## Facts

- Karen and Anthony Hayes married in 1977.
- In 2006, Karen, uninsured, received emergency medical treatment at Southern New Hampshire Medical Center (SNHMC) for complications related to alcoholism.
- The treatment resulted in an unpaid balance of $85,238.88.
- At the time, the spouses jointly owned two unencumbered properties as joint tenants with rights of survivorship.
- SNHMC sued both Karen and Anthony for the unpaid charges and obtained prejudgment attachments on their real estate.
- The trial court entered summary judgment against Karen for $85,238.88 plus costs.
- After a bench trial, the trial court held Anthony liable for the same amount under the common-law doctrine of necessaries and excluded evidence or argument on “elopement” via a motion in limine.
- During the litigation, the spouses divorced under an agreement allocating each spouse’s uninsured medical debts to that spouse and specifically assigning the SNHMC debt to Karen.
- Anthony asserted the parties had effectively been separated for years before the treatment and contested liability for Karen’s medical expenses.

## Issues

1. Whether New Hampshire’s common-law doctrine of necessaries remains valid and, if so, whether it must be applied in a gender-neutral manner.
2. Whether a spouse may be held liable for the other spouse’s necessary medical expenses as a matter of marital status alone, or only under a fact-specific standard (including inability of the treated spouse to pay).
3. Whether separation-related circumstances and a subsequent divorce decree allocating the debt affect a third-party creditor’s claim against the non-treated spouse under the necessaries doctrine.

## Decision

- The Supreme Court of New Hampshire affirmed summary judgment holding Karen directly liable to SNHMC for the unpaid bill.
- The court reversed the judgment holding Anthony liable under the doctrine of necessaries and remanded for a new trial.
- The court held that any continued necessaries doctrine must be gender-neutral and applied consistently with New Hampshire’s statutory regulation of spousal rights, duties, and creditor remedies.
- The trial court erred by imposing broad, status-based liability on Anthony without applying the doctrine in a legally constrained, fact-dependent manner.

## Legal Principles

- A creditor’s claim against the patient for necessary medical services is not eliminated by a divorce decree allocating that debt between former spouses; the creditor is not bound by that internal allocation.
- The doctrine of necessaries, to the extent recognized, cannot impose obligations on husbands but not wives; it must operate in a gender-neutral way.
- Spousal liability for necessaries is not automatic by virtue of marriage; courts must apply a limiting, circumstance-dependent standard consistent with legislative schemes governing spousal support and creditor collection.
- When applying any necessaries-based theory to a non-treated spouse, courts must consider relevant facts bearing on the statutory support obligation and the treated spouse’s ability to pay, rather than presume liability from marital status alone.

## Conclusion

The court left intact the patient’s direct liability for her hospital bill but rejected an automatic, status-based extension of liability to the other spouse; any necessaries doctrine in New Hampshire must be gender-neutral, constrained by statute, and applied through a fact-specific inquiry on remand.


Southern N.H. Med. Ctr. v. Hayes, 159 N.H. 711, 992 A.2d 596 (N.H. 2010)