Doctors are not the only ones who sometimes find EMTALA confusing as a recent Tennessee case highlights. Lawyers apparently don’t understand it either.
A patient came to the hospital with severe eye pain, was treated with eye drops, and sent home. A few days later he returned with increased pain and was given an ointment and sent home. He returned several days later with complaints of increased problems and alleged he was denied exam or treatment. As a result, the patient sued the physicians and the ED group for EMTALA violation.
The court ruled that EMTALA does not create a cause of action against the physicians or the group, and dismissed the case. Every case where the plaintiff has tried to sue the physician under an EMTALA count has resulted in a similar ruling.
So, does that mean you cannot sue physicians over EMTALA incidents?
The answer is that the proper EMTALA defendant is the hospital, but the physicians and the ED group may be named in other counts of the suit for malpractice and the EMTALA law and hospital policies and procedures can be used to prove a deviation from standard of care on the part of the physician.
So, who gets the fine?
Another common question is: “Who gets the $50,000 fine?” The answer to that question is that the fine (otherwise known as a civil monetary penalty) and the EMTALA civil liability are two separate penalties that can attach to the same incident. The fines go to the federal government. Any civil recovery by a patient or their heirs goes to the private party claimant.
Can anyone else sue?
One of the most potentially devastating EMTALA law suits allowed under the law has only occurred a few times, to my total amazement. Hospitals or providers who are harmed by a hospital violation of EMTALA are allowed to sue the offending hospital to recover their losses under EM TALA. A blatant example would be hospital A decides that an uninsured patient will cost them a tremendous amount of money to care for and decides to transfer the patient to Hospital B even though it has the capability to care for the patient. No advance acceptance is obtained, and the hospital simply places the patient in an ambulance and sends the patient to hospital B. If hospital B incurs $500,000 in billable services, they could sue hospital A for their loss because of the EMTALA violation.
Because this type of suit has been so rare, there are no legal rulings on the record, so we don’t know how far the court will go into the chain of expenses or whether the courts will allow billable charges or only actual costs to be recovered.
This case discussion was inspired by Cisneros v. Metro Nashville General Hospital (M.D. Tenn)