Mr W was walking down the street when he was hit by a car and suffered head and body injuries. He was transported to the emergency department (ED) of the nearest hospital with his companion, Ms V. At the hospital, both Ms V and Mr W told the hospital staff that Mr W had been “run over” by a car and needed medical attention. Mr W had visible head injuries.
After registration, Mr W was directed inside the hospital to wait. Because of COVID-19 restrictions, his companion was not allowed to stay with him. Although he had a potential head injury, Mr W sat alone in the waiting room unmonitored and unobserved. At some point he fell asleep. When he woke up, he went to the desk and again told them that he had been hit by a car and needed medical attention. This was 5 hours after first arriving at the ED.
The hospital employee told Mr W that his name had been called and that since he hadn’t responded he had been taken off the list and would have to go outside and reregister in order to be seen. Mr W became upset and reiterated that he’d been hit by a car and had a severe headache and needed attention. He was told by hospital staff that there was nothing they could do to have him seen unless he started the process again. Mr W became agitated and was asked to leave the emergency department. When he didn’t, security was called to escort him out of the hospital.
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Mr W was later diagnosed with a concussion and brain contusion by physicians at another hospital. He sought counsel from a plaintiff’s attorney and filed a lawsuit against the original hospital and its employees for violation of the Emergency Medical Treatment & Labor Act (EMTALA). Mr W asked the court for summary judgment on the EMTALA violation claim. Summary judgment is granted if there are no disputes as to the material facts of the case and the person asking for summary judgment is entitled to it as a matter of law.
Legal Background
Mr W claimed that he was entitled to summary judgment on his EMTALA claim because the hospital had failed to screen him for an emergency condition and failed to stabilize him. The court examined each of these responsibilities separately.
Screening: The court held that it was undisputed that Mr W did not receive a medical screening although the ED had the capacity to do so. The hospital asserted that the reason why Mr W wasn’t seen was because “his name was taken out of the system” when he did not respond to being called, and “he needed to go outside and reregister in order to be seen” and “he did not wish to do so.” The undisputed facts, noted the court, were that the hospital could have provided Mr W with a screening but declined to do so because he did not respond when his name was first called.
Stabilization: Under EMTALA, a hospital has a duty to stabilize a patient once it detects an emergency medical condition. Again, the court found that it was undisputed that Mr W placed the hospital on notice of his emergency condition. Both he and his companion, Ms V, initially informed hospital staff that Mr W had been “hit by a vehicle,” “run over by a car,” and was in need of medical attention. The staff member who initially checked Mr W in observed and noted his injuries yet made no attempt to assign a provider for observation. Even as he was being escorted out of the hospital, Mr W was telling security that he had a severe headache and had been hit by a car.
Based on this evidence and the fact that the hospital did not present any conflicting facts in the case, the court found that the hospital had also failed to stabilize Mr W.
“EMTALA was designed to avoid and redress exactly what happened here,” noted the court in its decision. Mr W was not screened prior to being asked to leave the hospital despite waiting 5 hours. He was not stabilized despite multiple hospital staff being on notice that he had been run over by a car — a medical emergency. The court held that the hospital’s proffered reason for not screening or stabilizing him was that he fell asleep and refused to reregister but the hospital’s actions in not attending to Mr W right away and not letting his companion join him led to the situation. The court pointed out that while “EMTALA permits hospitals to triage and prioritize based on severity of need, it does not permit a hospital to place arbitrary barriers in the way of seriously injured patients seeking help and then standing behind those barriers in claiming that the hospital was unable to screen or diagnose.”
The court granted Mr W’s motion and ordered that the parties appear before a magistrate judge for settlement proceedings regarding damages.
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Proving an EMTALA violation does not require that much — a patient with an emergency situation must be screened and then provided with stabilizing treatment if necessary. The hospital here failed in that regard by never having any medical professional examine Mr W.
Compare this to another EMTALA violation case decided in December 2022 where a patient presented in the ED with a leg wound from a dog bite. The wound was briefly looked at, the patient was given a prescription and discharged. The patient later sued, claiming he was discharged while still in pain and that the hospital was required to stabilize him by giving him tetanus and rabies shots and allowing him to remain in the ED until his pain and panic reaction had subsided. The court dismissed the case against the hospital, holding that EMTALA stabilization only requires a hospital ED to “offer treatment that will assure that no material deterioration of the patient’s condition will result before treatment outside the hospital.”
The requirements to satisfy an EMTALA violation are fairly minimal: examine and stabilize the patient. Leaving a patient with a head injury sitting alone for 5 hours in a waiting room without being examined does not satisfy even the minimal of requirements.
Ann W. Latner, JD, a former criminal defense attorney, is a freelance medical writer in Port Washington, New York.
Disclosure: Cases presented are based on actual occurrences. Names of participants and details have been changed. Cases are informational only; no specific legal advice is intended. Persons pictured are not the actual individuals mentioned in the article.
