EMTALA and Failure to Treat or Stabilize

The Emergency Medical Treatment and Active Labor Act (“EMTALA”), is a federal law that was enacted in 1986, which mandates that anyone arriving at almost any emergency department must be stabilized and treated, regardless of the status of their insurance or ability to pay for medical treatment.

In other words, the EMTALA ensures emergency care for individuals is provided promptly and without any discrimination in relation to that person’s ability to pay for their emergency care. insurance status or ability to pay. It is important to note that the EMTALA applies to any hospitals that offer emergency services that participate in Medicare.

As far as why the EMTALA was enacted, it was the result of an increase in patient dumping. Patient dumping is when a public hospital postpones the screening, stabilization, and treatment of a person with an emergency medical condition (“EMC”) in order to transfer that person to another hospital.

With the enactment of the EMTALA, if a patient arrives and requests examination or treatment for an emergency medical condition, the hospital has an obligation to provide stabilizing treatment regardless of their ability to pay for such services.

This means that the hospital must screen and stabilize any patient who arrives anywhere on the hospital campus that has an emergency medical condition. An emergency medical condition under the Emergency Medical Treatment and Active Labor Act refers to any health situation that requires immediate medical attention.

Examples of medical situations that require immediate medical attention may include:

• An individual that has suffered or is suffering an active heart attack;
• An individual that has severe bleeding;
• An individual that is facing other life-threatening situations, such as weapon wounds, internal injuries, or other conditions impacting a person’s heart; and/or
• An individual that is under active labor is also covered under the EMTALA, as a pregnant individual is considered under the Act as a condition requiring urgent medical assessment and care.

Once a patient has been properly stabilized, they may then be transferred for further care at another facility, if appropriate. However, any individual that requires treatment for an emergency medical condition, must first be properly stabilized.

For example, if an individual arrives at a hospital with a gunshot wound, the hospital must first stabilize and treat the gunshot wound before the individual may be released or transferred to another facility. There are certain situations in which an individual may be transferred to another hospital before they are stabilized.

When May a Patient Who Is Not Completely Stable Be Transferred to Another Hospital?

Once again, the purpose of the EMTALA is to promote patient’s safety, regardless of their ability to pay for emergency medical treatment. As such, there are scenarios that may arise when a person arrives at a hospital and the hospital is not able to properly treat that individual or address their emergency medical condition.

In general, if a hospital cannot stabilize a patient within its capability, or if the patient requests to be transferred, then that may be sufficient enough reason to be transferred to another hospital.

As such a patient who is not completely stable may be transferred to another hospital under specific circumstances, such as:

• Medical Necessity: If a patient’s condition requires specialized care or treatment that the current hospital cannot provide, such as the necessity for a CT scan, a transfer to a facility with the necessary equipment and resources will be warranted;
• Patient Request: As mentioned above, if the patient requests to be transferred to another hospital, whether it be for personal reasons or something else, the hospital should arrange an appropriate transfer.
  • It is important to note that a hospital may still perform stabilization on the patient if their injury could be fatal upon transfer of the patient without such stabilization. In other words, if the patient’s transfer request is against medical advice, then the hospital will likely still perform medical stabilization to address any life threatening medical issues; and/or
• Consent: The patient, or their legal representative, may provide informed consent for a transfer to occur.
  • The consent form should address the risks of the transfer and will often include a waiver.

It is important that the transferring hospital communicates any and all relevant medical information to the hospital receiving the transfer patient. This ensures a continuity of care from one hospital to the next.

What Must First Be Confirmed to Prove That a Hospital Violated the Stabilization Prong of EMTALA?

In order to prove that a hospital violated the stabilization prong of the Emergency Medical Treatment and Active Labor Act, the person alleging that the hospital failed in their duty must demonstrate:

• First, the patient must show that the hospital conducted a medical screening examination and determined that the patient had an emergency medical condition;
• Next, if it was determined that a patient had an EMC, the patient must show that the hospital failed in their duty to provide proper stabilization and treatment;
• Next, the patient must demonstrate that the hospitals treatment or lack thereof, resulted in their condition worsening; and
• Finally, the patient must demonstrate that they were discharged from the hospital or transferred to another facility as a result of a lack of uniform treatment, such as them not possessing the ability to pay for treatment.

In other words, if a hospital treats a patient differently or provides insufficient screening or stabilization, then it is likely that the hospital will be considered to have violated the EMTALA. However, the patient must provide evidence that there was mistreatment or improper screening. If a hospital violated the EMTALA, then a patient that was harmed may sue the hospital for medical malpractice.

What Are the Consequences If a Hospital Failed to Treat or Stabilize a Patient?

Once again, if a hospital violates the EMTALA, then a patient that suffers harm as a result of that violation may be able to sue the hospital or medical professional responsible for the violation for any resulting damages under the theory of medical malpractice.

Specifically, medical malpractice is a negligent act that occurs when a medical professional, such as an emergency room physician and/or a healthcare organization, falls below the standard duty of care that is required of them when they are managing, diagnosing, and/or treating their patients.

In order for a plaintiff to be able to recover damages associated with a medical malpractice claim, the injured patient must prove all of the elements necessary for a medical malpractice case. It is important to note that the exact legal elements required to prove medical malpractice differ by state.

However, in general, all of the following elements must be proved by a plaintiff in order for them to recover for medical malpractice:

• The person or party responsible for the medical malpractice owed the patient a duty of care that they failed to meet
  • In the case of the EMTALA, hospitals owe patients with emergency medical conditions a duty to treat them;
• The medical malpractice caused an actual injury, resulting in actual damages to the patient in some way;
• The damages that were caused by the medical malpractice can be calculated into a specific monetary amount; and
• The injury to the plaintiff did not exist prior to the medical malpractice occurring.

In a medical malpractice case, if a plaintiff is successful in their claim, the legal remedies granted by the judge or jury generally consist of a monetary damages award. This damage award is a specific monetary amount that is intended to reimburse the plaintiff for any losses that they suffered as a result of the medical malpractice occurring.

Examples of common damages addressed by a damages award include damages associated with:

• Hospital bills, including their cost of stay and treatments performed on the patient during their stay;
• Treatments that are necessary to correct or reverse the medical malpractice negligent action, such as treatment at another facility;
• Lost work wages; and/or
• Pharmaceutical costs.

Do I Need a Lawyer?

If you have experienced an injury as a result of medical malpractice in conjunction with a violation of the EMTALA, then it may be in your best interests to consult with an experienced personal injury lawyer as soon as possible.

An experienced personal injury lawyer will be aware of your state’s specific laws on medical malpractice, and will be able to help you determine who you may hold accountable for your injuries. An attorney will be able to file a civil lawsuit on your behalf in order to help you recover from your injuries. Finally, an attorney will also be able to represent you in court, as needed.