Question

You are the administrator on call for Hospital A and are responsible for accepting and rejecting patients. You receive a call at 2:00 a.m. from Health Hospital B regarding a patient with a severed ear.

The ED physician is calling to arrange an EMTALA-qualified transfer from his hospital to yours, but the ENT physician on call at your hospital is refusing to accept the transfer, stating that the patient does not need a higher level of care.

You call your ENT on call, and he admits he has just had three glasses of wine and will not be available for about 6 hours. You electronically send him the record that Health Hospital B would send with the patient. The ENT physician advises that the ear looks salvageable and could easily be sutured in any ED. The ED physician at Health Hospital B is very nervous about the possibility of an EMTALA violation.

1. If you decide to reject the patient, is this a violation of EMTALA? Explain.
2. What decision will you make as the administrator? Explain.
3. Based on this scenario, what could be implemented to prevent this type of situation from occurring in the future?
4. Under what scenario would the Hospital A physician be concerned about an EMTALA situation?

Answer 1

EMTALA violation occurs when the patient not treated with their emergency condition in the non-discriminatory manner regardless of ability to pay or even with uncovered insurance etc. any time any emergency physician should provide chartity care for the patient. when they reject the patient even though it need lower level of care it is considered as EMTALA violation.
It is must on call physician should accept the call with in 30 to 60 minutes. administrator responsible to inform this to health care financing administration. the physician will be in civil fines upto $50,000 and possible for malpractice liability and excluded from the medicare.
All the emergency staff and physician need to be trained and educated to avoid violation, ensure the appropriate transfer followup for the patient, audit the EMTALA emergency compliant and track the necessary information and incidents, develop policies to followup.
Hospital A physician could have stabilize the patient instead of rejecting the patient. severed ear patient required to be stabilized and examined before shifting to the some other facility. Obligation to transfer need the individual to request transfer to some other facility or signed certificate from the physician to transfer to another facility to avoid risk.