## Facts

- Fred L. Charon, an HIV-positive man, suffered a severe reaction to an antibiotic while traveling and went to Memorial Hospital’s emergency room with his companion, Bruce Howe.
- An emergency-room physician examined Charon, diagnosed Toxic Epidermal Necrolysis (TEN), and sought to admit him.
- Hospital protocol required approval by an on-call admitting physician; Dr. Charles E. Hull was on call.
- Evidence, viewed for summary judgment, indicated Dr. Hull focused on whether Charon’s HIV had progressed to AIDS, did not inquire into Charon’s vital signs or TEN assessment, and did not examine Charon before disposition.
- Dr. Hull allegedly stated that “if you get an AIDS patient in the hospital, you will never get him out,” and directed transfer to an AIDS program at a different facility.
- Memorial did not admit Charon and transferred him to another hospital, where he received treatment and survived.
- Howe (later representing Charon’s estate) sued Dr. Hull and Memorial under Title III of the ADA, § 504 of the Rehabilitation Act, EMTALA, and Ohio claims for intentional and negligent infliction of emotional distress, alleging the transfer/refusal to admit was motivated by HIV status.

## Issues

1. Whether genuine disputes of material fact existed as to whether defendants denied admission or provided substandard treatment because of Charon’s HIV status in violation of Title III of the ADA and § 504 of the Rehabilitation Act.
2. Whether EMTALA permits a private damages action against an individual physician and, separately, whether the hospital could be liable under EMTALA based on screening, stabilization, and transfer requirements.
3. Whether the evidence could support Ohio claims for intentional infliction of emotional distress and negligent infliction of emotional distress.

## Decision

- The court granted in part and denied in part defendants’ motions for summary judgment under Rule 56.
- As to Dr. Hull:
  - Summary judgment granted on EMTALA (no private cause of action against individual physicians).
  - Summary judgment granted on negligent infliction of emotional distress.
  - Summary judgment denied on ADA, Rehabilitation Act, and intentional infliction of emotional distress.
- As to Memorial Hospital:
  - Summary judgment granted on negligent infliction of emotional distress.
  - Summary judgment denied on EMTALA, ADA, Rehabilitation Act, and intentional infliction of emotional distress.

## Legal Principles

- Summary judgment is inappropriate where the record presents genuine disputes of material fact and competing inferences on motive and causation.
- HIV infection may qualify as a disability for purposes of Title III of the ADA and § 504 of the Rehabilitation Act, and denial of hospital services based on HIV status may violate those statutes.
- An individual physician with sufficient control over admission/operations may be subject to Title III liability where the physician effectively operates access to a place of public accommodation.
- EMTALA’s private civil remedy runs against the participating hospital, not individual physicians; hospitals may face liability for failures in screening, stabilization, or improper transfer.
- Under Ohio law, intentional infliction of emotional distress requires conduct a factfinder could deem extreme and outrageous; negligent infliction of emotional distress is limited to narrow categories and was not available on these facts.

## Conclusion

The court held that a jury could reasonably find the transfer decision was driven by HIV-based discrimination rather than medical necessity, allowing ADA and Rehabilitation Act claims and intentional infliction of emotional distress claims to proceed against both defendants, while limiting EMTALA liability to the hospital and dismissing all negligent infliction claims.


Howe v. Hull, 874 F. Supp. 779 (N.D. Ohio 1994)