EMTALA: Nurse Assessed Patient - Had Patient Seen, No Violation, Court Says
Legal Eagle Eye Newsletter for the Nursing Profession
Quick Summary: EMTALA applies to emergency room nurses, although only the hospital itself can be sued under EMTALA for a nurse's violation.
Congress enacted EMTALA in 1986 to prevent hospitals from "dumping" patients unable to pay, by either refusing to provide emergency medical treatment or transferring patients before their emergency medical conditions were stabilized.
If a hospital has an emergency department, it must provide every emergency patient with an appropriate medical screening examination within the capability of the hospital’s emergency department, including ancillary services routinely available in the emergency department.
The hospital also must provide necessary stabilizing treatment, within the staff and facilities the hospital has available.
Any person harmed because a hospital violates the EMTALA can file a civil lawsuit against the hospital.
UNITED STATES DISTRICT COURT, NEW YORK, 1998.The six year-old patient was brought in by ambulance with a fever and headache, eighteen hours after he was hit in the head by a snowball.
The emergency room triage nurse saw him at 12:30 a.m. His vital signs were taken, revealing a temperature of 104.6o. The nurse was told by the mother he had been hit in the head by a snowball one or two days earlier and had had a headache ever since. She also told the nurse he complained of loss of appetite and generalized body pain. At 1:00 a.m. he was given 180 mg of Tylenol to reduce his fever.
The nurse was required to categorize every patient as "routine," "high priority" or "emergent." She categorized this patient as "high priority."
The nurse had him seen by the emergency department physician by 1:15 a.m. for a pediatric examination. By 2:20 a.m. the fever had dropped to 102o so the physician decided he was stable and sent him home.
He came back two days later, was admitted, and had a CT scan which showed he actually had a serious brain abscess.
The family sued for violation of the Emergency Medical Treatment and Active Labor Act (EMTALA) in the emergency room, and for the physician’s malpractice.
The United States District Court for the Eastern District of New York threw out the EMTALA aspects of the case.
The court said the key to avoiding EMTALA lawsuits is equal treatment of emergency department patients. Emergency room nurses and physicians must follow the hospital’s same standard screening and treatment procedures with any given emergency patient that they would follow for any other patient in the emergency department with the same medical condition.
Fisher v. Hospital, 989 F. Supp., 444 (E.D.N.Y., 1998).