DALTON SCOTT STAFFORD and KRISTINE MAJOR STAFFORD, Parents of JESSE TREY STAFFORD, Deceased, Plaintiffs/Appellants,
ANNE M. BURNS, M.D. and JOHN DOE BURNS, husband and wife; EMPOWER EMERGENCY PHYSICIANS, P.C., Defendants/Appellees.
from the Superior Court in Maricopa County No. CV2013-000019
The Honorable John Christian Rea, Judge
ACCEPTED; RELIEF DENIED
& Associates, Spring Lake, MI By B. Elliott Grysen
Co-Counsel for Plaintiffs/Appellants
& Roberts, P.C., Scottsdale By David L. Abney
Co-Counsel for Plaintiffs/Appellants
Skelton & Hochuli, P.L.C., Phoenix By Eileen Dennis
GilBride, Cristina M. Chait Counsel for Defendants/Appellees
Presiding Judge Kenton D. Jones delivered the Opinion of the
Court, in which Judge Randall M. Howe and Judge Donn Kessler
D. Jones, Presiding Judge
Dalton and Kristine Stafford (the Staffords) appeal the trial
court's orders denying their motions for new trial and
for relief from judgment following a jury verdict in favor of
Appellees (collectively, Dr. Burns) on the Staffords'
claims for medical malpractice and wrongful death after their
son, Jesse, died of a methadone overdose.
The Staffords argue the trial court erred in instructing the
jury, pursuant to Arizona Revised Statutes (A.R.S.) section
12-572(A),  that the Staffords bore the burden of
proof by clear and convincing evidence because, they contend,
Dr. Burns did not provide medical care "in compliance
with" the Emergency Medical Treatment and Active Labor
Act (EMTALA). See 42 U.S.C.A. § 1395dd (West).
As set forth below, we hold, as relevant here, the heightened
standard of proof for claims against a health professional
set forth in A.R.S. § 12-572(A) applies whenever the
acts or omissions plaintiff contends were deficient were
provided in the course of evaluating and treating a patient
in a hospital emergency department.
The Staffords also argue the court abused its discretion in
denying their motion for new trial based upon various
administrative and evidentiary rulings, for which we find no
Finally, the Staffords argue the trial court erred in
imposing sanctions pursuant to Arizona Rule of Civil
Procedure 68(g) because Dr. Burns' pretrial offer of
judgment was invalid in that it was not made in good faith.
We do not reach the merits of the Staffords' contention
because Rule 68(g) contains no such good faith requirement,
and we decline to impose one in contravention of the
rule's plain language and purpose.
5For the reasons stated below, we treat the
Staffords' appeal as a petition for special action,
accept jurisdiction, and deny relief. Accordingly, the
judgment and orders are affirmed.
FACTS AND PROCEDURAL
In the early morning hours of February 5, 2012, Jesse
presented at the emergency room of St. Joseph's Hospital
after having ingested an unknown quantity of methadone. After
several hours of testing, evaluation, and monitoring for a
possible methadone overdose, Dr. Burns took over Jesse's
care until he was discharged around 1:00 p.m. Jesse was found
dead the following day.
In January 2013, the Staffords filed a complaint against Dr.
Burns, asserting she negligently caused Jesse's death by
wrongfully determining his condition was stable and
discharging him prematurely. In response, Dr. Burns asserted
she complied with the standard of care and presented evidence
suggesting Jesse ingested additional methadone after his
discharge that ultimately caused his death.
After a twelve-day trial, the jury returned a defense
verdict. The Staffords timely filed motions for new trial and
for relief from judgment, which were denied. This appeal
This Court has an independent duty to examine whether it has
jurisdiction to consider an appeal. Stafford v. Farmers
Ins. of Ariz., 191 Ariz. 464');">191 Ariz. 464, 465 (App. 1997) (citing
Davis v. Cessna Aircraft Corp., 168 Ariz. 301, 304
(App. 1991)). Our appellate jurisdiction is generally limited
to issues arising from final judgments disposing of all
claims and all parties. Musa v. Adrian, 130 Ariz.
311, 312 (1981). A notice of appeal filed before entry of a
signed final judgment or resolution of a time-extending
motion is a nullity unless and until the final order enters.
See ARCAP 9(c); Craig v. Craig, 227 Ariz.
105, 107, ¶ 13 (2011) (citing Smith v. Ariz.
Citizens Clean Elections Comm'n, 212 Ariz. 407, 415,
¶ 39 (2006), and Engel v. Landman, 221 Ariz.
504, 509, ¶ 13 (App. 2009)); Tripati v.
Forwith, 223 Ariz. 81, 84, ¶ 15 (App. 2009).
Here, the Staffords filed two time-extending motions.
See ARCAP 9(e)(1)(D) (motion for new trial), (E)
(motion for relief from judgment). The trial court entered a
signed order denying the motion for relief from judgment and
denied the motion for new trial in an unsigned minute entry
order. Although this Court re-vested jurisdiction in the
trial court for the purpose of obtaining a signed, final
order corresponding to the minute entry denying the motion
for new trial, see Eaton Fruit Co. v. Cal. Spray-Chem.
Corp., 102 Ariz. 129, 130 (1967), no such order has been
issued. Accordingly, we lack appellate jurisdiction over this
Although we do not have appellate jurisdiction, we may, in
our discretion, consider the appeal as a petition for special
action. See Grand v. Nacchio, 214 Ariz. 9, 17,
¶ 20 (App. 2006) (citing Danielson v. Evans,
201 Ariz. 401, 411, ¶ 35 (App. 2001), and Lloyd v.
State Farm Mut. Auto. Ins., 189 Ariz. 369, 375 (App.
1996)); see also A.R.S. § 12-120.21(A)(4)
(granting court of appeals jurisdiction to hear special
actions "without regard to its appellate
jurisdiction"). We elect to do so here. The Staffords
present at least two issues of first impression and statewide
importance likely to recur. See Lind v. Superior
Court, 191 Ariz. 233, 236, ¶ 10 (App. 1998) (citing
Moss v. Superior Court, 175 Ariz. 348, 350 (App.
1993)). Additionally, were we to dismiss the appeal, nothing
that may occur in the trial court would likely alter the
disposition of the issues raised. Grand, 214 Ariz.
at 18, ¶ 24. Not wanting to elevate form over substance,
we exercise our discretion to treat this appeal as a petition
for special action and accept jurisdiction but, as set forth
below, deny relief.
Application of A.R.S. § 12-572(A)
A plaintiff must generally prove the elements of his medical
malpractice claim by a preponderance of the evidence. See
Harvest v. Craig,195 Ariz. 521, 523, ¶ 10 (App.
1999) (citing Thompson v. Sun City Cmty. Hosp.,
Inc.,141 Ariz. 597, 608 (1984)). In 2009, however, our
legislature adopted A.R.S. § 12-572(A), which heightened
the burden of proving a malpractice claim against "a
health professional . . . who provides or who is consulted to
provide services to a patient of a licensed hospital in
compliance with [EMTALA]" to clear and convincing
evidence. EMTALA is a federal statute enacted to address the
growing concern that hospitals were routinely refusing
emergency medical treatment to individuals unable to pay for
services. See Eberhardt v. City of LA., 62 F.3d
1253, 1255 (9th Cir. 1995) (citing H.R. Rep. No. 241, 99th
Cong., 1st Sess. (1986), reprinted in 1986
U.S.C.C.A.N. 726-27); Scottsdale Healthcare, Inc. v.
Ariz. Health Care Cost Containment Sys. Admin., 206
Ariz. 1, 6 n.6, ¶ 20 (2003) (citing Bryant v.
Adventist Health Sys./W.,289 F.3d 1162, 1165 (9th Cir.
2002)). The Staffords argue the trial court erred in
instructing the jury on the clear and convincing burden of
proof set forth in A.R.S. § 12-572(A) because, they