Tahirkheli v. Ascension Via Christi Hospital Pittsburg, Inc. et al

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UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF KANSAS
MARYUM AUTUMN TAHIRKHELI,
Plaintif
f, v.
ASCENSION VIA CHRISTI HOSPITAL
PITTSBURG, INC., SOUND PHYSICIANS
EMERGENCY MEDICINE OF KANSAS, LLC,
and KATHRYN M. CORNELIUS, M.D.,
Defendants.
Case No. 24-2426-EFM-BGS
MEMORANDUM & ORDER
NOW BEFORE THE COURT is Plaintiff’s Motion to Compel Defendant Ascension Via
Christi Hospital Pittsburg, LLC (“Defendant Ascension” or “Defendant”) to produce documents
Plaintiff alleges are relevant to her EMTALA claim. (Doc. 149.) For the reasons set forth herein,
Plaintiff’s motion is GRANTED in part and DENIED in part as set forth herein.
GENERAL FACTUAL BACKGROUND
Plaintiff alleges violations of the Emergency Medical Treatment and Labor Act, 42 U.S.C.A. §
1395dd (“EMTALA”) (Count I), violations of the Kansas Consumer Protection Act (Count II), and
intentional infliction of emotional distress (Count III) as a result of a May 24, 2024, ER visit for
Plaintiff’s minor daughter (“the minor child”). 1 Plaintiff alleges that Defendant Ascension violated
EMTALA by failing to: (1) determine whether the minor child was suffering from an emergency
medical condition, (2) obtain informed consent from Plaintiff as to the minor child’s treatment, (3)
involve Plaintiff in the treatment plan for the minor child, and (4) violating the privacy and safety of
1 These three claims remain pending against Defendant Ascension. Only Count III for intentional infliction of
emotional distress remains pending against Defendants Sound Physicians and Cornelius. (See Doc. 36).
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Plaintiff and her minor child. (See generally Doc. 1.) More specific factual allegations are summarized in
the District Court’s Memorandum & Order on Defendants’ Motion to Dismiss (Doc. 36, at 1-3). That
summary is incorporated by reference. Defendants generally deny Plaintiff’s allegations.
PLAINTIFF’S MOTION TO COMPEL
In her motion, Plaintiff seeks an Order compelling production of Defendant Ascension’s
Medicaid contract with the government, which Plaintiff contends would establish Defendant “is
required to implement federal regulations regarding patient care into its policy, including a mechanism
to enforce those policies.” (Doc. 149, at 1.) Plaintiff also seeks Defendant Ascension’s bylaws “to see
the mechanism [it] used … to enforce its policies regarding patient care.” (Id.) Finally, Plaintiff seeks
production of Defendant Ascension’s policies, including the “Downtime Policy,” that was “repeatedly
mentioned by Dr. Cornelius in her depositions.” (Id., at 1-2.) Plaintiff argues that this information is
central to her claims as well as Defendant’s defenses. (Id., at 2.)
Plaintiff contends that during the parties’ meet & confer telephone conference, Defendant
Ascension’s attorney stated that only a table of contents for the Medical Staff Bylaws from the
requested documents would be provided, but that the parties could then “discuss exactly what the
Plaintiff believes is relevant to the case, and [Defendant] would then decide if it would produce those
Bylaws, but then [Defendant’s] counsel only provided a redacted document with two partially readable
pages, not a complete table of contents, making the phone discussion meaningless.” (Id., at 3
(referencing Doc. 151).) Defendant generally argues that the documents sought by Plaintiff are
irrelevant to the claims and defenses in this case. (Doc. 157, at 2.)
ANALYSIS
I. 	Legal Standards for Motions to Compel Discovery.
The scope of discovery is governed by Federal Rule of Civil Procedure 26, which states in
relevant part that
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[p]arties may obtain discovery regarding any nonprivileged matter that is
relevant to any party's claim or defense and proportional to the needs of
the case, considering the importance of the issues at state in the action,
the amount in controversy, the parties' relative access to relevant
information, the parties’ resources, the importance of the discovery in
resolving the issues, and whether the burden or expense of the proposed
discovery outweighs its likely benefit. Information within this scope of
discovery need not be admissible in evidence to be discoverable.
Fed. R. Civ. P. 26(b).
To be discoverable, the information sought must be nonprivileged, relevant, and proportional
to the needs of the case. Holick v. Burkhart, No. 16-1188-JTM-KGG, 2018 WL 372440, at *2 (D. Kan.
Jan. 11, 2018). Relevance is “construed broadly to encompass any matter that bears on, or that
reasonably could lead to other matter that could bear on, any issue that is or may be in the case.”
Oppenheimer Fund, Inc. v. Sanders, 437 U.S. 340, 351 (1978). See also Beaty v. Kansas Athletics, Inc., No. CV
19-2137-KHV, 2020 WL 1862563, at *2 (D. Kan. Apr. 14, 2020) (citations omitted).
Pursuant to Fed. R. Civ. P. 37, a party may move the Court for an order compelling answers to
interrogatories and requests for production of documents. The documents sought through discovery
need not be admissible to be discoverable. Federal Rule of Civil Procedure 26(b)(1). If the discovery
sought appears relevant, the party resisting discovery has the burden to establish the lack of relevancy
by demonstrating that the requested discovery (1) does not come within the scope of relevancy as
defined under Fed. R. Civ. P. 26(b)(1), or (2) is of such marginal relevancy that the potential harm
occasioned by discovery would outweigh the ordinary presumption in favor of broad disclosure. Brecek
& Young Advisors, Inc. v. Lloyds of London Syndicate 2003, No. 09-2516-JAR, 2011 WL 765882, at *3 (D.
Kan. Feb. 25, 2011). See Swackhammer v. Sprint Corp. PCS, 225 F.R.D. 658, 661, 662, 666 (D. Kan. 2004)
(stating that the party resisting a discovery request based on overbreadth, vagueness, ambiguity, or
undue burden/expense objections bears the burden to support the objections). Conversely, when the
relevancy of the discovery request is not readily apparent on its face, the party seeking the discovery
has the burden to show the relevancy of the request. Id. Relevancy determinations are generally made
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on a case-by-case basis. Id.
II. Documents Requested by Plaintiff.
By way of general context, Plaintiff argues that “EMTALA cases fundamentally turn on
whether a hospital followed its own policies and procedures.” (Doc. 149, at 4.) For instance, in Phillips
v. Hillcrest Medical Center, the Tenth Circuit held that whether a hospital has performed an appropriate
medical screening examination depends on whether the hospital adhered to its own policies and
procedures. 244 F.3d 790, 796-97 (10th Cir. 2001).
Plaintiff continues that it is improper to allow Defendant Ascension to
claim it complied with EMTALA while simultaneously refusing to
produce the policies by which such compliance must be measured.
[Defendant’s] EMTALA policy itself references “local Hospital policy”
when referring to Medical Screening Exam (MSE) and leaving Against
Medical Advice (AMA). ([Doc. 152, at 2, 5]). Without these policies and
procedures, it is impossible for the Plaintiff to demonstrate whether
[Defendant] adhered to its own standard procedures as required by law.
The underlying principle behind section 1395dd(a) is to ensure all
patients, regardless of their perceived ability or inability to pay, are given
consistent 	attention. 	EMTALA’s 	requirement 	of 	an 	appropriate
screening examination, stabilizing treatment, and appropriate transfer
require a hospital to apply uniform procedures and policies to all
individuals coming to the emergency room. A hospital’s failure to abide
by its established policies shows disparate treatment.
(Doc. 149, at 4-5.)
It is true that EMTALA liability attaches “[u]nless each patient, regardless of perceived ability
or inability to pay, is treated in a uniform manner” in accordance with the hospital’s existing policies
and procedures. Phillips, 244 F.3d at 797 (citing Repp v. Anadarko Mun. Hosp., 43 F.3d 519, 522 (10th
Cir.1994)). Further, EMTALA § 395dd(a) imposes a strict liability standard. Id., at 798 (citing Stevison v.
Enid Health Sys’s, 920 F.2d 710, 713 (10th Cir.1990) and Roberts v. Galen of Virginia, 525 U.S. 249, 252,
119 S.Ct. 685, 142 L.Ed.2d 648 (1999)). Within this context, the Court will analyze the discoverability
of the documents at issue.
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A. 	Medicaid Contract (Request for Production No. 1).
Plaintiff’s Request No. 1 asks for the “[c]ontract between Ascension Via Christi Hospital
Pittsburg, Inc. (Ascension) and Medicaid (MCD) KanCare United Healthcare,” which will hereinafter
be referred to as the “Medicaid contract.” (Doc. 150, at 1.) Defendant objected that the request is
irrelevant and beyond the scope of discovery as it “has no importance in resolving the issues of the
case.” (Id.) Defendant continues that the “burden or harm to [it] of producing the contract also
outweighs its nonexistent benefit because the contract contains negotiated terms the parties to the
contract consider sensitive and confidential.” (Id.)
Plaintiff seeks an Order compelling the contract because the document apparently would
establish that Defendant Ascension “is required to implement federal regulations regarding patient care
into its policy, including a mechanism to enforce those policies.” (Doc. 149, at 1.) According to
Plaintiff, this document “requires hospitals to follow federal regulations, which would entail policies to
enforce those regulations, and consequences for violations,” making it “crucial for demonstrating
whether [Defendant Ascension] met its obligations under federal regulations governing Medicaid
participating hospitals and patient rights pursuant to 42 C.F.R. § 482.13.” (Id., at 5-6.)
Defendant Ascencion acknowledges that it accepts Medicaid dollars from the federal
government, thus making it bound to EMTALA and other federal laws that accompany the money.
(Doc. 157, at 7.) Defendant also admits that Plaintiff’s daughter’s medical services were paid for by
Medicaid, that it has an EMTALA policy, and that it is an EMTALA-participating hospital pursuant to
42 U.S.C. § 1395dd with a provider agreement pursuant to 42 U.S.C. § 1395cc (which is the Medicaid
Contract at issue). (Id.)
While Defendant admits EMTALA is applicable, it states the following defenses:
(1) that Plaintiff has not actually stated an EMTALA claim through her
factual allegations; (2) that Plaintiff lacks standing to pursue an EMTALA
claim when it was her daughter who was the patient; and (3) that the
Hospital complied with EMTALA when it treated Plaintiff’s daughter.
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(Id. (citing Doc. 109, Defendant’s Summary Judgment brief, at 10-17).) In other words, Defendant
“would not take the position it complied with EMTALA if EMTALA did not apply to it in the first
place.” (Id., at 8.) Thus, according to Defendant, its Medicaid Contract is unnecessary for Plaintiff to
prove Defendant must comply with EMTALA, making the contract itself have “no importance in
resolving the issues of the case.” (Id.)
By admitting the application of EMTALA, Defendant Ascension conversely and tacitly admits
the facial relevance of the contract. Even though the applicability of EMTALA is not in dispute, this
does not mean that Plaintiff must simply forego exploring what specific requirements are imposed on
Defendant by the contract.
Defendant also argues that the terms of the Medicaid contract constitute “sensitive business
information that both parties [to the contract] hold confidential” and that disclosure would cause them
harm. (Doc. 157, at 8.) It is well-settled in this District that
confidentiality does not act as a bar to discovery and is not grounds to
withhold documents or information from discovery. 	‘A concern for
protecting 	confidentiality 	does 	not 	equate 	to 	privilege.’ 	While 	a
confidentiality objection may be appropriate when a party seeks a
protective order limiting the parties’ use or disclosure of confidential
information, it is generally not a valid objection to withholding discovery
altogether.
High Point SARL v. Sprint Nextel Corp., No. 09-2269-CM-DJW, 2011 WL 4008009, at *1 (D. Kan. Sept.
9, 2011) (citations and footnotes omitted). See also Kendall State Bank v. West Point Underwriters, LLC,
No. 10-2319-JTM-KGG, 2013 WL 593957, at *2 (D. Kan. Feb. 15, 2013) (holding that “ ‘privileged’
and ‘confidential’ are two distinct concepts.”) The Court finds the contract to be relevant and that any
confidentiality concerns can be remedied by the Protective Order in effect in this case (Doc. 55).
These objections from Defendant Ascension are overruled and this portion of Plaintiff’s motion is
GRANTED.
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B. 	Medical Staff Bylaws, Rules and Regulations, and Appointment Policy2 (Request
for Production No. 2).
Plaintiff’s Request No. 2 asks for Defendant’s “Medical Staff Bylaws, Rules and Regulations,
and Appointment Policy” in effect on the date in question. (Doc. 150, at 1.) Defendant objected that
the bylaws, rules and regulations “in their entirety” are irrelevant and overly broad. (Id.)
Plaintiff argues that these documents are “essential to understanding the incorporation of the
federal rules into [Defendant’s] rules, thereby effecting [Defendant’s] policies.” (Doc. 149, at 6.)
Plaintiff continues that the documents
define 	which 	medical 	personnel 	are 	qualified 	to 	conduct 	medical
screening examinations under EMTALA. 	[Defendant’s] EMTALA
policy specifically references ‘individuals defined by the medical staff’s
bylaws, 	rules, 	and 	regulations 	or 	other 	document 	approved 	by
[Defendant’s] 	governing 	body 	to 	perform 	the 	medical 	screening
examinations.’ 	([Doc. 152, at 2].) 	[Defendant’s] Emergency Medical
Service Agreement with Sound Physicians requires that ‘[it] will make
available copies of the bylaws, rules and regulations, policies and/or
procedures of the Medical Staff and governing board relevant to
Contractor’s 	and 	Physicians’ 	performance 	of 	services 	under 	this
Agreement.’ ([Doc. 153, at 10.])
(Id.) Thus, according to Plaintiff, the documents “directly govern how EMTALA policies are
conducted in the Hospital and are essential to determining compliance.” (Id.) Plaintiff continues that
the local policy, if one exists, “would be important for issues of specific conduct” because Defendant
Ascension’s “generic” EMTALA policy is “full of great concepts as ‘respect for human dignity,’ ” thus
failing “to show how these concepts are implemented through the Hospital policy.” (Id. (citing Doc.
152, at 9.)
Defendant Ascension argues that an EMTALA violation case is different and distinct from a
medical malpractice case and Plaintiff is conflating the two. (Doc. 157, at 3-4.) Defendant asserts that
the motion to compel demonstrates Plaintiff’s “misunderstanding of the EMTALA issue in the case”
2 Plaintiff states that her Second Requests for Production “mistakenly referred to the Hospital Policy as ‘Appointment’
Policy,” but that this mistake was clarified during the parties’ Rule 37.2 meet & confer telephone conference. (Doc. 149, at
2.) Plaintiff’s motion and reply make no further reference to requesting an “Appointment” policy.
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because an EMTALA claim “does not open the door to every hospital policy and procedure for a
review of whether the hospital complied.” (Id., at 3.) EMTALA requires
a hospital to create standard emergency room screening procedures based
upon the hospital’s particular needs and circumstances. EMTALA
imposes strict liability upon a hospital that creates screening procedures
but fails to apply the essential elements of those procedures. In resolving
a claim of failure to screen under EMTALA, a court should ask only
whether the hospital adhered to its own procedures, not whether the
procedures were adequate if followed.
Tank v. Chronister, 941 F.Supp. 969, 972 (D. Kan. 1996). Thus, Defendant argues it should be judged
on whether it has an EMTALA policy and whether it was followed. (Doc. 157, at 3-4.) Defendant
notes that it has produced its EMTALA policy to Plaintiff. (Id., at n.2 (citing Doc. 152).)
According to Defendant, the remaining bylaws, rules and regulations requested by Plaintiff are
“very broad and cover a wide array of topics, ranging from various administrative procedures like
medical staff discipline and appeals – to specific requirements for obtaining written consent to conduct
an autopsy.” (Id., at 4.) Because this is not a medical malpractice or negligence case, the Court agrees
with Defendant that “[t]here is no relevance in Plaintiff fishing through every Hospital patient care
policy to see whether or not Plaintiff’s daughter’s care providers complied with the policy.” (Id.)
Plaintiff replies that Defendant has admitted that bylaws are “used to discipline the staff,” so
they “should reveal enforcement mechanisms for EMTALA compliance.” (Doc. 160, at 2 (citing Doc.
157, at 4, n.4.) This does not mean, however, that each and every bylaw – which is what Plaintiff has
requested – relates to this, or any other relevant, issue in this case. By seeking each and every hospital
bylaw, rule, and regulation, Plaintiff’s Request No. 2 is facially overbroad and seeks information that is
both irrelevant and disproportionate to the needs of the case. This portion of Plaintiff’s motion is,
therefore, DENIED.
C. 	Downtime Policy and Disaster Policy (Request for Production No. 3).
At the time of the subject treatment to Plaintiff’s daughter, Defendant Ascension was
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undergoing a systemwide cyberattack rendering its electronic medical record system unavailable. (See
Doc. 157, at 5.) As a result, certain medical records in this case are handwritten rather than created in
electronic format.
In this context, Plaintiff’s Request No. 3 asks for Defendant’s “Downtime Policy, and Disaster
Policy” in effect on the date in question. (Doc. 150, at 2.) Defendant objected that the phrases
“Downtime Policy” and “Disaster Policy” are vague and ambiguous. Defendant continued that
[t]o the extent Plaintiff seeks Ascension’s plans or policies related to
large-scale emergencies – like natural or human-caused disasters – such
plans or policies would not be relevant to this case. To the extent Plaintiff
seeks Ascension’s plans for managing IT system outages, Plaintiff’s
‘Downtime Policy’ request is overbroad and encompasses a significant
amount of material that has nothing to do with this case.
(Id.)
Plaintiff describes production of these policies as “crucial” because it is “important to know
what steps are taken to protect the patients when the hospital systems are down, and whether proper
protocols were followed.” (Doc. 149, at 7.) 	She describes hospital policy and training as “integral” to
Defendant’s compliance obligations under EMTALA.3 (Id.)
Plaintiff argues that Defendant “refuses to provide these documents” even though
“[t]hroughout the documents provided by the Defendant – the Emergency Medicine Service
Agreement and the EMTALA policy – there are repeated references to ‘local Hospital policy,’ federal
rules, and state regulations that physicians are required to follow.” 	(Doc. 149, at 7 (citing Doc. 152).)
Plaintiff points to Defendant’s Emergency Medical Service Agreement with Sound Physicians, which
requires doctors to “comply with the requirements set forth in the bylaws, rules and regulations,
policies and/or procedures of the Medical Staff and Hospital’s governing board.” (Id. (citing Doc. 153,
at 2).) Plaintiff also discusses various passages from the deposition of Defendant Dr. Cornelius in
3 When shown a certain medical record during her deposition, Defendant Dr. Cornelius testified “That is one of our
downtime order sheets.” (Doc. 154, at 24.)
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which she testified that she received no training from Defendant Ascension. 4 (Id., at 8 (citing Doc.
154, at 13, and 94.) According to Plaintiff, Defendant’s “refusal to produce the policy and related
documents while simultaneously claiming it complied with its policies is absurd.” (Id.)
1. 	Disaster Policy.
Defendant describes its “Disaster Policy” as encompassing “a variety of internal plans and
protocols, covering what to do across a range of potential mass casualty events, in circumstances both
where the event directly impacts the Hospital or is outside the Hospital.” (Doc. 157, at 6.) Defendant
asserts that the plans are “highly sensitive, treated by the Hospital as confidential, and have nothing to
do with this case.” (Id.) As stated previously, however, confidentiality does not necessarily prohibit
discovery. High Point SARL, 2011 WL 4008009, at *1 (holding that “confidentiality does not act as a
bar to discovery and is not grounds to withhold documents or information from discovery.”).
That stated, the Court finds that the relevance of the “Disaster Policy” – which relates to mass
casualty events – is not facially apparent to the facts of this case. As such, it is Plaintiff’s burden as the
party seeking discovery to show its relevance. Design Basics, LLC v. Strawn, 271 F.R.D. 513, 523 (D.
Kan. 2010) (citation omitted) (holding “when the relevancy of the requested discovery is not readily
apparent, the party seeking the discovery has the burden to show the relevancy of the request.”).
In this regard, the only specific reference to the “Disaster Policy” in Plaintiff’s motion or reply
brief is the following: “The Downtime Policy and Disaster Policy are crucial because Dr. Cornelius
testified about downtime procedures during her deposition … .” (Doc. 149, at 7 (emphasis in
original).) Plaintiff then states that “[t]hese policies are important to know what steps are taken to
protect the patients when the hospital systems are down, and whether proper protocols were
followed.” (Id.) This argument clearly relates more, if not only, to the Downtime Policy, discussed
4 Plaintiff also asserts there was additional relevant testimony during Dr. Cornelius’s second deposition, but that the
transcript was not yet available when the present motion was filed. Plaintiff offered to provide the transcript upon receipt,
but the Court finds further deposition citations unnecessary to its analysis.
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infra, rather than the Disaster Policy. As such, Plaintiff has failed to meet her burden to establish the
relevancy of the Disaster Policy and this portion of her motion is DENIED.
2. 	Downtime Policy.
Defendant admits the “Downtime Policy” is “closer to what [Plaintiff] ostensibly seeks because
it contains the protocol for how to handle an unplanned outage of the Hospital’s electronic system,”
which is what occurred on the day in question. (Doc. 157, at 6.) Even so, Defendant argues this
policy is “still irrelevant” and “has no bearing on Plaintiff’s claims in this case.” (Id.)
This description of the “Downtime Policy” by Defendant, however, establishes that it is facially
relevant to the facts of this case. As discussed above,
[r]elevancy is broadly construed during the discovery phase, and a request
for discovery should be considered relevant if there is ‘any possibility’
that the information sought may be relevant to the claim or defense of
any party. When the discovery sought appears relevant on its face, the
party resisting the discovery has the burden to establish that the
requested discovery does not come within the scope of relevance as
defined under Rule 26(b)(1), or is of such marginal relevance that the
potential harm occasioned by discovery would outweigh the ordinary
presumption in favor of broad disclosure.
Design Basics, LLC, 271 F.R.D. at 523 (emphasis added) (citations omitted). Defendant’s unsupported
assertion that the policy is “still irrelevant” does not meet this burden to overcome the facial relevance
of the policy. As such, Plaintiff’s request to compel the “Downtime Policy” is GRANTED.
IT IS THEREFORE ORDERED that Plaintiff’s Motion to Compel (Doc. 149) is
GRANTED in part and DENIED in part as more fully set forth herein. Defendant shall submit the
documents ordered to be produced on or before February 4, 2026.
IT IS SO ORDERED.
Dated January 28, 2026, at Wichita, Kansas.
/S/BROOKS G. SEVERSON ____
Brooks G. Severson
U.S. Magistrate Judge
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