Legal Eagle Eye Newsletter for the Nursing Profession (7)5 May 99

Quick Summary: The Supreme Court of California recently upheld a substantial jury verdict against a hospital because an eighteen-month old infant was not given complete blood cultures and antibiotics following presentation in the emergency room with fever, vomiting, diarrhea, difficulty breathing, elevated pulse and elevated respiratory rate.

   According to the court, the emergency room physician did not order tests to rule out bacterial sepsis or begin antibiotics because the physician believed the patient’s family belonged to an HMO which required prior approval before a subscriber or family member could receive payment for emergency treatment at a non-HMO facility. The HMO itself was not a party to the suit.

   A Federal law, the Emergency Medical Treatment and Active Labor Act says that every person who comes to a hospital emergency department must receive an appropriate medical screening, including indicated medical tests, to determine if an emergency medical condition exists, and if one does exist the person must receive treatment necessary to stabilize the emergency condition, within the hospital’s capabilities.

   In this case the infant had an emergency medical condition, the court believed, for which bacterial cultures and antibiotics were necessary before the infant could leave the hospital. It was not appropriate, the court believed, for the hospital to tell the parents to take the child to an HMO-operated facility.

   The court also noted the US Supreme Court ruled this year that proof of motive or intent to discriminate on the basis of finances or insurance status is no longer needed to file a lawsuit against a hospital under EMTALA. If a patient is denied proper emergency screening and care, the patient can sue, period. Barris v. County of Los Angeles, 972 P. 2d 966 (Cal., 1999).