Court ruling makes it easier to sue hospitals Plaintiffs who allege 'patient dumping' may now bypass state arbitration

June 26, 1993|By Norris P. West | Norris P. West,Staff Writer

A federal appeals court has made it easier for patients to sue hospitals by accusing them of violating a so-called patient-dumping law.

The 4th U.S. Circuit Court of Appeals ruled that a Baltimore man can proceed with his federal lawsuit against Maryland General Hospital and the University of Maryland Medical System, both of which he accuses of failing to treat him promptly for neurological problems.

Robert M. Brooks, 54, a former truck driver, said that Maryland General's emergency room personnel refused to treat him and that he endured a long wait at the UM Medical System's emergency room. He charges that delays caused him permanent spinal damage.

Lawyers for the hospitals had argued that Mr. Brooks could not sue the hospitals until the case was reviewed by the Maryland Health Claims Arbitration Office, which reviews malpractice complaints.

But the federal appeals court said cases alleging only "patient dumping" -- and not malpractice -- do not have to go before state arbitrators before being taken to federal court.

The appeals court reinstated Mr. Brooks' 1991 federal suit, which was dismissed in June 1992 by U.S. District Judge John R. Hargrove.

In an opinion written by Circuit Judge Paul V. Niemeyer, the court ruled Monday that the hospitals could be liable in federal court for violating the Emergency Medical Treatment and Active Labor Act.

The 1986 law aims to prevent hospitals from turning away patients who cannot afford to pay for emergency-room treatment. It requires hospitals to screen all patients and treat every emergency condition.

"In a world of shrinking rights that people have with their health providers, this is a reprieve," said Mark E. Herman, a lawyer for Mr. Brooks.

This was the first time a federal appeals court has ruled that a patient does not have to go before a state health claims arbitrator -- in states that have them -- because a patient-dumping suit can be filed.

Mr. Herman said the arbitration process is lengthy and expensive for anyone trying to sue a hospital for patient dumping. He said costs usually run between $2,500 and $3,000, and he noted that an arbitrator's decision is not binding.

"It seemed inconsistent to have a law to try to help poor people and then burden them with another layer of litigation," he said. "You would figure that if patients were able to afford arbitration, they would have been able to afford to pay for treatment."

Jeffrey G. Cook, an attorney for two doctors sued in the case, said he was pleased with another part of the court's ruling that dismissed his clients from the suit -- the court said patient-dumping charges may only be brought against hospitals, not personnel.

But Mr. Cook said he was disappointed that the court has made it possible for patient-dumping claims to bypass state arbitrators.

Lawyers for the hospitals maintained, however, that few cases would be affected by the decision.

"Of all the malpractice cases filed in this state, only a small amount applies to emergency room care, and [the patient-dumping law] applies only to emergency room care," said Michael J. Baxter, a lawyer for Maryland General.

Nancy M. Fiedler, a spokeswoman for the Maryland Hospital Association, said she doesn't expect many federal cases to be filed because hospitals in the state "treat first and ask questions about payment later."

"My sense is that it is rare that a situation like that will ever occur," Ms. Fiedler said.

The state health arbitration office does not keep figures on how many of its cases allege patient-dumping violations, said docket clerk Darryl Washington. There were 545 cases overall filed with the office last year, and 181 cases filed by April 27 this year, he said.

Mr. Brooks filed his federal lawsuit Sept. 30, 1991, claiming that he had gone to the Maryland General emergency room Oct. 5, 1989, with complaints of acute weakness and a sudden inability to walk. He says he had no medical insurance at the time.

He says he waited more than six hours before being examined, but still was not treated or evaluated for his problems. About 3 1/2 hours later, he was transferred to UM's emergency room. He says it was three hours before he received a CAT scan and other tests and that he had to wait three days for the result.

He contends that the delay in treatment caused him to suffer permanent spinal cord damage.

Susan T. Preston, a lawyer for UM Medical System, disputed Mr. Brooks' claims. She said the hospital followed its requirements under the federal patient-dumping law and that she would file another motion to dismiss the suit.

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