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U.S. Court In Wyoming Finds No EMTALA Violation In Emergency Room Treatment Of Child Who Later Died


HLD, v. 31, n. 3 (March 2003)

U.S. Court In Wyoming Finds No EMTALA Violation In Emergency Room Treatment Of Child Who Later Died

Randy Kilroy brought his three-year-old daughter Emily to the emergency room at Star Valley Medical Center (Star Valley) because she had flu-like symptoms. Emily was evaluated by a nurse who contacted Dr. Allen Carter, the on-call physician for the emergency room. Carter examined Emily and diagnosed a lower respiratory tract infection and ear infection, and he also made differential diagnoses of bronchiliatis, viral pneumonia, or bacterial pneumonia. After prescribing an antibiotic and Albuterol for Emily, Carter discharged her. The following day Randy Kilroy found that Emily had died in her sleep. The Kilroy family (plaintiffs) sued Carter and Star Valley in federal district court for wrongful death, alleging, among other things, violations of the Emergency Medical Treatment and Active Labor Act (EMTALA). Star Valley moved for partial summary judgment on the EMTALA claims.

The U.S. District Court for the District of Wyoming granted Star Valley's motion. Congress' purpose in enacting EMTALA, said the court, was to prevent "patient dumping" for patients who cannot pay for services, but it was not intended to function as a federal malpractice statute. Star Valley contended that there was no EMTALA violation in Emily's care because Carter was unaware of whether she was covered by insurance or whether her parents could pay for her treatment. Plaintiffs argued that there was a violation of EMTALA not because of Carter's lack of knowledge of Kilroy's ability to pay for treatment, but because Star Valley's standard procedures were not followed. Under the EMTALA medical screening requirement, a hospital must follow its own standards for assessing a patient who comes to the emergency room. Reviewing the procedures followed in Emily's treatment, the court determined that the hospital's procedures were not thoroughly followed, but that the variations were minor and the treatment met the minimum standard for alerting the physician to the need for medical care. The court held that the facts showed that Emily was not given disparate treatment.

EMTALA also has a requirement for necessary stabilizing treatment for emergency medical conditions, said the court. In Holcomb v. Monahan, 30 F.3d 116 (11th Cir. 1994), the Eleventh Circuit set forth the requirements for a stabilization requirement claim: "(1) the patient had an emergency medical condition; (2) the hospital knew of the condition; (3) the patient was not stabilized before being transferred; and (4) the hospital neither obtained the patient's consent to transfer" nor certified that the transfer was beneficial. Concluding from the evidence that the nature of Emily's medical condition was only relevant to the medical malpractice claim, the court found that the hospital had "made no official determination that an emergency medical condition existed." Applying the Holcomb test, the court found that there was no emergency medical condition and therefore the hospital did not have a duty under EMTALA to stabilize Emily. Accordingly, the court granted Star Valley's motion for partial summary judgment.

Kilroy v. Star Valley Med. Ctr., No. 02-CV-1015-B, 2002 WL 31845956 (D. Wyo. Dec. 18, 2002) (22 pages).

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