A recent New Mexico Supreme Court decision has huge professional liability ramifications for physicians treating patients from another state. The March 13, 2017, ruling is of importance to emergency physicians who, under EMTALA, are unable to deny a patient care due to illness, injury, inability to pay, or lack of health history.

The issue at stake in Montaño v. Frezza was which state’s laws claim legal jurisdiction when a patient who resides in one state (New Mexico, in this case) receives care in another (Texas, in this case).

Montaño-Frezza Case Background

More than a half million patients from eastern New Mexico rely on a range of medical care from physicians in Lubbock, Texas. Texas has significant medical liability reforms; New Mexico does not.

In 2003, Texas passed comprehensive reforms regarded nationally as the gold standard in medical liability legislation. These reforms included a $250,000 cap on pain-and-suffering-type damages and a heightened willful and wanton standard of negligence for those providing emergency care.¹ A voter-approved constitutional amendment affirmed the legality of the damage cap.² Since 2003, 118 counties have grown their base of emergency physicians, including 53 counties where previously no emergency physicians practiced.^3,4

Eastern New Mexico is largely rural and has a significant shortage of primary and tertiary care. Patients often drive one to three hours from New Mexico to Texas to receive needed care. Covenant Health, the dominant hospital system in the Texas Panhandle, accepts multiple critically ill patients from New Mexico daily.

In 2004, Kimberly Montaño, a New Mexico resident, traveled to Lubbock to have gastric bypass surgery. The operation was performed in-network by bariatric surgeon Eldo Frezza, MD. At the time, Dr. Frezza was the chief of bariatric surgery at Texas Tech Hospital in Lubbock, a facility owned and operated by Texas Tech University Health Sciences Center. In the ensuing years, Dr. Frezza provided follow-up care for complications related to Ms. Montaño’s surgery. All of the care rendered by Dr. Frezza was in Texas. Dr. Frezza’s only connection to New Mexico was the fact that he was the only bariatric surgeon on the Lovelace New Mexico Health Plan.

Ms. Montaño sued Dr. Frezza in a New Mexico court. She argued her case should be tried under New Mexico law because her injuries “manifested” in New Mexico.

The Courts’ Decisions

The New Mexico appellate court agreed with the plaintiff, concluding the “place of wrong” is the place where the injury manifested and not where the alleged injury occurred.