Legal Background

Anna’s parents consulted with a plaintiff ’s attorney, who believed that they had a case against the hospital. The attorney filed suit on behalf of the parents, alleging that Anna had presented to the hospital with an emergent medical condition and that the hospital and staff had failed to stabilize her before discharge, as required by Emergency Medical Treatment & Labor Act, known commonly as EMTALA.

The law was enacted in 1986 to ensure public access to emergency medical services regardless of ability to pay. The Act requires hospitals that participate in Medicare and offer emergency services must provide a medical screening examination when requested for an emergency medical condition, including active labor, regardless of whether the patient has insurance and can pay or not. Hospitals are required to provide stabilizing treatment for patients with emergency medical conditions. If a hospital is unable to
stabilize a patient, or if the patient requests, an appropriate transfer must be implemented.

The hospital’s attorneys moved for summary judgment, asking the court to dismiss the case against it. The hospital claimed that it had provided an appropriate medical screening as required by EMTALA. Thus, the issue at stake was whether the child’s condition had been stabilized before discharge. The hospital argued that the “failure to stabilize” claim should fail because after Dr E recognized that the child had an emergent medical condition, he treated it and believed her to be stable. The hospital argued that Dr E was not required by EMTALA to rescreen the child before discharge because the Act requires only that a hospital provide an initial screening when a patient presents.

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The plaintiffs introduced expert testimony from a physician who contended that Dr E did not wait long enough after the child’s final breathing treatment to discharge her. The expert contended that the final pulse oximetry reading of 99% was measured so closely to her final breathing treatment that the
supplemental oxygen given during the treatment could have artificially increased the reading beyond what the child was able to maintain on her own. The expert witness also opined that Dr E discharged Anna without observing her for long enough to know whether the steroid he administered would
be an effective treatment.

The court held that the plaintiffs had presented evidence sufficient to create a genuine dispute of facts as to whether the child had received proper care to stabilize her, and the court denied the defendant’s motion to dismiss. This case is on track to proceed to trial (if it does not get settled out of court).

Protecting Yourself

EMTALA defines “to stabilize” as “to provide such medical treatment of the condition as may be necessary to assure, within reasonable medical probability, that no material deterioration of the condition is likely to result from or occur during the transfer of the individual from a facility.” (“Transfer” includes discharge under EMTALA.)

Assessing and treating an emergency medical condition is not enough under EMTALA — the patient also must be stabilized such that no severe consequence will result from the patient’s transfer or discharge. Taking the extra time to monitor a patient and screen the patient before discharge could save lives and protect against liability.