Consumer group finds hundreds of EMTALA violations

Public Citizen says hospitals must do a better job of caring for uninsured emergency patients; hospitals say patient dumping is rare.

By Tanya Albert, AMNews staff. July 30, 2001.

The government cited 527 hospitals in the United States and Puerto Rico -- about 9% of all hospitals -- for violations of the Emergency Medical Treatment and Active Labor Act over the past several years, according to a new report by Public Citizen.

The consumer watchdog group, founded by Ralph Nader, called the violations a "disgrace."

"It's distressing that this law has been in place for 15 years and hospitals are still [flouting] it," said Sidney M. Wolfe, MD, director of Public Citizen's Health Research Group and co-author of the report. "The government needs to do more to force the hospitals to comply."

Congress enacted EMTALA in 1986 to stop hospitals from turning away patients without insurance -- a practice commonly called patient dumping.

Public Citizen's sixth report on the issue, which covered violations in 1997, 1998, 1999 and parts of 1996 and 2000, confirmed violations at hospitals in 46 states, the District of Columbia and Puerto Rico. Delaware, Hawaii, New Mexico and Wyoming were the four states where no hospitals had confirmed violations.

The report highlights the most egregious violations, including an incident in which a surgeon repeatedly refused to come in to see a patient with a suspected abdominal condition requiring surgery. After the surgeon arrived, he made disparaging remarks about the patient's mental retardation, according to the report. The patient died.

Dr. Wolfe said the $50,000 fine associated with an EMTALA violation needs to be increased and fines need to be enforced more often to deter hospitals. Of the 500 hospitals that could have been fined during the study period, only 85 had been charged as of April, according to the report. [...]