Legal Eagle Eye Newsletter for the Nursing Profession (5)4 Apr 97 (Editor's note 6/2/06- this case has been overruled by a change in HCFA's regulations and is no longer good law)

   A patient must come to the emergency department and must present for care in the emergency department before the hospital’s obligations under the EMTALA come into play.

   In a recent case from the Court of Appeals of Texas, a patient with his arm in a sling from a fresh industrial injury walked through the emergency department with a family member, stopping only to ask directions to the admitting department. Unable to find the admitting desk, they left and went to another hospital. There was no treatment until four hours later, when the injury was significantly worse.

   The patient sued the first hospital for violating the Emergency Medical Treatment and Active Labor Act (EMTALA). EMTALA has been commonly referred to as the "Patient Anti-Dumping Act." It is a Federal statute which applies to every hospital in the U.S. that participates in the Medicare program. It applies to every patient, whether insured, uninsured, able or not to pay privately, on or not on Medicare, eligible or not eligible for Medicaid.

   A hospital which has an emergency department is required by law to give every patient who comes to the emergency department an appropriate medical screening examination and necessary stabilizing medical care if the screening examination reveals that an emergency medical condition exists.

   The court ruled, however, that a patient must come to the emergency department and present for care in the emergency department before the hospital’s obligations under the EMTALA come into play. The patient and the family member did not request an examination or treatment. They merely asked directions to another hospital department. Thus the patient had no basis for a lawsuit. Rios vs. Baptist Memorial Hospital System, 935 S.W. 2d 799 (Tex. App., 1996).