© 2009 The Medical-Legal News
By Rose Clifford, RN, LNCC, editor
A hospital discharged a 39-year-old man twice from its ER. The man, James “Milford” Gray, died at a relative’s home shortly after the second discharge. The cause of death was purulent peritonitis caused by a rupture of a duodenal ulcer due to duodenal peptic ulcer disease.
Gray’s estate filed a suit claiming: 1) medical negligence on the part of the hospital for a failure to diagnose, and 2) that the hospital violated the Emergency Medical Treatment and Active Labor Act (EMTALA) for failing to stabilize Gray’s emergency medical condition prior to discharging him.
The hospital argued that a failure to diagnose case and an EMTALA case are mutually exclusive. That is, even if the hospital failed to diagnose Gray’s condition, for which it would be liable, the hospital then would not also be liable under EMTALA for failing to stabilize an emergency medical condition that its doctors did not detect.
The court said no. The court made it clear that the two legal theories have different elements of proof and that EMTALA actions are all about ignoring severe acute symptoms that are likely to lead to a patient’s deteriotation after discharge, whether a specific diagnosis is made or not. Thus, both actions can lie at once.
The case is Thomas v. St. Joseph Healthcare, Inc., 2007-CA-001192-MR. Dec. 5, 2008 (Ky. Court of Appeals).
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