EMTALA: Ethics and the Law

Dr. Em & Dr. Taul's Emergency Room Adventure   Case 2  Second Opinion A 3-month-old child is evaluated in an emergency room and found to have bronchiolitis.  Treatment is initiated.  As the parents are preparing to leave the emergency room, the nurse who is reviewing discharge instructions with the parents senses that they are still uncomfortable about the child's condition.  She states "If I were you I would go to John Sealy for another opinion." How does EMTALA regard this recommendation? Because the nurse is part of the healthcare team in the emergency room and has made a recommendation for a second opinion, this can be regarded as a violation of EMTALA guidelines.  The emergency facility she suggested has not been informed of the "transfer" or accepted the patient. Since the nurse is only informally advising the parents this cannot be construed as an actual transfer, and no EMTALA violation has occurred. An EMTALA violation would only occur if there were no physicians who have expertise with children at the receiving emergency room. ANSWER