Brief Fact Summary. Plaintiff Lewellen was in a drunk driving accident and was taken to the hospital. Doctors there performed only a cursory examination of him and did not properly review his x-rays and despite his complaints of great lower back pain, discharged him after one hour. He was immediately taken to jail overnight where his condition worsened until a jail officer took pity on him and arranged for him to go back to the hospital. Overnight a burst fracture in his spine damaged spinal nerves leaving him permanently neurologically disabled.
Synopsis of Rule of Law. Under the Emergency Medical Treatment and Active Labor Act (“EMTALAâ€), federally-funded hospitals must meet two requirements: (1) A hospital must provide for an appropriate medical screening examination to determine whether an emergency medical condition exists, and (2) If such a condition exists, the patient may not be discharged until he has received a stabilizing treatment. EMTALA was passed to combat the problem of patient dumping (the practice of transferring or discharging indigent or non-insured patients while their emergency conditions worsen).
Issue. Whether a jury could find that the hospital’s treatment and examination of Lewellen did not satisfy EMTALA’s “appropriate medical screening†requirement.
Held. Yes. There are two requirements for certain federally-funded hospitals under EMTALA. (1) A hospital must provide for an appropriate medical screening examination to determine whether an emergency medical condition exists, and (2) If such a condition exists, the patient may not be discharged until he has received a stabilizing treatment. If either requirement is not met a patient may sue the hospital. A hospital does not satisfy the first requirement if the examination is so cursory that it is not “designed to identify acute and severe symptoms that alert the physician to the need for immediate medical attention to prevent serious bodily injury.â€Â The court held that a reasonable jury could conclude that the screen performed was too cursory and thus did not satisfy EMTALA. Specifically, Lewellen was discharged as the x-rays were printing off, so a jury could conclude that the doctor did look at them or looked at them too casually to catch what other physicians said was obvious: the burst fracture in his spine. Moreover, Lewellen still had a bleeding gash in his arm with dirt and grass in it when he arrived at the jail. Accordingly, the court denied defendant’s motion for summary judgment.
Discussion. EMTALA was passed to combat the problem of patient dumping, that is, the practice of transferring or discharging indigent or non-insured patients while their emergency conditions worsen. It is not a national medical malpractice statute. Accordingly, a hospital that conducts an appropriate medical screening according to the first requirement, yet in that process fails to detect or misdiagnoses an emergency medical condition—even if negligent and liable under the common law—is not liable under EMTALA.