I think the ER stole my patient

[Just Plain Ruff]

Ruff, EMTALA covers that situation specifically, as you noted. If the hospital choose to try to intervene in this case, I'd probably tell them to take a flying fornication at a rolling donut and get out of my truck. We can deal with the specifics later, including forwarding them a copy of the applicable EMTALA regulation later.

Actually back in the early 90's EMTALA had not been as fully fleshed out as it is now.

The hospital was trying to say that once I put a wheel on their property, that patient was theirs. I disagreed with them.

About 2 years later the actual verbage for helipads came out and they said something to the effect that if you are using a landing pad on the hospital property solely for a secured landing zone then the hospital cannot say that the patient is theirs.

Funny thing was that the physicians both at the hospital (not the ER doc who refused us at first) but the Hospital medical director and also the children's hospital physicians all backed me and my decision. They said the child would most likely have died if I took the patient to that ER since they didn't have the trauma team there or the surgeons to work on this kids brain/skull.

The hospital administration was making a big deal out of it because an incident report was filed and whatnot. I can't really remember who had the bigger issue, the administration of the hospital or the ED nursing administration because I refused the nurses/doctors orders to bring the patient in after they refused him in the first place.

I think it was really an ego trip because this particular hospital had just received it's Level 2 trauma center rating about 3 months earlier and they weren't getting the numbers that they thought they would be getting.

It all boiled down to politics if you ask me and not what was best for the patient. My first priority was for the patient and I don't do politics very well.

[ERDoc]

It's funny how EMTALA covers helipads. When I first started working at a rural hospital it freaked me out that they would use the helipad. I was told that the hospital lawyers had looked into it and said it was okay. The assumption is that the patient is being accepted by the ultimate receiving hospital so the helipad hospital is not involved. I agree, it is a much safer place to land a helicopter so why not use it. I don't know if this has ever been tested in court, so it would be interesting to see what would happen. At the same hospital though we had an ambulance who had an ortho patient and wanted us to come out to the ambulance bay to see if they should bring the pt to us or to the trauma center. They weren't too happy when we said we wouldn't be doing that. They were told that they would need decide what the better destination would be for the pt based on their assessment.

[firecoins]

I had a similiar experience. Somebody got hit by a car on the street in front of the ER. A bystander called 911 and a family member alerted the ER staff. The ER staff responded with their own equipment and were treating the patient before we arrived. I had no problem with the ER staff doing this but the patient was off hospital property, on a street. None of them were watching traffic while they were on the street. All I needed was another car to plow into the ER staff on top of the patient they were treating. How do you explain that?! An MCi made up of the ER staff. The thought was frightening.I had to stop traffic and make sure the ER staff was safe as well as the patient.

The ER staff insisted I write a PCR because the patient was off hospital property and they were not covered by insurance to do such. So I ended up covering the hospital and their staff in both safety and liability. I didn't care for that aspect. The patient did fine and had only minor injuries.

Edited June 14, 2011 by firecoins