Legal Eagle Eye Newsletter for the Nursing Profession(4)3 Dec 95


   Quick Summary: Any hospital which has a Medicare provider agreement is subject to the Emergency Medical Treatment and Active Labor Act. Any person who comes to the hospital seeking emergency care is entitled to receive from the hospital either a medical examination and treatment to stabilize the emergency medical condition, if such a condition exists, or an appropriate transfer to another facility to get medical care.

   The explicit wording of the Emergency Medical Treatment and Active Labor Act was recently reviewed by the Federal District Court for the Southern District of Mississippi.

   The Act defines an emergency medical condition as a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in placing the health of the individual in serious jeopardy, or serious impairment to bodily function, or serious dysfunction of any bodily organ or part, according to the court.

   An appropriate transfer may be made when the patient’s emergency medical condition has stabilized. Reviewing the explicit wording of the Act, the court ruled that an emergency medical condition is "stabilized" within the meaning of the law if no material deterioration of the condition is likely, within reasonable medical probability, to result from or occur during the transfer of the individual from a facility.

   The EMTALA also explicitly defines the circumstances in which a hospital may elect a transfer of an individual with an emergency medical condition who has not been stabilized. Such a transfer may be an "appropriate" transfer when the patient or one who is legally responsible to act for the patient requests the transfer in writing after being informed of the hospital’s obligations under the EMTALA, or a physician, or other qualified medical personnel if a physician is unavailable, certifies in writing that the medical benefits reasonably expected from the provision of appropriate medical treatment at another medical facility outweigh the increased risks to the individual from effecting the transfer.

   The transferring hospital must still provide medical treatment within its capacity to minimize the risks to the individual’s health, and the receiving hospital must have available space and qualified personnel to treat the individual, and must agree to accept transfer of the individual and to provide appropriate medical treatment.

   The transferring hospital must also send to the receiving hospital all medical records related to the emergency medical condition. The transfer must be carried out through qualified personnel and transportation equipment. Deron vs. Wilkins, 879 F. Supp. 603 (S.D. Miss., 1995).

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