EMTALA, two decades later: A descriptive review of fiscal year 2000 violations

Dustin W. Ballard, Robert W. Derlet, Ben A. Rich, Robert A. Lowe

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Purpose: To determine to what extent cases sanctioned under the Emergency Medical Treatment and Active Labor Act (EMTALA) reflect willful refusal of screening or stabilization. Basic Procedures: The Centers for Medicare and Medicaid Services were petitioned for all confirmed EMTALA citations from year 2000. Each citation was classified into one of three categories: (1) willful refusal to perform a screening exam or to stabilize; (2) possible refusal to screen or stabilize; or (3) no evidence of refusal to screen or stabilize. Citations were reviewed to determine the presence of 10 other characteristics. Three investigators independently reviewed a subset of data to verify acceptable inter-rater reliability. Findings: We received 157 (53%) of the 294 records requested. Of the 131 involving ED personnel, 44 (34%) demonstrated willful refusal of screening or stabilization. Thirty-two (24%) were possible refusals of service, and 55 (42%) contained no evidence of refusal. Principal Conclusion: Emergency department willful refusal of screening and stabilization still occurs despite enforcement of EMTALA.

Original languageEnglish (US)
Pages (from-to)197-205
Number of pages9
JournalAmerican Journal of Emergency Medicine
Issue number2
StatePublished - Mar 2006
Externally publishedYes

ASJC Scopus subject areas

  • Emergency Medicine


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