The federal government recognizes that individuals have a right to seek care in an emergency room even if they lack health insurance or the ability to pay for treatment. When ER providers fail to perform a timely medical screening, patients can sue for damages.
ER Medical Screenings Are Not Part of the Triage Process
An ER medical screening exam is different from the triage process. Triage refers to a nurse or other provider taking vital signs and assessing the urgency of a person’s condition to determine the order in which to see patients. An ER screening exam must be done by a doctor, advanced practice nurse, or physician assistant to find out the cause of a patient’s symptoms. They must use all relevant tools at their disposal, including CT scans, MRIs, and lab tests, to conduct the screening.
Screenings Can’t Be Delayed Due to an Inability to Pay
Federal law provides specific protections for patients in an emergency room. Under the Emergency Medical Treatment and Labor Act (EMTALA), patients must be provided a certain level of medical care regardless of their ability to pay if the facility is accepting payments from Medicare or Medicaid.
It is against the law for the facility to refuse to perform a medical screening or to delay the screening until the patient’s insurance coverage or ability to pay has been verified. Patients without insurance and/or a source of income must be provided the same level of care as others presenting the same symptoms. Patients can’t be refused care even if they already owe the facility for unpaid bills from a previous visit.
If a medical screening reveals an emergency medical condition, a patient must then be stabilized—even if they do not have medical insurance or can’t pay for the necessary care. If the facility can’t stabilize the patient due to a lack of resources, they must arrange a transfer to another facility. An emergency medical condition is defined as one that is likely to result in disability or death if treatment is not received. However, a pregnant woman in active labor is also considered to be experiencing an emergency.
If the screening does not reveal a medical emergency, the facility is not obligated to provide care under EMTALA. Patients can be instructed to seek care from their own doctor or a community health clinic.
Suing for Damages
In addition to providing legal protection for patients in need of emergency care, EMTALA also gives you the right to sue for damages when a doctor or facility violates the provisions of the law. Your lawsuit is separate from the civil penalties for EMTALA violations that can be applied by the federal government.
If the circumstances dictate it is appropriate, you can file claims under EMTALA and Kentucky malpractice law. This maximizes your potential monetary recovery.
Suits for EMTALA violations differ from a standard Kentucky malpractice case in one key way: EMTALA does not require you to provide proof of negligence. In a malpractice claim, you must establish that the defendant violated the standard of care for your condition and that this violation caused you harm. In an EMTALA claim, you only need to prove that the hospital did not follow the exact requirements of the statute. You can be compensated even if you were not severely hurt. This is referred to as strict liability.
Hospitals found in violation of EMTALA can potentially lose their Medicare eligibility. This gives hospitals a powerful incentive to quickly settle claims, since a federal investigation that results in a loss of Medicare eligibility puts the future of the entire facility at risk.
As with a Kentucky medical malpractice claim, you have two years from the date the incident occurred to file your EMTALA case. The best way to proceed is to consult an attorney to discuss your legal options.
The legal team at Gray & White Law can help you evaluate your case and determine if you have a claim for medical malpractice and/or an EMTALA violation. Contact us today to schedule a free, no-obligation initial consultation.