Did Florida ER Violate Anti-Dumping Statute?

Both Florida and federal law against patient dumping (EMTALA) may have been violated at a hospital in Daytona Beach, FL.

My experience with EMTALA cases is that violations are often an easier route to compensation if the patient victim has suffered harm than a medical malpractice action. This is particularly true because of recently enacted protections for emergency rooms and the doctors who staff them in Florida.

Doctor fired after near-drowning victim sent to another hospital

Eight-year-old Jarius Radcliff, the victim of a near drowning, was wheeled into the emergency room at Bert Fish Medical Center, and 13 minutes later paramedics wheeled him back out on their way to Halifax Medical Center.

What did or did not happen in those 13 minutes prompted Bert Fish administrators to fire one doctor and raised questions about whether the Edgewater child was denied treatment at the New Smyrna Beach hospital.

Jarius remained at Halifax Medical Center in Daytona Beach Friday where family members asked that his condition not be released, according to hospital spokesman Kate Holcomb.

Dr. John B. Milton Jr., the attending ER physician at Bert Fish, was fired. Milton said he conducted a visual evaluation of the child and determined he was stable, breathing on his own and his circulation was OK, but the boy needed more care than his facility could provide. He was on the phone arranging a transfer to Halifax, where a trauma and pediatric intensive care unit were available, when the EVAC ambulance crew left with Jarius.

EVAC spokesman Mark O’Keefe said the agency’s paramedics dispute Milton’s account.

O’Keefe said he was told the ambulance crew were never allowed to take Jarius off their stretcher and Milton did not evaluate or treat the youngster.

After the 13-minute wait, “the paramedic very wisely realized the patient needed to be transported as quickly as possible to the next closest emergency room for treatment,” O’Keefe said.

Bert Fish officials said Milton, 49, who has been with the hospital for 16 years, violated hospital procedures and a federal law requiring hospitals to treat any patients who come through the doors of their emergency room. As a result he was terminated.

Toby Philpot, a media specialist for the health care administration, said he could not confirm nor comment on potential investigations into violations of the federal anti-patient dumping law — the Emergency Medical Treatment and Active Labor Act [EMTALA].

But he said the law is clear that “a patient or individual cannot be turned away.” It imposes specific obligations on hospitals that offer emergency services and requires that they guarantee a patient or individual upon arrival at the emergency room a medical screening exam or treatment for emergency medical condition, Philpot said.