Finally, Partin’s contention that he was reporting a future EMTALA violation fails because the statute permits suit only when an existing violation is reported.
Analysis of State Law Claims
The Court then analyzed each of Partin’s state law claims, in turn. First, as to Partin’s contractual claims, the Court found Partin’s reliance on Baptist’s medical staff bylaws (the “Bylaws”) to be misplaced. Partin suggested that these Bylaws demanded that Baptist follow certain procedural mechanisms before removing him from the emergency department. However, the Court held that the 2016 Bylaws unequivocally stated that no contractual relationship shall be construed to arise therefrom, while the 2019 Bylaws expressly provided that voluntary relinquishment of clinical privileges shall occur without hearing or appeal.
Furthermore, the Court rejected Partin’s claim that, because he was facing likely termination, his resignation was involuntary and under duress. The Court reasoned that, per Indiana case law, an employer’s “threat” to remove an employee does not constitute actionable duress as the opportunity to make a choice is in the employee’s best interest. See Guzik v. Town of St. John, 875 N.E.2d 258, 268–69 (Ind. Ct. App. 2007); Crabtree v. Lee, 469 N.E.2d 476, 478 (Ind. Ct. App. 1984).
Next, the Court quickly disposed of Partin’s good faith and fair dealing claim, as procedurally, Partin waived his argument by failing to raise it in his opening brief. But the argument also failed on the merits: neither rendition of the Bylaws expressly created a duty, and even assuming such a duty could be implied, Partin received all of the process he was due under the terms of the 2019 Bylaws.
The Court was unconvinced by Partin’s next argument: that as a third-party beneficiary to Baptist’s contract with Floyd, which proscribed Baptist from requesting the immediate removal of a physician unless he violated Baptist’s written policies, procedures or bylaws, he could sue to enforce this provision. Following the Indiana Supreme Court’s careful circumscription of third-party beneficiary suits, the Court found that nothing in Baptist’s agreement with Floyd manifested an intent to bestow rights upon a third party; rather, the agreement merely conferred a benefit upon Partin, which is insufficient for enforceability.
The Court again rejected Partin’s claim that Baptist and Eichenberger tortiously interfered with his employment contract with Floyd by exerting unfair economic pressure to remove him. Specifically, Partin pointed to Eichenberger notifying Floyd that Baptist “will have no choice but to issue … a 90-day written notice of termination of the Agreement” if Partin were not removed. The Court was unpersuaded: The agreement bilaterally permitted the right to cancel for any reason with a 90-day notice, thereby not amounting to unfair economic pressure.
Finally, the Court found that no rational jury could conclude that statements by Eichenberger or Baptist’s Nurse Director for Emergency Services per se defamed the physician. Under Indiana law, an otherwise defamatory statement may nonetheless be protected by the defense of qualified privilege if none of the statements were made maliciously, in bad faith or without belief or grounds for belief in its truth. Here, the Court found insufficient evidence of defamation, so Partin’s defamation claim against Baptist on a respondeat superior theory failed.
Practical Takeaways
- Not All Physician Objections Trigger EMTALA Protection: To claim retaliation under EMTALA, the physician must report an actual violation or refuse to transfer an unstable patient – anticipated or theoretical concerns don’t qualify as protected activity.
- Disagreements Over Medical Judgment Are Not Subject to Remedy Under EMTALA: The Court affirmed the long-held opinion that EMTALA does not create a federal remedy for matters appropriately addressed by state law, and it distinguished between conduct protected under EMTALA and unprotected professional disagreements. Disagreements regarding patient treatment do not constitute grounds for retaliation liability.
- Medical Staff Bylaws Rarely Create Enforceable Rights: Hospital bylaws, even if referenced in employment decisions, typically do not create contractual obligations unless they explicitly state otherwise, limiting a physician’s ability to sue over procedural deviations.
If you have questions or would like more information about this topic, please contact:
- David Honig at (317) 977-1447 or dhonig@hallrender.com;
- Kennedy Bunch at (317) 977-1420 or kbunch@hallrender.com;
- Megan Culp at (317) 429-3644 or mculp@hallrender.com; or
- Your primary Hall Render contact.
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