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Federal law bans hospital emergency rooms from dumping patients in active labor or with emergency medical conditions

After COVID, some hospitals seem to ignore EMTALA requirements

After recently watching Tom Cruise’s Top Gun: Maverick, I can’t help but nostalgically thinking about the 1980s of my childhood. In my book, one of the great things about the 80s was President Ronald Reagan. 

One of President Reagan’s enduring legislative accomplishments, which is still relevant to medical malpractice, is the Emergency Medical Treatment and Active Labor Act (EMTALA), which he signed into law in 1986.

For sure, not everything was rosy in the 80s. For instance, there was a real problem with patient dumping by hospitals and emergency room personnel. Patients with life-threatening medical conditions or in active labor were turned away and dumped on the streets if they couldn’t first prove that they could pay for the life-saving health care services.

Then came EMTALA.

This federal law applies to any hospital that accepts Medicare and has an emergency department (ED or ER). Here are the high points:

• It applies to patients who present to the ER with an “emergency medical condition.” This is a condition where there are acute symptoms that are severe enough (including pain) that the patient would be in serious jeopardy without immediate medical attention. A woman in active labor also qualifies as being in an emergency medical condition.

• The hospital must provide a “medical screening examination” to determine whether there’s an emergency medical condition. This has to be the same type of exam that would be given to a patient with insurance or paying out of pocket.

• Speaking of money, the exam and treatment can’t be delayed to deal with payment or insurance paperwork.

• If there’s a verified emergency medical condition, the patient must be treated until the condition is resolved or stabilized. 

• Hospitals with specialized capabilities must accept transfers from hospitals with lesser capabilities to treat unstable emergency medical conditions.

• Unstable patients can’t be transferred to another hospital unless: (1) a physician certifies the expected medical benefits outweigh the risk; or (2) a patient requests transfer in writing after being informed of EMTALA rights and the risks of transfer. 

• When a transfer occurs, the transferring hospital must provide ongoing care to minimize risks to the patient, provide a copy of the medical records, confirm that the accepting hospital has space for the patient, and achieve the transfer with qualified personnel and equipment.

In the age of COVID, we’ve seen an uptick in potential EMTALA cases. Many hospitals adopted unfriendly policies that tried to keep patients an arm’s length away—even if they had emergency medical conditions. I really think some hospital leaders have lost sight of what they’re in business to do.

The federal government can assess fines against hospitals and physicians, but patients whose EMTALA rights have been violated also have the right to file an EMTALA lawsuit in federal court. These cases are sometimes pursued independently and other times in conjunction with a traditional state law medical malpractice claim.

If you’ve been seriously injured because of patient dumping or poor emergency room care in Texas, then contact a top-rated, experienced Texas medical malpractice lawyer for a free conversation about your potential case.

Robert Painter is an award-winning medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits all over Texas. Contact him by calling 281-580-8800 or emailing him right now.


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