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Federal law may extend beyond ERs to protect urgent-care patients

The Emergency Medical Treatment and Active Labor Act, or EMTALA, is a federal law intended to ensure that hospitals don't "dump" emergency patients who may be indigent or uninsured by refusing to examine or treat them or by sending them to other hospitals. EMTALA requires hospitals to thoroughly screen all patients who report to emergency rooms and, if they are found to have a serious medical condition, to properly stabilize them before transferring or releasing them.

Hospitals that fail to comply with EMTALA can be hit with significant fines. Additionally, the patient may be able to bring the hospital to court, obtain damages and have his or her attorney's fees paid.

A recent ruling by a federal judge in Rhode Island suggests that EMTALA covers not only traditional emergency-room visits, but can also extend to off-campus urgent-care clinics affiliated with hospitals. In the Rhode Island case, a 49-year-old woman reported to the urgent/walk-in care clinic at a local hospital with complaints of severe chest pain and pain in her right arm. Shortly before she went to the clinic, she texted co-workers that she was going to the "ER" to get checked out for possible heart-attack symptoms. At the clinic, she was diagnosed with reflux and sent home with a "gastrointestinal cocktail." She died the next day of cardiovascular disease.

Her estate sued the hospital that operated the clinic for both malpractice and for violating the EMTALA. The hospital sought to dismiss the case, arguing that EMTALA did not apply because the clinic wasn't an "emergency care facility." The judge disagreed, finding that because it held itself out as treating emergency medical conditions on an urgent basis without a scheduled appointment, it fit the definition of an emergency care facility. In fact, the court determined, based upon her texts, that this particular patient, thought she was going to an ER when she visited the clinic. As a result of this decision, the estate's claim was allowed to proceed.

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