HospitalInspections.org

Based on review of facility documents and staff interviews (EMP), it was determined that the facility failed to comply with ?489.24 and failed to follow their adopted policies in relation to the Emergency Medical Screening Treatment & Transfer [EMTALA].

Findings include:

Review of facility policy "Emergency Medical Screening, Treatment & Transfer Policy (EMTALA)" dated October 2010, revealed "(1) Any individual who comes to the Hospital Emergency Department requesting examination or treatment shall be provided with an appropriate medical screening examination (MSE) ... (4) The medical screening examination shall include ancillary services routinely available to the Emergency Department. The medical screening examination must be similar for patients presenting with similar symptoms. ... (6) The purpose of the medical screening examination is to determine if an individual is experiencing an emergency medical condition. (a) An "emergency medical condition" is a condition manifesting symptoms (including severe pain, psychiatric disturbances and/or symptoms of substance abuse) which, in the absence of immediate medical attention, is likely to cause serious dysfunction or impairment to a bodily organ or function or serious jeopardy to the health of the individual or unborn child."

1) Telephone call from EMP9 on January 20, 2011, to report that a patient presented to The Washington Hospital by ambulance and that EMP13 told the ambulance personnel to take the patient to another facility without the patient receiving a medical examination.

2) Review of the ambulance trip sheet dated January 19, 2011, revealed "07:58 5402 arrive TWH (The Washington Hospital), met at ER (emergency room) door by two ED techs at TWH [ED techs told ambulance personnel] ED Physician ... refuse[sic] pt (patient) and evaluation stating ... is to be transported to ... trauma facility."

Based on review of facility policy, facility documents, and interview with staff (EMP), it was determined that the facility failed to provide an appropriate medical screening examination within the capability of the hospital's emergency department, including ancillary services routinely available to the emergency department, to determine whether or not an emergency medical condition exists for one of one patient (PT1).

Findings include:

Review of facility policy "Emergency Medical Screening, Treatment & Transfer Policy (EMTALA)" dated October 2010, revealed "(1) Any individual who comes to the Hospital Emergency Department requesting examination or treatment shall be provided with an appropriate medical screening examination (MSE) ... (4) The medical screening examination shall include ancillary services routinely available to the Emergency Department. The medical screening examination must be similar for patients presenting with similar symptoms. ... (6) The purpose of the medical screening examination is to determine if an individual is experiencing an emergency medical condition. (a) An "emergency medical condition" is a condition manifesting symptoms (including severe pain, psychiatric disturbances and/or symptoms of substance abuse) which, in the absence of immediate medical attention, is likely to cause serious dysfunction or impairment to a bodily organ or function or serious jeopardy to the health of the individual or unborn child."

1) Telephone call from EMP9 on January 20, 2011, to report that a patient (PT1) presented to The Washington Hospital by ambulance and that EMP13 told the ambulance personnel to take the patient to another facility without the patient receiving a medical examination.

2) Review of the ambulance trip sheet dated January 19, 2011, revealed "07:58 5402 arrive TWH (The Washington Hospital), met at ER (emergency room) door by two ED techs at TWH [ED techs told ambulance personnel] ED Physician ... refuse[sic] pt (patient) and evaluation stating ... is to be transported to ... trauma facility."

3) Interview with EMP9 on January 24, 2011, at approximately 10:00 AM when asked if there was any documentation that the patient presented to the facility, EMP9 stated "No, they[ambulance personal] never took (PT1) out of the ambulance."

4) Interview with EMP11 on January 24, 2011, at approximately 11:00 AM confirmed that there was no documentation that the patient presented to the facility or that a medical screening was completed.

5) Interview with EMP12 on January 24, 2011, at approximately 11:35 AM revealed "There was no communication that day, we [physicians] talk with them [ambulance personnel] and decide what we [physicians] want to do with the patients and it didn't happen."