EMTALA: The Emergency Medical Treatment and Active Labor Act
The Emergency Medical Treatment and Active Labor Act (EMTALA) was enacted in 1986 as a part of the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985. EMTALA was enacted to prevent hospitals with Emergency Departments from refusing to treat or transferring patients with emergency medical conditions (EMC) due to an inability to pay for their services. This act also applies to satellite locations whom advertise titles such as “Immediate Care” or “Urgent Care,” and all other facilities where one-third of their patient intake are walk-ins. Several rules and regulations to this act have been established and it has become a very serious piece of legislation and health care regulation, as it is enforced by several government entities. Originally known as the “anti-dumping act,” EMTALA has saved the accreditation of health care today as it was quickly in transformation to becoming an unreliable, acquisitive practice, rather than a dependable source of care. History of EMTALA
There were a few incidents that led to the enactment of EMTALA. One in particular was the case of Eugene “Red” Barnes from California in January of 1985. Barnes suffered a gruesome stab wound to the head during an altercation and was rushed to the emergency room of Brookside Hospital by ambulance. Once he arrived, the emergency physician performed a computed tomography (CT) scan, which revealed an intracranial injury that was necessary for immediate surgical action by a Neurosurgeon (Moy, 2010, pp. 33-41). Upon contacting the Neurosurgeon on-call, he refused to come in to treat the patient. Another Neurosurgeon was also contacted, but refused to come in because he was not on call (Flint et al., 2008, pp. 172-173). Brookside attempted to transfer the patient to two separate facilities to no avail, but finally received approval for transfer to San Francisco General Hospital after sitting in Brookside’s ED for four hours (Flint et al., 2008, pp. 172-173). Although immediate surgery was performed upon arrival to San Francisco, Barnes passed 3 days later (Flint et al., 2008, pp. 172-173). This created a national uproar as the story spread across the United States, and investigations of the case were soon underway.
Another case involved a pregnant woman named Sharon Ford who was in active labor when she arrived at Brookside. Upon evaluation of her insurance she was transferred to Samuel Merritt Hospital, because her insurance, Medicaid HMO, was contracted with them (Moy, 2010, pp. 33-41). Upon arrival at Samuel Merritt, they discovered that Medicaid was late in adding her to the list of covered persons and she was then transferred to the county hospital, where she ultimately delivered a stillborn baby (Flint et al., 2008, pp. 172-173). This incident in particular is the reason why “active labor” is considered an EMC under EMTALA.
As the national press dug deeper into these cases, several more were revealed. There was a case of a man that was diagnosed with anemia, alcoholism, and pneumonia who died during transfer after he was deemed “stable” upon leaving the health care facility (Moy, 2010, pp. 33-41).
The New York Times ran a report of a woman who was transferred to another hospital in another city. She presented a note from her doctor requesting they provide her medical treatment, because she could no longer afford him as a doctor due to her current lack of medical assistance (Moy, 2010, pp. 33-41).
William Jenness arrived at a private hospital after a severe car accident. They would not admit him to the hospital until he paid a $1,000 deposit for his services, which he did not possess (Moy, 2010, pp. 33-41). They transferred him to the county hospital where he waited for four hours before surgery began. He died that same day.
Congress recognized the public outcry these cases produced and decided to hold hearings where they deemed this practice as “dumping.” This term “refers...
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