The definition provided under the statute is:
"A medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in --
placing the health of the individual (or, with respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy,
serious impairment to bodily functions, or
serious dysfunction of any bodily organ or part, or
"With respect to a pregnant woman who is having contractions --
that there is inadequate time to effect a safe transfer to another hospital before delivery, or
that the transfer may pose a threat to the health or safety of the woman or her unborn child.
...and here are the relevant court cases:
12. What if an emergency medical condition is not properly diagnosed at the transferring hospital?
If the patient is erroneously diagnosed, and the physician mistakenly believes that he does not have an "emergency medical condition", when in fact he does, several courts have held that the statute does not apply to that case. Urban v. King, 834 F Supp 1328 (1993). There could, of course, be a claim for professional negligence for failure to make a diagnosis under State malpractice law in this situation.
The court in Jones v. Wake County Hospital System, Inc., 786 F.Supp. 538 (E.D.N.C. 1991) stated that EMTALA requires only that a medical screening procedure be established and that it be followed in every case, without regard to ability to pay, and that EMTALA is not violated even if the screening procedure is insufficient under state malpractice law.
Some of the cases have suggested otherwise, however. There was a brief mention in Deberry v. Sherman Hospital Association, 741 F. Supp. 1302 (N.D. Ill.1990), to the effect that a hospital could be found to be in violation of EMTALA for failure to diagnose an emergency medical condition through an inadequate screening procedure. This principle is at least implicitly recognized in other cases as well. See, for example, Power v. Arlington Hospital, 42 F3d 851 (4th Cir 1994) (failure to order CBC, leading to missed diagnosis of sepsis).
The most prominent case on this point is Summers v. Baptist Medical Center of Arkadelphia, 69 F.3d 902 (8th Cir. 1995), rev on reh en banc 91 F.3d 1132 (1996). In that case, an examination of a patient who had fallen from a tree stand while hunting was allegedly incomplete because a chest x-ray had not been included when a set of spinal x-rays was ordered. The physician did not believe that the patient had any fractures, and discharged him home, with instructions. There was no transfer to another facility involved. The patient presented at another hospital two days later, and he was diagnosed with an acute comminuted vertebral fracture, a sternal fracture, and bilateral hemopneumothoraces secondary to untreated rib fractures.
The original decision of the three-judge Court of Appeals was that the Complaint did state a claim on which relief may be granted, and that the failure of a doctor to follow what he admitted was a standard screening diagnostic protocol supported a claim for a violation of EMTALA. When the case was decided on rehearing by the full Eighth Circuit, sitting en banc, this decision was reversed and it was held that providing a screening examination, even if it is negligent under state-created malpractice law, is sufficient to provide full compliance with EMTALA, and that only disparate treatment in the screening process would support a claim. Further information on this case is found at the EMTALA.COM site,
Summers.
FAQ on EMTALA