Ricky Koel v. Citizens Medical Center, Inc., et al.

A tightly stretched fence wire snapped into Ricky Koel’s right eye, piercing the globe. He arrived at Citizens Medical Center—vomiting from pain but still able to perceive light—indicating vision could be saved with timely intervention. Staff suspected a ruptured globe, a known emergency. Yet instead of referring him to an ophthalmologist or arranging transfer, the hospital summoned an optometrist—unqualified under EMTALA or hospital bylaws to screen. Mr. Koel was misdiagnosed, not transferred, and left permanently blind. This case presents a clean vehicle to resolve a core EMTALA issue left open by the Court’s dismissal of Moyle v. United States, 603 U.S. 324 (2024): when hospitals fail to treat or transfer patients with known emergencies. Unlike Moyle, there is no state law barrier here—only a failure to follow EMTALA’s mandate. EMTALA forbids hospitals from treating emergency patients differently based on diagnosis, staffing, cost, or internal workarounds. The Questions are:

1. Whether the emergency imperative of EMTALA displaces a State Law medical malpractice exception just as the EMTALA emergency imperative displaced a state law abortion ban for purposes of the District Court’s injunction in Moyle v. United States?

2. Whether the Tenth Circuit’s zeal to adhere to the EMTALA malpractice exception in Repp v. Anadarko Mun. Hosp. exposes a Circuit Split with the Fourth Circuit’s “standard to which the hospital adheres” rule in Power v. Arlington Hosp. Ass’n?