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Did Mrs. Waters present to the emergency department?

June 26, 2021
Christopher R. Teeple

Hypothetical Fact Pattern – Sheila Waters, 34-weeks pregnant, woke up one early morning with severe stomach pain, dizziness, and a small amount of bleeding. She immediately woke up her husband and told him to take her to the emergency room because she “just didn’t feel right.” They quickly packed an overnight bag and got in their car for the 10 minute ride. The roads were empty and the traffic lights weren’t working because of last night’s tornado that hit the center of their small town. Major damage to homes, buildings, and roads were everywhere. The roof to the hospital’s entrance had been torn off and damage to other parts of the hospital was apparent. Her husband drove to the back parking lot to where the emergency room entrance was located. Sheila’s stomach pain was unbearable at this point and she could not get out of the parked vehicle. Her husband ran into the emergency room which was nearly empty and called for help. A nurse immediately said that the tornado damaged the hospital’s emergency generator and water supply, and that there was only one ER physician who was already treating two other critically injured patients. The nurse said that University Hospital, about a 25 minute drive, was open and available. Her husband demanded that someone take a look at his wife.
Analyze the hospital’s EMTALA’s obligations by answering the following questions.
Did Mrs. Waters present to the emergency department?
What duty, if any, does the hospital owe to Mrs. Waters and her unborn child?
Do you think she was suffering from an emergency medical condition that required stabilization?
How could an appropriate transfer to University Hospital be effectuated?
Can the ER close its doors because of the tornado? Would a public emergency relieve the hospital of its EMTALA obligations?
Finally, assume Ms. Waters had recently been laid-off from her job and lacked health coverage at the time. Could the hospital then bill her for the treatment she received that day? What if she had to be admitted to the hospital for two days, would her hospitalization be covered or would she have to pay for it?

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