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Based on a review of facility policy and medical records (MR) and facility documentation, and interviews with staff (EMP), it was determined that the facility failed to ensure Emergency Department staff adhered to hospital policies and procedure to comply with the requirements of the Emergency Medical Treatment and Labor Act, as evident by an Emergency Department physician instructing a paramedic to take a patient (found lying on back alongside of a road) to a psychiatric hospital, without a Medical Screening Exanination to rule out an Emergency Medical Condition.


Findings Include:


A review of the facility's policy and procedure "Emergency Medical Treatment and Labor Act (EMTALA)" last approved September 2019, stated, "It is the policy of Allegheny Health Network that any individual who comes to the Hospital Property or Premises requesting examination of treatment and is suffering from an Emergency Medical Condition is entitled to and must be provided an appropriate Medical Screening Examination to determine whether or not an Emergency Medical Condition exists, stabilization to the extent the facility is able to do, and an Appropriate Transfer if necessary."

Further review of the facility's EMTALA policy revealed, "Hospital Property or Premises means the entire main hospital campus, including .... A Hospital owned and operated ambulance (air or ground) even if the ambulance is not on the hospital's campus. ..."

A review of MR1 revealed that the patient presented to the hospital's Emergency Department on August 28, 2021, with chief complaints of Syncope and Fall. Additionally, the patient left the hospital AMA (Against Medical Advice) on August 29, 2021.

A review of a Canonsburg Hospital (owned and operated) Ambulance Service trip sheet, dated August 29, 2021, revealed that MR1 was found lying on back alongside of the road about 20 minutes after leaving the hospital AMA. Further review of the ambulance trip sheet revealed the patient's initial acuity was 'Emergent' and level of consciousness was 'Responds to Pain.' Additionally, it was documented that paramedics were unable to obtain any vital signs other than SP02 (Blood Oxygen Level).

Further review of the Canonsburg Hospital Ambulance Services trip sheet dated August 29, 2021, revealed that the paramedics spoke with Emergency Department physician EMP2 via radio and provided an update on the status of MR1. Paramedics informed Emergency Department physician EMP2 that the patient was going to be transported back to the hospital. Further review of the trip sheet revealed that Emergency Department physician EMP2 instructed paramedics to not bring the patient back to the hospital as the patient recently signed out AMA.

During a phone interview on September 2, 2021, at 2:30 pm, Emergency Department physician MR2 stated the following: The patient (MR1) left the hospital AMA and ended up in a ditch. The patient was not physically impaired, and vitals were good. The medics were instructed to not bring MR1 back to the hospital but to take the patient to a psychiatric hospital where the patient could receive psychiatric care.

During an interview on September 3, 2021, at 9:30 am, EMP1 confirmed the above information.

During an interview on September 3, 2021, at 4:00 pm, EMP7 confirmed that the instructions provided to the paramedics by Emergency Department physician EMP2 were not consistent with the facility's EMTALA policy.

Based on a review of facility policy and medical records (MR) and facility documentation, and interviews with staff (EMP), it was determined that the facility failed to ensure a patient in a hospital owned and operated ground ambulance received a Medical Screening Examination to determinate whether or not an Emergency Medical Condition exists.

Findings Include:


A review of the facility's policy and procedure "Emergency Medical Treatment and Labor Act (EMTALA)" last approved September 2019, stated, "It is the policy of Allegheny Health Network that any individual who comes to the Hospital Property or Premises requesting examination of treatment and is suffering from an Emergency Medical Condition is entitled to and must be provided an appropriate Medical Screening Examination to determine whether or not an Emergency Medical Condition exists, stabilization to the extent the facility is able to do, and an Appropriate Transfer if necessary."

Further review of the facility's EMTALA policy revealed, "Hospital Property or Premises means the entire main hospital campus, including .... A Hospital owned and operated ambulance (air or ground) even if the ambulance is not on the hospital's campus. ..."

A review of MR1 revealed that the patient presented to the hospital's Emergency Department on August 28, 2021, with chief complaints of Syncope and Fall. Additionally, the patient left the hospital AMA (Against Medical Advice) on August 29, 2021.

A review of a Canonsburg Hospital (owned and operated) Ambulance Service trip sheet, dated August 29, 2021, revealed that MR1 was found lying on back alongside of the road about 20 minutes after leaving the hospital AMA. Further review of the ambulance trip sheet revealed the patient's initial acuity was 'Emergent' and level of consciousness was 'Responds to Pain.' Additionally, it was documented that paramedics were unable to obtain any vital signs other than SP02 (Blood Oxygen Level).

Further review of the Canonsburg Hospital Ambulance Services trip sheet dated August 29, 2021, revealed that the paramedics spoke with Emergency Department physician EMP2 via radio and provided an update on the status of MR1. Paramedics informed Emergency Department physician EMP2 that the patient was going to be transported back to the hospital. Further review of the trip sheet revealed that Emergency Department physician EMP2 instructed paramedics to not bring the patient back to the hospital as the patient recently signed out AMA.

During a phone interview on September 2, 2021, at 2:30 pm, Emergency Department physician MR8 stated the following: The patient (MR1) left the hospital AMA and ended up in a ditch. The patient was not physically impaired, and vitals were good. The medics were instructed to not bring MR1 back to the hospital but to take the patient to a psychiatric hospital where the patient could receive psychiatric care.

During an interview on September 3, 2021, at 9:30 am, EMP2 confirmed the above information.

During an interview on September 3, 2021, at 4:00 pm, EMP7 confirmed that Canonsburg Hospital Ambulance Service was owned and operated by the hospital. During the interview EMP7 also confirmed that the patient did not receive an appropriate Medical Screening Examination, as per facility policy.