American Academy of Emergency Medicine

EMTALA Beyond the Gates

by Robert V. West, MD JD FAAEM

On January 22, a divided U.S. Court of Appeals for the 9th Circuit ruled that a family of a heart attack victim-who was en route to a hospital but died after his ambulance was rerouted to another facility-can sue under EMTALA. In these days of ED overcrowding, this ruling poses an additional concern and burden for hospital EDs on diversion status. (Arrington v. Wong, 9th Cir., No. 98-17135, 1/22/01).

Relying upon an HHS regulation, the court held that a hospital, which is contacted by an ambulance about a patient, who is en route cannot escape its EMTALA duty to treat emergency patients regardless of ability to pay, unless the hospital lacks the staff or facilities to treat the patient.

The decision expands on EMTALA, which provides that any individual who "comes to the emergency department" of a hospital and requests treatment of a medical condition must be given an appropriate medical screening.