to maintain Emergency Departments (EDs).
• Starting in the 1960s, courts begin establishing a duty for hospitals to provide aid to individuals – particularly when they needed emergency care.
fire, EMTs) to aid victims of accidents or emergencies.
treat or transferring uninsured patients who can’t
pay for care
(b) Necessary stabilizing treatment for emergency
medical conditions and labor
(e) Definitions: term “emergency medical condition”
patient and meet standards of care, which include:
2. Finding a capable hospital willing to accept a patient
3. Transferring medical records to accompany the patient
4. Using qualified staff and proper equipment for the transfer
• EMTALA provisions apply to any hospital that participates in the Medicare Program.
• The patient only has to be stabilized; post stabilization
discharge or transfer does not violate EMTALA.
• The hospital can not delay stabilizing care to determine
the patient’s “method of payment” ((42 USC 1394dd(h))
• “[…] any physician who is responsible for the examination, treatment, or transfer of an individual in a participating hospital, […] and who negligently violates a requirement of this section […] is subject to a civil money penalty of not more than $50,000 for each such violation”
may be confusing in practice.
2. When does the duty to stabilize the patient begin? When has the patient
come to the hospital?
3. Does it matter why the hospital denies treatment?
person has an “emergency medical condition.”
• To do so, an “appropriate medical screening” must be
• Within 250 yards of the main hospital building
• In ambulances owned or operated by the hospital
• On hospital property in non-hospital owned ambulances
• In any hospital that offers emergency service, regardless of whether is has a separate ED.
ambulance is considered to be at the hospital.
• The requirement is uniform treatment of all patients – regardless of ability to pay.
• The slightest aid can be construed as the provision of care.
timely manner and consistent with hospital policies.
• Transfer is appropriate when the patient’s condition is
stabilized or otherwise meets EMTALA obligations.
• Discharge should include instructions for continuing care
for the patient and to the provider to whom the patient is
• Has qualified practitioners and staff
• Contains proper facilities and equipment
• Is engineered to provide timely diagnosis, stabilization, treatment, and referral.
standards in the ED
• Medical staff privileges should be determined for each ED doctor.
• Absent a Good Samaritan statute to the contrary, a
person who starts to assist at the scene has a duty to
exercise reasonable care under the circumstance.
many states, are meant to
encourage doctors, other
professionals, and sometimes
any person to aid strangers in an
• Typically, immunize Good Samaritans from liability for ordinary negligence in providing aid at the scene of an
emergency as long as they assist in good faith.
• A few states cover doctors providing aid in a hospital if
there is an emergency.
• Typically, these statutes do not cover people with an
existing duty to respond (e.g. patient-physician
because of the requirement to provide reasonable care
under the circumstances.
medicine or dentistry, who in good faith renders emergency
care at the scene of an accident or to a victim at the scene
of a crime, without remuneration, shall be liable for any civil
damages as the result of any act or omission in rendering
such emergency care”