HospitalInspections.org

Based on interview and record review the facility failed to follow their policy and did not provide a Medical Screening Exam (MSE) to one patient (Patient #5) of 23 sampled Emergency Department (ED) patients.
Findings included:
1. Review of the facility policy titled: EMTALA (Emergency Medical Treatment and Labor Act) last revised 8/09 revealed:
I. It is the policy of the facility to provide patients with emergency medical care that meets or exceeds the requirements of EMTALA. Accordingly, individuals who come to the ED and request examination or treatment (or request is made on their behalf) will receive an appropriate medical screening examination beyond medical triage provided by a qualified medical personnel as determined by the hospital's board of directors.

2. Review of Patient #5's medical record revealed the patient presented to the Emergency Department (ED) on 1/5/10 at 4:37 PM. The patient was taken to exam room 5, but left the facility without receiving a MSE or treatment.

During an interview on 1/27/10 at 10:00 AM, Staff A, Manager of Regulatory Compliance stated Patient #5 was registered as an ED patient, but it was an error. Staff A said Patient #5 presented with a physician's order to receive an outpatient radiological procedure and should have been registered as an outpatient not an ED patient. Staff A said the ED physician on duty did not intend to provide a MSE to Patient #5 because the patient presented for an outpatient procedure not seeking emergency care.

During an interview on 1/27/10 at 9:35 AM, Patient #5 confirmed he presented to the ED on 1/5/10. Patient #5 said he was told by the physician's office to go to the ED to get a MRI Venogram to rule out a deep vein thrombosis (blood clot). Patient #5 said he expected to see the physician since he was going to the ED to see if he had a blood clot. Patient #5 said after registering he sat in the ED waiting room until a nurse took him back to an exam room. On the way to the exam room, Patient #5 said he overheard the ED physician yelling "I don't want him back here". Patient #5 said he did not understand the comment. Patient #5 said he was not seen by the ED physician for the MSE and staff did not encourage him to stay and receive an examination before he left.

Based on interview and record review the facility failed to provide a Medical Screening Exam (MSE) within the capability of the hospital's Emergency Department (ED) for one patient (Patient #5) of 23 sampled patients. This resulted in the delay of the identification of a possible emergency condition.
Findings included:
1. Review of Patient #5's medical record revealed the patient presented to the Emergency Department (ED) on 1/5/10 at 4:37 PM. The patient was taken to exam room 5, but left the facility without receiving a MSE or treatment.
During an interview on 1/27/10 at 10:00 AM, Staff A, Manager of Regulatory Compliance stated Patient #5 was registered as an ED patient, but it was an error. Staff A said Patient #5 presented with a physician's order to receive and outpatient radiological procedure and should have been registered as an outpatient not an ED patient. Staff A said the ED physician on duty did not intend to provide a MSE to Patient #5 because the patient presented for an outpatient procedure not seeking emergency care.
During an interview on 1/27/10 at 9:35 AM, Patient #5 confirmed he presented to the ED on 1/5/10. Patient #5 said he was told by the physician's office to go to the ED to get a MRI Venogram to rule out a deep vein thrombosis (blood clot). Patient #5 said he expected to see the physician since he was going to the ED. Patient #5 said after registering he sat in the ED waiting room until a nurse took him back to an exam room. On the way to the exam room, Patient #5 said he overheard the ED physician yelling "I don't want him back here". Patient #5 said he did not understand the comment. Patient #5 said the ED physician did not examine him before he left and went to a second hospital. Patient # 5 said that staff did not encourage him to stay and receive an examination.