Case Law / Emtala

The article I chose to discuss was a court case involving the Emergency Medical Treatment and Active Labor Act (EMTALA). A Dickinson County hospital violated EMTALA for failing to provide emergency care for a patient who was transferred to a different hospital without being completely stable enough for transfer. In 1985, Congress passed the law of “Emergency Medical Treatment and Labor Act” also known as (EMTALA) to ensure public access and treatment to emergency services regardless of race, ability to pay, or legal status (U. S. Dept.

of Health, 2010). This act states that all individuals needing emergency medical support should never be discharged or transferred until their condition is stable. This act also states that hospitals should then provide stabilizing treatment for patients with emergency medical conditions. If a hospital cannot stabilize a patient within its capability, the hospitals duty is then to treat the patient’s condition and in the event the patient needs to be transferred to become stable then a risk and benefit consent form needs to be signed by the patient.

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The transferring physician must also sign a certificate that explains the transfer outweighs the risks of not being transferred. In this paper I will examine the court case and convey how this case relates to the nature, sources, and functions of the law. On February 11, 2004 a patient was brought into the emergency room at Dickinson’s Memorial Hospital. The patient, at eight months pregnant, had originally called 911 with contractions and vaginal bleeding; before the ambulance could arrive to her the amniotic sack had ruptured.

Even with consulting a specialist from the hospital that the patient would be transferred to, administering medications, and an ultrasound performed, the results showed slight abnormality in the placenta. The patient was then transferred to another hospital in Sioux Falls at approximately 10:25 p. m. by ambulance. While being transferred the patients vaginal bleeding and her abdominal cramping became chronic. Just before midnight the patient arrived and the physician who performed the immediate examination noted severe pain and clearly had an abrupt placenta and/or ruptured uterus.

The patient was taken to surgery immediately where her unborn child was born stillborn. Dickinson County Hospital was ordered by the US Department of Health and Human Services Office of Inspector General (OIG) to pay a penalty of $50,000 for failing to transfer a patient under stable conditions which resulted in the death of her unborn child (Med-scape 2007). The Administrative Law Judge (ALJ) Paul A. Zoss determined that Dickinson’s county hospital violated EMTALA by failing to provide stabilizing treatment for the patient.

Paul A. Zoss stated that the failure to provide the proper stabilizing before transferring the patient was the ultimate result of the medical condition to become life threatening to the patient and / or her unborn child. The Dickinson’s Hospital staff that participated in the examination, administering medications and tests results is ultimately not reliable or responsible for the outcome of this patient’s condition.

Dickinson County and Sioux Valley Hospitals tried to argue that the EMTALA was not violated because the patient did sign a consent form to be transferred and the physicians signed a certificate to transfer because the risks and benefits would be worse for the patient’s condition if not transferred. With all the facts and evidence Paul A. Zoss determined that the both hospital’s physicians should be held accountable for the loss of the unborn child.

The court agreed with plaintiff, holding that “absence of summary of risk and benefits on transfer certificate does not create EMTALA liability as a matter of law, but creates a jury question as to whether risk/benefit analysis was properly made by physician (Ream 2007). ” According to the EMTALA all hospitals must provide a screening examination to every individual who comes into the emergency room requesting treatment. The lives of people virtually rely on any of the professionalism from the individuals working in the emergency room.

These are the individuals that ultimately people will trust both physically and mentally. One way to assure proper screenings take place, customer surveys can be put into place that would have to be over seen by a completely different department to keep honesty remaining as a factor. Once the surveys are completed someone other than the examining physician should assure they are complete and can be turned over to the department in charge of examining the information.

This case is the results of poor judgment in defining “stabilized” according to EMTALA. The substantial evidence in the record, that the patient was having contractions while at the Hospital, suggested in the court’s ruling that she could not have been “stabilized” for purposes of EMTALA (Ream 2007). In conclusion I have examined a legal issue involving regulatory issue in health care and conveyed how this issue relates to the nature and function of the law.

This is a case of nothing more than unintentional tort of negligence. The physician was not intentionally trying to place the patient in harm’s way or her unborn child. I believe that the physician consulted with the leading physician in order to complete the best care and correct decisions in the best interest of the patient and the unborn child. Finally, both physicians involved in this case will ultimately have a better understanding of “stabilized” when referring to EMTALA. References Ream, K.

(2007). American Academy of Emergency Medicine: Specialty Hospital’s Use of 911 Services Questioned by Senator: EMTALA Claim Proceeds to Trial for Determination of Stabilization. Retrievedfromwww. medscape. com/viewarticle/707402,http://www. iand. uscourts. gov/eweb/decisions. nsf/0/8/B6AB34E325E02E58625733E0059A3EC/$File/Heimlicher+v. +Steele. pdf U. S. Department of Health & Human Services (2010). Centers for Medicare & Medicaid Services. Overview EMTALA, Retrieved from www. cms. gov/EMTALA.

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