Index Case 7
Ankle Injury
Testing and Treatment
Disposition
Billing
Return ED Visit
Outcome
Plaintiff Claims
Defense Response
Legal Outcome
Case Review
Documentation Review
The hospital’s law firm responded vigorously to the plaintiff’s claims. They first address the EMTALA requirement for medical screening. In particular, they note that the screening must be done in a way consistent with other patients presenting with similar complaints. Faulty screening that fails to identify an underlying emergency does not constitute an EMTALA violation (although it certainly may generate a tort claim in state civil court). Furthermore, a hospital is only required to provide screening within the capabilities of their ED.
The defense notes the extensive screening that was carried out on the first ED visit, including multiple lab tests and imaging. In addition, they emphasize the fact that the patient was in the ED for 5 hours, countering the plaintiff’s insinuation that the screening was insufficient and limited in nature. In the text below, FAC (first ammended complaint) refers to the plaintiff’s assertions shown in the previous post.
The defense also counters the claim that the patient was treated differently for financial reasons.
Note that the physician’s explicit documentation of his thoughts about the possibility of necrotizing fasciitis were of assistance to the defense team. Even though his assessment about the final diagnosis was incorrect, documenting his thought process was useful.
Another concern raised by the plaintiff was in regards to the patient’s stabilization. The defense notes the physician documented that the patient was stable for discharge at his first visit. Furthermore, the defense claims that under EMTALA, the duty to stabilize has been fulfilled once the patient is admitted to the hospital. This is not to say that any patient admitted to the hospital is medically stable, but that the duty to stabilize under EMTALA has been fulfilled.
After disputing the entirety of the plaintiff’s claims and noting the relevant case law, the defense team filed a motion to dismiss, requesting that the judge throw out the entire claim.
Continue to the next page to see the judge’s decision.