Don’t take “No” for an answer: EMTALA Violations
Jamila arrived at the jail intoxicated and vomiting. The booking officers immediately activated EMS transport for a doctor’s evaluation. The on-call ER doctor declined to evaluate Jamilia, stating: “I don’t come in for drunk inmates.” Jamila was sent back to jail without being evaluated. Shortly after, she experienced an overdose and passed away.
The Emergency Medical Treatment and Active Labor Act (EMTALA) states that everyone, no matter incarceration status, insurance, or ability to pay, has the right to a medical evaluation by a qualified practitioner.¹ A hospital doctor cannot refuse to evaluate a detainee.
Escalate EMTALA violations
If a doctor is refusing to evaluate a detainee, notify your chain of command and turn on your body camera. The ER cannot refuse to see a detainee. An EMTALA violation happens when a qualified practitioner refuses to lay eyes on the detainee. If a detainee is evaluated and then discharged back to the jail, this is not a violation. However, TRUST YOUR GUT. Get your chain of command involved any time you think a detainee needs a higher level of care. Escalate EMTALA violations.
Document clearly, timely, and completely
If a refusal occurs, document:
Patient name
Date & time the detainee was refused evaluation
Name(s) of individuals who communicated the refusal, for example:
a. A nurse who says “the doctor won’t see them”
b. A practitioner who says “I won’t see them”
c. A transport officer who reports “they wouldn’t see them”
Provide this report to your supervisor and/or medical team leadership, who can assist with reporting the violation. It is also important to keep a copy of documentation in the detainee file and medical chart. Thorough documentation helps validate a report to oversight bodies and the hospital. Document clearly, timely, and completely.
For more information, please contact training@sparktraining.us.
Emergency Medical Treatment and Labor Act, 42 U.S.C. § 1395dd (1986).https://www.law.cornell.edu/uscode/text/42/1395dd
Disclaimer
All materials have been prepared for general information purposes only. The information presented should be treated as guidelines, not rules. The information presented is not intended to establish a standard of medical care and is not a substitute for common sense. The information presented is not legal advice, is not to be acted on as such, may not be current, and is subject to change without notice. Each situation should be addressed on a case-by-case basis. When in doubt, send them out!®
