Congress enacted the Emergency Medical Treatment and Labor Act (“EMTALA”) in 1996 in response to claims that hospital emergency rooms were refusing to treat patients with emergency conditions but no medical insurance.  EMTALA imposes duties on covered facilities, hospitals which accept Medicare funding with an emergent care department, to: (a) provide an “appropriate medical screening examination” for those who come to an emergency room seeking treatment, and (b) provide, in certain situations, “such further medical examination and such treatment as may be required to stabilize the medical condition.”

To establish an EMTALA violation, a plaintiff must show that the hospital either (a) did not afford the patient an appropriate screening in order to determine if she had an emergency medical condition, or (b) bade farewell to the patient (whether by turning her away, discharging her, or improvidently transferring her) without first stabilizing the emergency medical condition.

What is an “appropriate medical screening?” Unfortunately, EMTALA does not define this phrase other than to state that its purpose is to identify an emergency medical condition. However, courts have uniformly held that whether a medical screening is appropriate is determined “by whether it was performed equitably in comparison to other patients with similar symptoms,” not “by its proficiency in accurately diagnosing the patient’s illness.” An appropriate medical screening is one which is reasonably calculated to identify critical medical conditions that may be afflicting symptomatic patients and which provides that level of screening uniformly to all those who present substantially similar complaints. Thus, a hospital is liable under EMTALA if it fails to detect the nature of the emergency condition as a result of a disparate screening.  A hospital satisfies the screening requirements of § 1395dd(a) if its standard screening procedure is applied uniformly to all patients in similar medical circumstances.

Stated another way, a negligent “medical screening” does not necessarily give rise to an EMTALA violation.  State malpractice law and general principles of negligence provide one theory of recovery against a hospital where the alleged substandard treatment results in injury, EMTALA provides a separate and distinct theory of recovery, either of which may be invoked by a plaintiff.