Case Study

Five auto accident patients, two with severe head injuries and internal abdominal injuries and bleeding who were later transferred to another hospital were brought by ambulance in the early morning hours to the emergency room of a small rural hospital in south Williamson, Kentucky. The Williamson Hospital had no trauma center, had no equipment for monitoring the effect of anesthesia on the brain during surgery, and had a longstanding policy of not performing neurosurgery on the injuries to the brain. Rather, as on the evening of the events in question, it always transferred such patients to other larger hospitals, with trauma centers and the medical expertise and equipment to perform brain surgery.

Dr. Cherukuri, the attending physician on call that night at Williamson Hospital decided to transfer the two patients with head injuries to the trauma center at St. Mary’s Hospital, 85 miles away. He did so before operating on their stomach injuries which would have stopped internal bleeding. He also effected the transfer an hour before receiving express consent to transfer from the physicians at St. Mary’s Hospital. A lawsuit against Dr. Cherukuri and the Williamson Hospital was filed, citing violations under EMTALA.

What ruling do you believe is justified, given what you know about EMTALA provisions?