EMTALA: Knowing Your Rights When You Present To The Hospital

METRO DETROIT MEDICAL MALPRACTICE LAWYER
 

The Emergency Medical Treatment and Active Labor Act 

It is important to know and understand your rights when you or your loved one is a patient in the hospital. For instance, did you know that hospitals are required to provide appropriate treatment and screening to every patient who presents to the emergency room regardless of insurance coverage, ethnicity, or citizenship? 

The Emergency Medical Treatment and Active Labor Act (EMTALA), 42 USC 1395dd, often referred to as the “anti-dumping” statute, is a federal law enacted by Congress in 1986. It's purpose is to prevent private hospitals from transferring or discharging unstable, uninsured and indigent patients to public hospitals and applies to all hospitals participating in Medicare (98% of hospitals in U.S. and U.S. territories). 

Under the law, hospital emergency departments have three main requirements: 

  1. Provide Appropriate Medical Screening Examination

  2. Stabilize Emergency Medical Conditions

  3. Effect Appropriate Transfer, If Necessary and Appropriate
     

Provide Appropriate Medical Screening Examination

Under the law, hospitals must provide an appropriate screening to all patients to determine whether they have an “Emergency Medical Condition”. The screening must be the same or similar to that provided to all patients presenting to the emergency department complaining of the same condition or exhibiting the same symptoms.

A patient has an Emergency Medical Condition, if he or she has acute symptoms of sufficient severity (including pain) such that absence of immediate medical attention could reasonably result in either:

  • Placing health of individual (or unborn child) in serious jeopardy;
  • Serious impairment of a bodily function; or
  • Serious dysfunction of any bodily organ or part. 

Stabilize Emergency Medical ConditionS

If it is determined that a patient suffers from an Emergency Medical Condition, the hospital must provide treatment required to stabilize the patient’s condition, if possible. A patient is “Stabilized” when there is no likely material deterioration of the condition, within reasonable medical probability, to result from or occur during transfer.

A patient who is pregnant with contractions can only be stabilized upon delivery. Accordingly, the hospital cannot transfer a pregnant woman if she will deliver before the completion of a safer transfer, or if she or the child is in imminent danger of death or serious disability.

Effect Appropriate Transfer

Under the law, the hospital cannot transfer an unstable patient, unless the expected benefits of the transfer outweigh the foreseeable risks. This may be necessary when the hospital does not have the resources necessary to provide the care the patient requires. Under this scenario, the emergency physician must:

  1. Certify that the benefits outweigh the risks.
  2. Obtain patient’s informed consent.
  3. Arrange that an “appropriate transfer” take place. 

The emergency physicians’ certification that the benefits outweigh the risks must be in writing and include the following language: 

Based on the information available to me at the time of this transfer, the medical benefits reasonably expected from the provision of appropriate medical treatment at another medical facility outweigh the increased risk to the individual and, in the case of labor, to unborn child from effecting the transfer.
— 42 USC 1395dd(c)(1)(A)(ii).

Consequences FOR a HOSPITAL's VIOLATION OF EMTALA

The law creates a personal injury cause of action against the hospital by any person harmed by the failure to provide medical treatment and examination, or stabilization before transfer. The injured party can bring a claim in either state or federal court against the hospital. However, the law does not create a cause of action against the individual physician. Oftentimes, EMTALA violations will be brought along with a medical malpractice action.

Additionally, two federal agencies, Center for Medicare and Medicaid Services (CMS) and the Office of the Inspector General (OIG) have enforcement powers with regard to EMTALA violations. Penalties for EMTALA violations can include: 

  • Termination of the hospital or physician’s Medicare provider agreement
  • Hospital fines up to $50,000 per violation
  • Physician fines up to $50,000 per violation

CONTACT METRO DETROIT INJURY LAWYERS

If you or someone you love was denied proper medical treatment or an examination in violation of EMTALA, or have a medical malpractice case, contact the Metro Detroit Injury Lawyers today. At our firm, you are not a number on a filing cabinet, but a person who needs help.

Let Metro Detroit Injury Lawyers help you take back your life today. Call us today at (248) 430-8929 or fill out our online form for a free consultation with no obligation.