U.S. Court of Appeals for the Seventh Circuit Confirms the Dismissal of a Claim of “Patient Dumping”

An Indiana University Hospital did not violate a law prohibiting patient dumping when it sent a woman suffering from severe abdominal pain to another facility to have dying portions of her intestines removed. The U.S. Court of Appeals for the Seventh Circuit in Chicago declined to revive the lawsuit that Jodie Martindale’s husband filed against Indiana University Health Bloomington Hospital under the Federal Emergency Medical Treatment and Labor Act (EMTALA or Treat Act) following his wife’s death. IU Health transferred Martindale to Community Healthcare Systems in Munster, Ind., after examining her. Martindale died at Community Hospital after ongoing intestinal surgery.

A panel of the Seventh Circuit rejected the argument that the Treatment Act required IU Health to stabilize Martindale before transferring her.

The panel acknowledged the Treatment Act generally bars a hospital from transferring a patient with an emergency medical condition if the patient has not been stabilized.

But a provision of the act sets out two narrow exceptions of the general rule.

Quoting Section 13.95(dd)(c), the opinion stated that a hospital may send a patient who has not been stabilized to another facility if the patient asks for the transfer in writing “after being informed of the hospital’s obligations under [Treatment Act] and of the risk of transfer.”

Or a hospital may transfer a patient who has not been stabilized if a physician certifies in writing that “the medical benefits reasonably expected from the provision of appropriate medical treatment at another medical facility outweigh the increased risks to the individual” from a transfer.

If either of these two situations exists, a hospital may transfer the patient, but only if the transfer meets the four conditions required for the transfer to be “appropriate.”

IU Health’s transfer of Martindale met all of the requirements of the Treatment Act, the opinion stated. The U.S. Court of Appeals in Chicago upheld the decision by the U.S. District Court judge of the Southern District of Indiana, granting summary judgment in favor of IU Health and the dismissal of the lawsuit filed by Martindale’s husband, Kenneth Martindale.

After Jodie Martindale arrived at IU Health’s emergency room one morning in January 2017, doctors there determined she needed emergency surgery to remove parts of her intestines. The doctors thought, incorrectly, that her condition was related to the gastric bypass surgery she had previously undergone. They arranged for her to be transferred to Community Hospital so that the doctor who had performed the gastric bypass could perform the new surgery.

She developed sepsis and suffered multiple organ failure following the surgery and died two days later. She was just 50.

Kenneth Martindale sued IU Health in January 2019. The trial judge granted summary judgment to IU Health in September 2021 and the U.S. Court of Appeals upheld that ruling.

In the U.S. Court of Appeal’s opinion, the panel wrote that the Treatment Act requires a hospital to examine everyone who comes to the emergency room to determine if they have an “emergency medical condition.”

The act states such a condition involves “acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to” threaten a patient’s health or impair his or her body functions or organs.

If the patient has an emergency medical condition but has not been stabilized, the hospital still may transfer the patient if the transfer satisfies Section 1395(dd)(c)’s four “appropriate” conditions. Three of the conditions require the transferring hospital to locate a hospital “with available space and qualified personnel” that “has agreed to accept transfer” and then treat the patient; to provide the transferee hospital with “all medical records” that are “related to the emergency condition;” and must make the transfer using “qualified personnel and transportation equipment.” Martindale argued that the only way University Health could have minimized the risks to his wife was by performing the surgery needed to stabilize her before transferring her. However, the Treatment Act does not address whether a hospital had the capacity to stabilize the patient before transfer. Instead, the act addresses only whether it is appropriate to transfer a patient before he or she had been stabilized. Martindale’s transfer met the requirements set out in Section 1395(dd)(c).

Kenneth Martindale v. Indiana University Health Bloomington Inc., No. 21-3015 (U.S. Court of Appeals for the 7th Circuit).

Kreisman Law Offices has been handling medical malpractice lawsuits, hospital negligence cases, nursing negligence lawsuits, birth trauma injury cases, obstetrician negligence lawsuits and wrongful death cases for individuals, families and loved ones who have been harmed, injured or died as a result of the carelessness or negligence of a medical provider for more than 45 years in and around Chicago, Cook County and its surrounding areas, including Rosemont, Evergreen Park, Tinley Park, Arlington Heights, Orland Park, Elmhurst, Winthrop Harbor, Glenview, Itasca, Inverness, South Holland, Chicago (Humboldt Park, Bridgeport, McKinley Park, Little Village, West Garfield Park, Logan Square, Ukrainian Village, Portage Park, Uptown, Andersonville, Buena Park, Ravenswood Gardens, Irving Park East, Albany Park, Jefferson Park, Union Ridge), Des Plaines, Park Forest and Crestwood, Ill.

Robert D. Kreisman has been an active member of the Illinois and Missouri bars since 1976.

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