The First Circuit Court of Appeals has ruled that the District Court of PR improperly dismissed an EMTALA lawsuit and remanded the case for trial.
The plaintiff presented to the hospital complaining of vaginal discharge and spotting in her 3rd trimester of pregnancy. The ED physician performed a pelvic exam, found that the patient was not dilated, phoned the on-call specialist and discharged in the patient with medications. The patient notes indicated the patient was stable on discharge. The patient saw her doctor two days later and was transferred to another hospital for “incompetent cervix” and was delivered by c-section. The child died.
In its ruling, the court distinguished the current case from prior cases by noting that in prior cases within the Circuit the patient had received a medical screening examination consistent with that which other patients of similar condition would have received. In the current case, the hospital admitted that the hospital had a specific protocol for patients with 3rd trimester bleeding and that the protocol was not followed, demonstrating a possible case supporting the plaintiff’s claim of improper screening that would require a trial.
Cruz-Vazquez v. Mennonite Gen. Hospital, No. 11-2297 (1st Cir. May 29, 2013
This is why “protocols” are dangerous and only “guidelines” should be embraced.
There are several ways to skin a cat, and all can be correct.
I endorse the use of guidelines, but with EMTALA, you have to remember that a single case can establish disparate care.