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June 2011, Volume 41 Number 6 , p 55 - 59


  • Sally Austin JD, ADN, BGS


IN JUNE 2010, a Chicago hospital paid penalties of $50,000 for allegations of failure to perform a medical screening exam or stabilizing treatment. Mr. D came to the ED via ambulance and was left unattended in the waiting room for 3 hours without receiving a screening exam. He was never logged into the hospital's system. After a family member approached the ED staff with concerns that Mr. D hadn't been seen, the triage nurse went to see the patient and found him unresponsive. Mr. D was taken to an exam room and pronounced dead. The nursing staff had a duty to evaluate the patient to assure he was properly screened, prioritized, and monitored, but according to the Emergency Medical Treatment and Active Labor Act (EMTALA), they didn't provide these services.When a patient comes into the hospital where you work, do you know what your obligations are under EMTALA?Enacted in 1986, EMTALA applies to hospitals receiving Medicare dollars.1 Lawmakers felt it was needed to protect patients who don't have insurance from being either turned away from the ED or sent to another hospital via ambulance even if the transferring hospital had the resources needed to treat the patient-a circumstance sometimes called "patient dumping." This article discusses what EMTALA requires and how it applies to your nursing practice.EMTALA requires that any patient who comes to a hospital's dedicated ED with what the patient believes to be an emergency medical condition must be given a medical screening exam by a qualified healthcare provider to determine if a medical emergency exists. EMTALA defines an emergency medical condition as one where a patient presents with acute symptoms (including pain) of sufficient severity that in the absence of immediate medical attention could reasonably be expected to seriously jeopardize the patient's health or body functions, or cause serious dysfunction of any body organ or part. It also covers women coming to the ED in active labor.1Many states have statutes

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