Legal Eagle Eye Newsletter for the Nursing Profession (4)9 Jun 96


   The hospital did not violate the Emergency Medical Treatment and Active Labor Act. The patient received an appropriate medical screening in the emergency department. It was noted he had sustained multiple serious injuries.

   The patient was badly hurt in a motorcycle accident on a rural highway. He was taken to the nearest hospital's emergency department.

   Due to the severity of his injuries, he was admitted to the hospital’s intensive care unit for further evaluation and treatment.

   The next morning, at his mother’s request, the patient was transferred to a medical center in a large city, where a torn renal artery was detected which resulted in loss of a kidney.

   He got appropriate medical treatment for his emergency medical condition. He was admitted to the intensive care unit for close observation and further care. The hospital was not proven to be at fault for not catching the renal artery tear.  UNITED STATES DISTRICT COURT, KANSAS, 1996.


   The Emergency Medical Treatment and Active Labor Act says that a hospital emergency room must provide an appropriate medical screening examination for every person who comes to the emergency department and requests care or on whose behalf another person requests care for an emergency medical condition.

   If the hospital determines that an emergency-room patient has an emergency medical condition, the hospital must either: (1) Through its staff and available facilities provide the medical treatment necessary to stabilize the patient’s emergency medical condition; or (2) Transfer the patient to another facility for care, in accordance with Federal regulations.

   To decide whether it had been appropriate for purposes of Federal regulations to transfer the patient in this case to another facility, it was sufficient for the U.S. District Court in Kansas to note that the patient’s mother had requested on his behalf that he be transferred to the trauma department at a big-city medical center, rather than continue to receive care in the rural facility’s intensive care unit.

   The first hospital was not responsible for failing to detect the patient’s torn renal artery prior to his transfer. There was no proof offered to the court that the first hospital could have detected the torn renal artery, or that the kidney could have been saved with prompt surgical intervention.

   The first hospital had taken all appropriate measures to screen the patient, and then, in light of the apparent seriousness of his condition, had admitted him to the unit providing the highest level of care it could offer. This satisfied the intent behind the EMTALA that hospitals not engage in tactics designed to dump patients whom, for one reason or another, they do not want to care for. Green vs. Reddy, 918 F. Supp. 329 (D. Kan., 1996).