The family of a man having a heart attack couldn’t get anyone in the ER to treat him, so they called 911 from the emergency room to try to get him seen sooner. He died soon after they checked him into the hospital. A motorcycle accident victim was rushed to his local ER. There was no doctor available to treat him. He died of his injuries. A woman needed surgery to repair a hole in her colon, but the on-call specialist refused to treat her. She later died of sepsis.
These are some of the cases examined in the investigative report, “Deprived of Care: When ERs Break the Law.” The collaboration by WebMD and Georgia Health News looks at violations of a 1986 federal law passed to prevent “patient dumping” by hospitals – most often of poor, uninsured, patients — and to protect women in labor. The law, known as EMTALA (Emergency Medical Treatment and Labor Act), requires hospitals to medically screen any patient that seeks emergency care and or stabilize or transfer people with medical emergencies, regardless of ability to pay. Through data from 10 years of Open Records requests, interviews with patient families, and expert interviews, the report explored how and why these violations continue to happen and their impact on the families left behind. The package included three stories and two videos. The main story, “Lives Lost Amid ER Violations,” found:
• More than 4,300 violations from 1,682 hospitals in total over 10 years.
• Violators represent about a third of the nation’s approximately 5,500 hospitals.
• Hospitals in the Southeast accounted for 1,175 violations over 10 years, more than any other region. • Smaller hospitals — those with fewer than 100 beds — accounted for the largest number of violations — 1,488, or 34% of the total.
• Failure to do a thorough medical screening exam was the most common violation committed by hospitals, accounting for more than 1,300 citations.
• From January 2016 to March 2018, at least 34 patients died after emergency departments violated the law.
The video “Deadly Delay,” used audio from a 911 call to help tell the story of Randy Strickland, the man whose family called 911 from the hospital ER when they couldn’t get help. Like other families interviewed for the article, the Stricklands had no idea Randy’s death was the subject of a federal investigation.
About 1 in 12 EMTALA violations involved women who were pregnant or in labor. The story “Pregnant Women Face Risk Despite Federal ER Law,” highlights the case of Jamie Larson, who went to the hospital in premature labor but was told her pain was caused by a UTI. The hospital discharged her, and she delivered her son at 24 weeks about an hour later in the hospital parking lot. A doctor happened to be nearby and he helped rush her son to the NICU – likely saving his life.
The investigation also found that about 1 in 7 violations involved patients who were having a mental health crisis, including suicidal thoughts. The video “Turned Away” features the story of James Brieske, a man with bipolar disorder who was having suicidal thoughts and went to the ER for help. Instead he was discharged, and Brieske died by suicide after jumping off a bridge later that day.
Experts say the problems today are due more to a lack of hospital resources than turning people away for insurance reasons. They also said the true number of violations is likely higher given that the system for reporting EMTALA violations discourages people from filing complaints.