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Being refused treatment while seeking immediate medical attention is every patient’s worst nightmare. If you’re sick, injured, or hurt, can a healthcare organization, like a private doctor, hospital, or family doctor’s office, refuse to treat you, even when you have health insurance? The answer, unfortunately, is yes.
While there is legislation that exists that requires hospitals to provide a certain standard of care to all patients, there are circumstances where legally, a hospital can refuse to treat patients for their medical conditions, even when they seek care through an emergency room.
However, these circumstances are not common, and it’s only in a few instances that healthcare providers can refuse to treat patients experiencing medical emergencies. If you are denied treatment outside these limited circumstances, you may be able to seek compensation through a medical malpractice lawsuit.
The Emergency Medical Treatment and Active Labor Act (EMTALA) is a federal law that requires hospitals with emergency departments to provide emergency treatment to anyone in need, regardless of their ability to pay.
The Emergency Medical Treatment and Active Labor Act was enacted to prevent hospitals from “patient dumping” or transferring an uninsured patient with emergency medical conditions to other facilities based on their inability to pay.
EMTALA mandates that hospitals conduct a medical screening examination to determine whether an emergency medical condition exists, and if so, provide stabilizing treatment or transfer the patient to another facility, such as an emergency department with the appropriate capabilities to handle their care. Emergency conditions include disruption of bodily function, injury, or severe illness.
An emergency medical condition is defined as a condition that, if left untreated, could result in impairment or serious dysfunction of a patient’s bodily functions, organs, or body parts.
Failure to comply with EMTALA can result in severe penalties for the hospital, including fines and loss of Medicare funding. Additionally, hospitals that are found to be rejecting patients in patient dumping schemes can also face civil penalties and medical malpractice lawsuits.
Active labor is considered its own emergency medical condition under the Act, which means that healthcare staff must provide medical treatment to address anything that is placing the unborn child’s health, the patient’s health, or both in serious jeopardy. Patients seeking treatment primarily for pregnancy-related emergency medical conditions are protected specifically against refusing treatment.
This means that in every circumstance, emergency care must be given to the woman and her child until labor is complete, stabilization and transfer to appropriate facilities can occur, or the contractions cease, which can be the case in ‘false labor’ cases when the contractions don’t actually signal that the baby is coming. This applies even to non-emergency medical settings, like private doctors’ offices or non-emergency departments within private hospitals.
If a hospital refused to treat a patient, and the hospital’s refusal results in injury, harm, or even death, the hospital or healthcare or health insurance provider may be subject to a medical malpractice lawsuit. In such cases, the patient who was seeking emergency care or their family would need to prove that the hospital or doctor was negligent and that this negligence led to the harm that was suffered.
Consulting with a medical malpractice attorney can help determine if a case has merit and guide the patient’s health and or their family through the legal process. To establish a medical malpractice case, the plaintiff must demonstrate four elements:
While emergency rooms are required to provide emergency medical care under EMTALA, not all medical facilities are subject to the same regulations as an emergency room. Urgent care clinics, private doctors’ offices, and some private hospitals may not be required to provide emergency treatment to all patients.
These facilities and private doctors may be allowed to refuse treatment based on factors such as insurance status, inability to pay, or the nature of the patient’s condition. However, if a patient’s condition is life-threatening, even private facilities are obligated to provide at least stabilizing treatment before transferring the patient to an appropriate facility.
There are certain exceptions when hospitals and doctors may be allowed to refuse treatment. These exceptions may include:
Hospitals and emergency rooms are generally required to provide emergency treatment to patients, regardless of their ability to pay, their medical condition, or their insurance status under federal law. Understanding the legal requirements and exceptions for medical treatment is essential for patients to protect their rights.
If you believe you have been wrongfully refused treatment by a hospital or a doctor refused to treat you, it is crucial to consult with a medical malpractice attorney to discuss your case. An experienced attorney can help determine if your case has merit, guide you through the legal process, and represent you in court or during settlement negotiations.
It is important for patients to be aware of their rights and the limitations of medical facilities when seeking treatment. If a hospital or doctor’s office decided to not provide treatment, you may be entitled to compensation. We’re here to help: if you believe that you’ve been wrongfully refused treatment, call us at 816-542-6734 and one of our experienced attorneys will be happy to help walk you through your options.