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From Health Law Daily, May 10, 2018

Case against hospital for negligence, violations of EMTALA moves forward

By Rebecca Mayo, J.D.

A motion for summary judgment is not appropriate where there are conflicting expert testimonies or medical records that conflict with witness accounts. In denying a hospital’s motions to claims against it for negligence and violations of the Emergency Medical Treatment and Active Labor Act (EMTALA), a district court found that there were genuine issues of fact relating to whether the hospital followed its own screening procedures, provided an appropriate medical screening examination (MSE), and provided timely treatment (King v. VHS San Antonio Partners, LLC, June 1, 2016, Jackson, L.).

The injury. A patient went to the hospital’s emergency room (ER) complaining of persistent right-sided neck pain and various related complaints, including numbness and weakness in his extremities, three times over the span of five days. Each time the patient was diagnosed with muscles spasms, given medication, instructed to see his primary care physician and sent home. After being discharged the third time, the patient fell while leaving the hospital and the patient was again admitted to the ER.

After running more tests, the doctor concluded that the patient likely had a small amount of subdural hematoma. The patient was transferred to another hospital where he underwent surgery, but he was left with a permanent cervical spinal cord injury that caused quadriplegia/paresis.

The claim. The patient alleged that he had a large ventral epidural abscess centered at cervical vertebrae 4 and 5. The patient argued that had the hospital provided him with a proper MSE, he would have received earlier treatment to release the compression and he would not have suffered permanent damage. He believed he was treated below the applicable standards of care from other ER patients with the same or similar symptoms based on his lack of insurance in violation of EMTALA. The patient filed claims against the hospital, the doctor and the physician’s assistant (PA) who treated him in the ER.

Causation. The hospital moved for summary judgment on the negligence claim arguing that there was no evidence that the alleged delay of proper care caused the permanent spinal cord injury. The hospital presented an expert witness who claimed that the as long as the surgery to decompress the epidural abscess is performed within 24 to 36 hours after the onset of neurological symptoms, the surgery is timely. Since the patient did not present neurological symptoms until the final hospital admission, his surgery was within 12 hours and therefore timely. The patient presented a witness that argued that the decompressive surgery should have been performed as soon as possible, the court held that the conflicting expert testimony on the question of causation created a question for the jury and therefore the motion for summary judgement was denied.

EMTALA. The hospital moved for summary judgment on the EMTALA claims arguing that the patient was provided with an appropriate MSE. However, a doctor testified that patients who complain of neck and back pain need a neck and back exam, but the hospital doctor’s exam notes do not show that a new exam was ever done on the patient. The hospital doctor argued that a neck exam was done even though it was not noted in the records. The patient argued that a neck exam was never completed and that the failure to document the purported exam further violated the hospital’s EMTALA policies, which stated that the results of the MSE will be recorded on the appropriate documentation sheet and become part of the patient’s permanent record. The court found that there was at very least an issue of fact as to whether the patient received an appropriate MSE by alleging that the hospital did not follow its own standard screening procedures. Therefore, the motion for summary judgment was denied.

The case is No. SA-16-CV-1201-XR.'

Attorneys: Christopher T. Hernandez (Marynell Maloney Law Firm, PC) for Carl King and Latanya Walker-King. Carol Yolande Kennedy (Cooksey, Marein & Huston, PLLC) for VHS San Antonio Partners, LLC d/b/a Mission Trail Baptist Hospital.

Companies: VHS San Antonio Partners, LLC d/b/a Mission Trail Baptist Hospital

MainStory: TopStory CaseDecisions IPPSNews EMTALANews TexasNews

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