Friday, October 19, 2012

Bryant v. Adventist Health System/West case brief

Bryant v. Adventist Health System/West (2001)
289 F.3d 1162

-The decedent sought treatment at the hospital operators’ emergency room for coughing up blood and a fever.
-Based on an x-ray, the emergency room physician diagnosed pneumonia and asthma.
-The physician failed to detect a large lung abscess (an admitted emergency condition) from the x-ray, and, after administering the medication, discharged the decedent.
-When another doctor read the x-ray and discovered the ABCs, the decedent was admitted to the hospital as an inpatient.
-The decedent was then transferred to the intensive care unit of another hospital and later released, after which he suddenly died.

Procedural History
-Plaintiff heirs sued several defendants, including defendant hospital operators, arising from the death of the heirs’ decedent. The claims against the hospital operators included violation of the Emergency Medical Treatment and Active Labor Act (EMTALA).
-The heirs appealed the grant of summary judgment to the hotel operators by the United States District Court for the Northern District of California.

-What duty of care does a hospital have?

-Under the Emergency Medical Treatment and Active Labor Act, a hospital has a duty to stabilize only those emergency medical conditions that its staff detects.  HOWEVER, A hospital may be found liable  if the screening examination is so cursory that it is not designed to identify acute and severe symptoms that alert the physician of the need for immediate medical attention to prevent serious bodily injury.

-If an individual seeks emergency care from a hospital with an emergency room, and if that hospital participates in the Medicare program, then the hospital must provide for an appropriate medical screening examination within the capability of the hospital’s emergency department to determine whether or not an emergency medical condition exists.
-If the hospital’s medical staff determines that there is an emergency medical condition, then, except under certain circumstances, the staff must “stabilize” the patient before transferring or discharging the patient.
-To stabilize means to provide such medical treatment of the condition as may be necessary to assure, within reasonable medical probability, that no material deterioration of the condition is likely to result from or occur during the transfer of the individual from a facility.
-Transfer includes both discharge and movement to another facility.
-Under the Emergency Medical Treatment and Active Labor Act, an “emergency medical condition” is defined in part as: a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in (1) placing the health of the individual in serious jeopardy, (2) serious impairment to bodily functions, or (3) serious dysfunction of any bodily organ or part.
-The United States Court of Appeals (Ninth Circuit) holds that a hospital does not violate the Emergency Medical Treatment and Active Labor Act, if it fails to detect or if it misdiagnoses an emergency condition. An individual who receives substandard medical care may pursue medical malpractice remedies under state law.

•    The court of appeals affirmed the judgment of the district court.

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