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Can You Sue a Hospital or Doctor for Denying Medical Treatment?

Doctor and nurses rushing critical patient to emergency room.

Roughly 130 million emergency department visits occur in the U.S. every year, according to the Centers for Disease Control and Prevention. Under Federal law, private hospitals with Medicare approval must provide emergency care to patients in need, regardless of their insurance status or ability to pay. However, there are exceptions to this rule.

If a hospital or urgent care clinic denied you treatment and you suffered health problems because of it, you may have the right to file a medical malpractice lawsuit to seek compensation. To learn more about your legal options, contact The Law Offices of Dr. Michael M. Wilson M.D., J.D. & Associates in Washington, D.C. for a free and confidential initial consultation.

Can a Washington, D.C. Hospital Legally Refuse Treatment?

Most hospitals must provide emergency treatment to anyone who needs it, whether they can pay for the treatment or not. However, this was not always true.

In the past, no laws required private hospitals to provide care. Private facilities frequently refused to treat patients who didn’t have the means to pay. They would transfer them indiscriminately to public hospitals in a practice known as “dumping.” This transfer sometimes meant patients were dumped even as they suffered from serious medical emergencies. Sadly, many died or saw their conditions worsen as a result.

Then, in 1986, the federal government enacted the Emergency Medical Treatment and Active Labor Act (EMTALA) as a nationwide anti-dumping measure. Under EMTALA, private hospitals that receive public funds through Medicare must provide emergency care to patients in need, regardless of their ability to pay. Now, hospitals are also legally prohibited from releasing a patient to another facility or refusing additional treatment until the patient is stable.

However, not all medical facilities are subject to the provisions of EMTALA. For example, private doctor’s offices, hospitals without emergency departments, and medical labs are not required to provide emergency care. However, recent amendments and court decisions have asserted that EMTALA rules apply to hospital-affiliated urgent care clinics.

Of course, just because most private hospitals are required to treat you does not mean you are entitled to immediate care. Triage nurses in emergency departments are trained to assess patients’ conditions and prioritize treatment. It’s not the same as the hospital denying you care if you wait several hours to be seen for a broken wrist because other patients with heart attack symptoms or other critical conditions receive treatment first.

There are also circumstances under which a hospital has the right to deny patients emergency medical care, including when:

  • Patients appear to be seeking treatment primarily to obtain drugs.
  • Patients have delusions of suffering from an illness despite not being ill.
  • Patients behave destructively or dangerously while awaiting care.

Under What Circumstances Can a Doctor Refuse to Treat a Patient?

Doctor refusing patient a check up.EMTALA provisions do not apply to private doctors. These providers have the right to refuse care to patients for almost any reason, including the inability to pay. Doctors are prohibited from refusing treatment only if their decision is based on some form of illegal discrimination. These discriminations include age, gender, sexual orientation, race, nationality, or religion.

Private doctors can refuse to provide treatment to new patients if:

  • The doctor’s office is not accepting any new patients.
  • You are unable to pay for the costs of the treatment you need.
  • The doctor’s office does not take your health insurance.
  • The doctor has decided not to treat patients with your illness or injury.
  • You or your spouse practice as a medical malpractice lawyer.

Furthermore, private doctors can refuse to provide treatment to existing patients if:

  • You have not paid for treatment received from them in the past.
  • The doctor’s office decided to stop accepting your health insurance.
  • You have exhibited repeated or persistent drug-seeking behavior.
  • You have been disruptive or destructive as a patient.
  • The doctor chooses not to provide care due to religious or conscientious beliefs.

If you are an existing patient who would suffer adverse health effects without continued treatment, your doctor is legally required to provide treatment until you can locate a new doctor. You may have grounds for a medical malpractice case if your condition deteriorates because your doctor refused to provide care.

What Is The Emergency Medical Treatment and Active Labor Act?

EMTALA was signed into law to prevent private hospitals from “dumping” patients with emergency medical conditions or women in active labor.

Under EMTALA, an emergency medical condition is defined as any condition with a sudden onset and symptoms. Symptoms include intense pain, psychiatric disruption, substance abuse withdrawal, or other symptoms that could lead to:

  • A severe impairment of bodily function
  • A serious dysfunction of a body part or bodily function
  • Jeopardizing the patient’s health
  • Jeopardizing an unborn child’s health

The provisions of EMTALA prohibit hospitals from releasing or transferring patients until they are stabilized. Once a patient’s condition is stable, hospitals have the right to release the patient, transfer them, or refuse to provide additional care.

How Can a Washington, D.C. Medical Malpractice Attorney Help Me?

If you believe a hospital or urgent clinic wrongfully denied you treatment, you have the right to seek compensation by filing a medical malpractice claim. A trusted medical malpractice attorney can help you by:

  • Reviewing the details of your situation to determine whether you have grounds for a medical malpractice case
  • Conducting an independent investigation to determine how the hospital or clinic wrongfully denied you treatment and how that denial affected your health
  • Managing every aspect of your claim for you, from handling necessary claim paperwork to communicating on your behalf
  • Negotiating aggressively to pursue maximum compensation for your case
  • Taking your case to court and representing you at trial, if necessary

At the Washington, D.C. Law Offices of Dr. Michael M. Wilson M.D., J.D. & Associates, our principal attorney Dr. Michael Wilson has training as both a doctor and a lawyer. Dr. Wilson’s background allows him to provide insights into his clients’ malpractice cases by analyzing legal and medical factors through a unique professional lens.

To learn more about your legal options, contact us today for a free claim review. We will not charge a fee unless and until we secure compensation for you. Our dedicated team can begin work on your case promptly and work toward the compensation you deserve.

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