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Sunday, January 24, 1999 Mychelle Williams, 18 months old, died of a treatable infection that a simple blood test would have detected--a victim both of malpractice and patient dumping, a Compton jury decided. The facts in Mychelle's case are harrowing: An ambulance picked the little girl up from her grandmother's Compton home in May 1993 and took her to Martin Luther King Jr./Drew Medical Center, the nearest hospital. Dr. Trach Phoung Dang then gave Mychelle medication for her fever and other ailments and intravenous liquids for dehydration. He wanted to run blood tests to determine why the feverish, limp girl, who her mother said had been fine just hours earlier, was now so desperately ill. But the girl's family belonged to the Kaiser health maintenance organization, and Kaiser's Dr. Brian Thompson repeatedly told King/Drew that the tests should be done at Kaiser. Dang suggested three times that King do the tests before a transfer. As the little girl's condition deteriorated, her mother, Dawnelle Keys, now 37,pleaded with doctors for more aggressive treatment. But the child could not be given antibiotics until after a blood test, and wasn't given the blood test because Kaiser wanted to do the tests. After 2 1/2 hours at the hospital, the girl suffered a seizure. The hospital's response to her mother's panicky demands for help was to summon security guards to escort her out of the building. By the time the toddler reached Kaiser--four hours after she arrived at King--she was near death. Her heart stopped about 20 minutes later, and she could not be revived. The family sued, alleging that the doctors at both King/Drew and Kaiser had committed malpractice and that King/Drew should have tested the child even if Kaiser did not pay for it. The jury found that both doctors had been negligent. Jurors also ruled that King/Drew had violated the federal anti-dumping law, known formally as the Emergency Medical Treatment and Active Labor Act. The 1986 federal anti-dumping law prohibits hospitals from transferring or discharging patients known to have emergency conditions, regardless of the patient's ability to pay. "The
child died because of her insurance status." "I saw my daughter die slowly. A lot of people are losing their loved ones the same way I lost my daughter. They slip right through." Copyright 1999 Los Angeles Times. All Rights |
Patient Dumping Guidelines for HMO Enrollees Cases of patient dumping seem to be increading, prompting the Special Advisory Bulletin alerting hospitals and doctors to their legal obligations to provide emergency medical care to plan members. The proposed guidance will explain the Federal law prohibiting the denial of emergency care to patients, and will detail the government's position as to how the law applies to enrollees in health maintenance organizations (HMO) and other types of managed care plans. "This proposed guidance will make clear that despite the terms of any managed care agreements between plans, hospitals, and enrollees, Federal law requires that stabilizing medical treatment be provided in an emergency, regardless of the patient's managed care provider." "Anyone who believes
they are experiencing a medical emergency-- Treatment must be provided if an emergency medical condition exists, and the condition must be stabilized before the patient is discharged. Furthermore, a hospital is not permitted to delay the provision of an appropriate medical screening examination or further stabilizing treatment in order to inquire about an individual's method of payment, insurance status, or prior authorization. "Investigations of patient dumping allegations have persuaded us that managed care patients may more likely be victims of dumping than other patients." While hospitals sometimes feel caught between the obligations imposed under the statute and the expectations of managed care plans, they clearly must abide by the statute in these cases."
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