Reference no: EM133531602

Problem

Fred Davis was a frequent visitor to the Bluefield Medical Center (BMC) emergency room. Every few days he would rush in, claim to be on the brink of death, and demand immediate medical attention. Invariably, his concerns proved to be unfounded, and the medical staff had come to see Mr. Davis as a nuisance. In fact, during one visit, Davis heard a doctor tell a nurse that he (the doctor) hated it every time Mr. Davis came to the ER.

Davis once again arrived at the ER complaining of a sore throat, chest pain while breathing, and dry heaves. Dr. Jennifer Alexander, the physician on duty, performed a battery of tests, including an electrocardiogram (required pursuant to hospital policy for all patients complaining of chest pain), a urine screening, and a blood gas test. The electrocardiogram and blood gas tests revealed nothing out of the ordinary. However, the urine analysis indicated an unusually high level of Anafranil (an antidepressant). In fact, the Anafranil level was high enough to suggest the presence of drug toxicity, but this possibility did not occur to Dr. Alexander.

Anxious to get rid of Davis so that she could attend to the "real" emergencies, Dr. Alexander told Fred Davis to go home. Shortly after leaving the hospital, Davis went into cardiac arrest and died. An autopsy revealed that excessive Anafranil caused the cardiac arrest.

Davis's estate has sued BMC for violating their obligations under EMTALA.

Question I. BMC is attempting to get the EMTALA claim dismissed and therefore thrown out of court. How should the court rule and why?

Question II. How, if at all, would your analysis of the EMTALA claim differ if Dr. Alexander failed to perform the electrocardiogram? Explain your answer.