A hospital was recently in the news over discharging a patient to the street on a cold, windy night. A nearby therapist saw the whole event unfold and called 911 for help. She captured on video hospital security personnel leaving the woman on hte street, wearing only a hospital gown and socks, when the temperature was in the 30s.
The Good Samaritan psychotherapist helped the lady find shelter and called 911. An ambulance took the patient back to the same hospital, which discharged her again the same night, this time to a homeless shelter.
As a Houston, Texas medical malpractice attorney, the two main types of discharge problems I see are emergency room (ER) patient dumping and premature discharge.
ER patient dumping
Federal law prohibits hospitals that accept Medicare refusing to treat patients with a bona fide emergency medical condition, or mothers who are in active labor.
The Emergency Medical Treatment and Active Labor Act (EMTALA) has been on the books since President Ronald Reagan signed it into law in the 1980s. Back then, the practice of patient dumping was quite common.
EMTALA basically requires hospitals to provide for an appropriate medical screening of all patients, regardless of the ability to pay. If the doctor performing the medical screening concludes that the patient has an emergency medical condition or is in active labor, then EMTALA requires the hospital and physicians to treat the patient.
Treatment must continue until the baby is safely delivered or other emergency patients have their medical condition stabilized. To stabilize a condition means that the patient would not suffer a serious or life-threatening deterioration in health status upon discharge or transfer to another hospital.
While I believe that the EMTALA law has done a great deal to curb the rampant patient dumping that occurred decades ago, the law’s existence has not eradicated the practice. In my experience, some patients continue to be discharged without being screened or stabilized, in violation of EMTALA, and this is an unacceptable threat to patient safety.
Premature discharge
Even when patients are appropriately processed through the emergency room and either treated or admitted to the hospital, there is a frequent problem of discharging them before they are ready to go home. Government agencies and healthcare experts measure this problem by readmission rates. Recently, Medicare has started to penalize the bottom quarter of hospitals with the worst readmission rates over certain complications.
In my experience as a Houston, Texas medical negligence lawyer, premature discharge from the hospital can happen with all types of patients and conditions. A few frequent types of early discharge errors come to mind.
The first type of error that I see a lot is when emergency room personnel want to push you out the door to make a bed available for someone else. I represent a client who went to a Humble, Texas emergency room three days in row complaining of the worst headache of his life. Each day the ER providers concluded that his pain as caused by a migraine and high blood pressure. On the third day, an ER doctor told him that the patient would have to leave the hospital because they needed the bed. Later that evening, this young patient had a life-changing stroke.
The second type of error is when the patient is discharged from the ER or the hospital with unaddressed problems. They could be in the same condition that brought them to the hospital in the first place, or perhaps have a hospital-acquired injury that was not properly treated.
I represent a client who went to a Clear Lake, Texas are hospital for a knee surgery. Within a few days after his surgery, he developed sacral bedsores (on his back side). Our medical and nursing experts explained that this should have never happened so quickly to a healthy, active man. The physicians discharged the patient home with no instructions on medications to treat his pressure ulcer. The next day, an ambulance took him to another hospital for wound surgery. He had to be admitted to hospitals and skilled nursing facilities for an astounding 100 days for his hospital-acquired injury to finally be healed.
What you can do
If you find yourself being pressured into hospital discharge and think it is too early, then that is the time to speak up.
Ask your doctor why you are being discharged, considering how your condition has not improved. Give specific examples. Request a second opinion or in-hospital consultation with an appropriate specialist.
Do not forget to ask the nursing staff for help and remind them of their duty to advocate for the care that you, as a patient need. Ask them to get a nursing supervisor involved, if needed.
When you are ultimately discharged, make sure that you receive all of the paperwork and ask your attending physician and nurse to go over it with you. See if they can call in any prescriptions to your pharmacy so you can avoid any delay. Make sure that you understand what changes to look for that would require you to come back for medical attention.
We are here to help
If you or a loved one has been seriously injured by medical malpractice, call Painter Law Firm, in Houston, Texas at 281-580-8800, for a free consultation about your potential case.
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Robert Painter is a medical malpractice and wrongful death attorney at Painter Law Firm PLLC, in Houston, Texas. He files lawsuits on behalf of patients and their families against hospitals, doctors, surgeons, anesthesiologists, and other healthcare providers. In 2017, H Texas magazine named him one of Houston’s top lawyers.
