Although medical malpractice cases are typically governed by state law, there are some situations in which federal law may also play a role. For example, the Federal Emergency Medical Treatment and Active Labor Act (EMTALA) sets standards that hospital emergency departments must follow when accepting Medicare patients. Hospitals may be held liable for failing to meet its EMTALA obligations, such as failing to properly screen or treat a patient who presents with a qualifying emergency medical condition.
Pham v. Black
The Georgia Court of Appeals recently addressed the application of EMTALA to a medical malpractice claim against a Georgia-based hospital and several of its doctors. This case began when the now-deceased victim arrived at the hospital’s emergency room complaining of a “racing heart rate.” One of the defendants, Dr. Pham, was on duty that night and had general responsibility for admitting patients to the emergency department.
A second physician, Dr. Trinh, saw the victim and then paged Dr. Pham and a third doctor, a cardiologist, for a consultation. Dr. Trinh diagnosed the victim with a condition known as a thyroid storm. The cardiologist advised admitting the victim to intensive care. Dr. Pham said she did not want to admit the victim “until his heart rate could be lowered.”
While the doctors continued to deliberate, the victim “coded” and needed to be placed on life support. At this point, Dr. Pham decided the patient should not be admitted, but rather transferred to a larger hospital. Dr. Trinh then signed the transfer orders. Unfortunately, the victim coded again and died while en route to the other hospital.
The victim’s estate sued the hospital and all three doctors for medical malpractice. Dr. Pham moved for summary judgment, arguing that since she never personally saw or treated the victim, she never had a “doctor-patient” relationship with him, which is required to sustain a malpractice claim under Georgia law. The trial court denied Dr. Pham’s motion, but the Court of Appeals reversed, holding that Dr. Pham’s “sole involvement with the decedent was consulting with his treating doctors regarding whether he should be admitted to” the hospital and was not enough to create a doctor-patient relationship.
Separately, the Court of Appeals rejected the estate’s argument that EMTALA created a separate cause of action against all three doctors. The appeals court noted that the EMTALA only allows for personal injury claims against hospitals for non-compliance, not the individual doctors.
One judge partially dissented from the Court of Appeals’ decision. Presiding Judge Christopher J. McFadden agreed with the majority with respect to the EMTALA issue, but he disagreed with the conclusion that “no doctor-patient relationship existed between Pham and the decedent.” Judge McFadden noted that there was some evidence that Dr. Pham “made a medical decision regarding the decedent’s care by determining that he should not be admitted,” and that this should be sufficient to preclude granting summary judgment to the defendant.