EMTALA Update

AAEM EMTALA Update

On April 19, the U.S. Court of Appeals for the Ninth Circuit held that, when a hospital wrongly diagnoses a patient's emergency condition but nonetheless provides an adequate medical screening, it does not breach the Emergency Medical Treatment and Active Labor Act. (Jackson v. East Bay Hospital, 9th Cir., No. 98-17152, 4/19/01).

In the case, Robert Jackson, who had been diagnosed with and was taking medication for a psychotic disorder, visited a hospital emergency room in California three times in four days. He then died of a heart attack caused by a psychotic delirium brought on by a drug toxicity, according to the decision. The doctors and nurses at the hospital emergency room did not diagnose a drug toxicity, and Jackson's family argued he did not receive an adequate EMTALA medical screening.

The Ninth Circuit (which joined most other federal circuit courts) used the case to announce its adoption of a "comparative test" as the standard for judging compliance with EMTALA's requirement that all emergency room patients be given an appropriate medical screening, regardless of ability to pay (42 U.S. C., Section 1395dd(a). A hospital generally satisfies EMTALA's screening mandate "if it provides a patient with an examination comparable to the one offered to other patients presenting similar symptoms," the court held.

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