The court faulted the ER nursing and medical staff because no chest x-ray was done. A chest x-ray was part of the hospital’s own standard screening procedure for any ER patient complaining of chest pains. Not following the hospital’s own standard screening procedures is a violation of the EMTALA’s requirement for an appropriate medical screening examination.  UNITES STATES COURT OF APPEALS, EIGHTH CIRCUIT (ARKANSAS), 1995. 

   The Emergency Medical Treatment and Active Labor Act (EMTALA) requires every hospital with an emergency department to care for each individual in the same manner it cares for the others it sees.

   In this case, a man came to the emergency room with chest pains. A nurse took his medical history and examined him. A physician then ordered a series of spinal x-rays. The spinal x-rays were normal, so the man was sent home.

   According to the U.S. Eighth Circuit Court of Appeals, hospitals must develop ER screening procedures and apply them uniformly to all patients. Each patient complaining of the same symptoms must receive the same screening examination from the same emergency department. To prove an EMTALA violation, a patient need not show that the hospital actually "dumped" the patient on another facility or even that it had a discriminatory motive in providing what care it provided. Summers vs. Medical Center, 69 F. 3d 902 (8th Cir., 1995).