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Based on review of facility documents, medical record (MR1), and staff interview (EMP), it was determined the on call anesthesiologist failed to report to the Emergency Department (ED) for a surgical case (MR1).

Finding include:

Review on March 6, 2024 of facility policy and procedure "Emergency Medical Treatment and Active Labor Act (EMTALA)," last reviewed February 23, 2023, revealed "... IV. Definitions ... 2. Emergency Medical Condition is "a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain, psychiatric disturbances, and/or symptoms of substance abuse) such that the absence of immediate medical attention could reasonably be expected to result in: placing the health of the individual ....in serious jeopardy; serious impairment to bodily functions; or serious dysfunction of any bodily organ or part; ... 5. Qualified Medical Person ("QMP") is a licensed physician or other qualified individual as determined by each hospital's medical staff bylaws or rules and regulations. ... V. Procedure ... 5....If the hospital determines that it does not have appropriate medical and/or staffing resources to properly stabilize the patient, transfer to an appropriate facility may be made if a physician certifies that the medical benefits of the transfer are expected to outweigh the risks of transfer; or if a QMP certifies that the benefits of transfer are expected to outweigh the risks of transfer, that must be certified by a physician. ... 12. Each UPMC hospital Emergency Department shall maintain a list of physicians who are on call 24/7 to provide further evaluation and/or treatment necessary to stabilize an individual with an Emergency Medical Condition. Physicians on-call are required to personally attend to the patient when requested to do so by the treating physician or QMP. ..."

Review on March 6, 2024 of facility policy and procedure, "Physician Ethics," last reviewed February 1, 2024, revealed "I. Policy/Scope It is the policy of UPMC that all physicians on the medical staffs of United States-based UPMC hospitals conform their behavior and relations with patients and the community at large to the principles enumerated in the AMA Code of Ethics. ... II. Principles of Ethics 1. Physicians shall be dedicated to providing competent medical service with compassion and respect for human dignity and rights. ..."

Review on March 6, 2024, of MR1 revealed the patient presented to the ED via private vehicle on January 19, 2024, at 2234, with complaints of abdominal pain. The patient was alert and oriented. The patient was triaged and seen by a provider at 2235. The provider noted the patient ' s abdomen soft with distention. There was right side tenderness on palpation with guarding. The CT of abdomen and pelvis revealed a large bowel obstruction. The provider notified the on call general surgeon (CF1) at 0104. CF1 presented to the Emergency Department and spoke with the patient. The patient required surgery for the large bowel obstruction. CF1 activated the Operating Room team. CF1 was then informed the on call anesthesiologist (CF4) refused to come into the hospital.

Interview with EMP2 on March 6, 2024, at 1115, confirmed MR1 required a surgical procedure. When CF4 was notified, CF4 refused to report to the ED for a requested surgical case. EMP2 confirmed CF4 was the provider on-call and was to respond within 30 minutes.

Review on March 6, 2024 of "UPMC Cole Daily Call Sheet" for January 20, 2024, revealed CF4 was the anesthesiologist on call.

Interview with EMP2 on March 6, 2024, at approximately 1500, confirmed the findings noted above.