Ordered Out of an Emergency Room Before Any Testing or Treatment

Attorney Answer

Being rude does not strip you of your rights under federal law. If the hospital determined you had an emergency condition and sent you out unstabilized, its opinion of your behavior is not a defense.

EMTALA, 42 U.S.C. § 1395dd, requires a hospital with an emergency department to provide an appropriate medical screening examination to anyone who comes to the department and requests examination or treatment (§ 1395dd(a)). If the hospital determines that an emergency medical condition exists, it must provide stabilizing treatment within its capabilities before discharge or transfer (§ 1395dd(b), (c)). It may not delay screening or stabilizing treatment to inquire about insurance or payment (§ 1395dd(h)). Pay attention to the trigger on the stabilization duty — it attaches once the hospital determines you have an emergency medical condition, and that determination is exactly what hospitals contest.

In Roberts v. Galen of Virginia, Inc., 525 U.S. 249 (1999), the Supreme Court held that § 1395dd(b) contains no express or implied improper-motive requirement: a plaintiff need not prove the hospital's failure to stabilize was motivated by indigency, race, sex, or any other improper reason. That is the answer to "they threw me out because I was cussing" — the reason does not have to be proven, and it does not excuse the failure. The Court expressly reserved whether a screening claim under § 1395dd(a) requires improper motive, so this helps the stabilization theory specifically.

The closest case to yours is Richard Thomas v. Christ Hospital and Medical Center, 328 F.3d 890 (7th Cir. 2003), which binds federal courts in Indiana. There, summary judgment for the hospital was reversed where the emergency department staff's own contemporaneous observations showed the patient may have been unstable at discharge. The court explained that under the applicable federal guidance a psychiatric patient is stabilized only if no longer a threat to self or others, and that threat is not limited to patients who are suicidal or homicidal. What matters is the facts known to the hospital's staff at the time of discharge, not how things turned out afterward. That patient was agitated and uncooperative too, and the hospital's own notes were what defeated its motion.

What you can do

1. Request your complete emergency department record in writing today — triage notes, vital signs, nursing and physician notes, discharge or against-medical-advice paperwork, and any security incident report. That record is the case. 2. Write down, with times, what you told them about your symptoms and what each person said back, including who told you to leave. 3. Get evaluated somewhere else now if the symptoms continue. That second record documents the condition that existed when you were sent out. 4. File an EMTALA complaint with the Indiana state survey agency for the federal Centers for Medicare & Medicaid Services. It is free, requires no lawyer, and triggers an investigation of the hospital. 5. File a written grievance with the hospital and keep its written response. 6. Take everything to an Indiana medical malpractice attorney early, because of the review panel step below.

⏱ Time limits apply. Ind. Code § 34-18-8-4 bars an action against a covered health care provider from being commenced in court until the proposed complaint has been presented to a medical review panel and the panel has given its opinion — a step that takes substantial time, though limited exceptions exist. Ind. Code § 34-18-7-1 sets an occurrence-based two-year limitations period running from the date of the act, omission, or neglect, not from when you discover an injury. The federal EMTALA claim under 42 U.S.C. § 1395dd carries its own two-year limit. All of these depend on your specific dates, so start now.