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Legal Eagle Eye Newsletter
For the Nursing Profession
PO Box 1342 Sedona AZ 86339
(206) 718-0861
EMTALA: No Failure To Screen, Stabilize Intoxicated Patient.
The hospital did not violate this emergency department patients rights guaranteed by the US Emergency Medical Treatment and Active Labor Act (EMTALA). In a patients lawsuit alleging an EMTALA violation the court does not second-guess the quality of care provided in the emergency department. The court looks instead at whether care offered to the patient was less extensive than care offered to other patients with similar presenting signs and symptoms.
This patient has not shown any proof that his care in the emergency department was less than what any other severely intoxicated person would have been offered.
The patient has also alleged that the hospital failed to stabilize his emergency medical condition before transferring him to the jail infirmary. However, that argument fails because the hospital admitted him as an inpatient for eleven days of care before his transfer. An eleven-day hospitalization cannot be viewed just as an attempt to circumvent the EMTALAs requirements.
UNITED STATES DISTRICT COURT PENNSYLVANIA July 14, 2016The patient was found on the porch of the home from which he had been evicted. He was unresponsive and incontinent of stool. He had had a seizure. Paramedics took him to the hospital emergency department where he continued to suffer confusion, loss of consciousness and seizures due to alcohol withdrawal. While still in the emergency department he was given a head CT which showed advanced atrophy unusual for his age and chronic microvascular ischemia indicative of small strokes.
The patient was admitted to the hospital as an inpatient for eleven days of care, after which time he was taken by the police in a wheelchair to the local county correctional facility where he was booked for second-degree assault. In the jail infirmary his seizures continued and was placed in suicide restraints. He remained in the jail two-hundred days.
The US District Court for the Eastern District of Pennsylvania found no violation by the hospital of the US Emergency Medical Treatment and Active Labor Act (EMTALA). Starting in the emergency department the hospital.
The hospital's nurses continually monitored and assessed this very difficult patient, reported their findings to the physician and advocated on his behalf for care including adequate medication for his agitation and repeated seizures.
Once he was an inpatient, nursing assessments determined he was a high fall risk due to his confusion and unsteadiness which made it difficult and unsafe for him to ambulate. As a precaution the nurses moved his bed closer to the nurses station so that he could be monitored closely. Over time the patient became even more agitated and combative, a fact the nurses communicated to the physician.
When he struck a nurse across the face with an open hand the nurses called hospital security who called the local police to facilitate his transfer out of the hospital directly into custody in the local county jail infirmary. The physicians documented his delirium had resolved by the time of transfer.
Hollinger v. Hospital, 2016 WL 3762987 (E.D. Penna., July 14, 2016).