Published online by Cambridge University Press: 20 January 2021
The lesson of this column is: In an emergency, treat first and ask legal questions later. This is both good medicine and good law.
There is no universally recognized definition of an emergency, and the law will generally accept the determination of health care professionals, if consistent with accepted practice, in defining an emergency condition or situation. The most common definition is that an emergency is any injury or acute medical condition liable to cause death, disability, or serious illness if not immediately attended to.
Obvious examples of emergency conditions that require the immediate attention of a physician or properly trained health professional to prevent loss of life include:
Massive hemorrhage from major vessels
Cardiac arrest
Cessation or acute embarrassment of respiration
Profound shock from any cause
Rapidly acting poison
Anaphylactic reactions
Acute epidural hemorrhage
Acute overwhelming bacteremia and
toxemia
Severe head injuries
Penetrating wound of the pleura or pericardium
Rupture of an abdominal viscus
Acute psychotic states.
This article is from a chapter entitled “Emergency Care” in Annas GJ, Glantz LH, and Katz B, The Rights of Doctors, Nurses & Allied Health Professionals, available at bookstores or from Avon Books, New York for $3.95. © 1981 by the American Civil Liberties Union.
1. Flint, Emergency Treatment and Management, 88 (3rd ed.; Philadelphia: Saunders, 1964).Google Scholar
2. Wilmington Gen. Hosp. v. Manlove, 54 Del. 15,174 A.2d 135 (1961).
3. See Powers, , Hospital Emergency Service and the Open Door, 66 Mich. L. Rev. 1455 (1968)CrossRefGoogle Scholar.
4. Stanturf v. Sipes, 447 S.W.2d 558 (Mo. 1969). And see Fabian v. Macyko, 344 A.2d 569 (Pa. Super. 1975) (phone call to emergency room alone insufficient to create reliance).
5. Williams v. Hospital Auth. of Hall County, 119 Ga. App. 626, 168 S.E.2d 336 (1969).
6. Guerrero v. Copper Queen Hosp., 112 Ariz. 104, 537 P.2d 1329 (1975).
7. Mercy Medical Center of Oshkosh v. Winnebago County, 206 N.W.2d 198 (Wis. 1973).
8. East. Ky. Welfare Rights Org. v. Simon, 506 F.2d 1278 (D.C. Cir. 1974), vacated on other grounds, 426 U.S. 26 (1976). Compare Newsom v. Vanderbilt U., 453 F. Supp. 401 (M.D. Tenn. 1978) (Indigents must be afforded due process in distribution of free care required by Hill-Burton).
9. Wilmington Gen. Hosp. v. Manlove, 54 Del. 15,174 A.2d 135 (1961). On the effectiveness of nurses in this role see Albin, et al., Evaluation of Emergency Room Triage Performed by Nurses, 65 Am. J. Pub. Health 1063 (1975)CrossRefGoogle ScholarPubMed.
10. Fjerstad v. Knutson and Sioux Valley Hosp., 271 N.W.2d 8 (S.D. 1978); 291 N.W.2d 786 (S.D. 1980).
11. O'Neil v. Montefiore Hosp., 202 N.Y.S.2d 436,11 A.D.2d 132 (App. Div. 1960); and see Carr v. St. Paul Fire & Marine Ins. Co., 384 F. Supp. 821 (W.D. Ark. 1974) (involving the negligent actions of an LPN and two orderlies) and Dumer v. St. Michael's Hosp. 69 Wis. 2d 766 233 N.W.2d 372, (1975) (emergency room nurses and attendants do not make medical diagnoses). And see Hicks v. United States, 368 F.2d 626 (4th Cir. 1966).
12. See, e.g., Campbell v. Mincey, 413 F. Supp. 16(N.D. Miss. 1975), aff'd mem., 542 F.2d 572 (5th Cir. 1976). (The authors cite this case, but note that it involves childbirth, seldom considered by the court an emergency conditioners?, and that the case may well have been decided against the plaintiff because she was black.)
13. Wilmington Gen. Hosp. v. Manlove, 54 Del. 15, 174 A.2d 135 (1961).
14. New Biloxi Hosp. v. Frazier, 245 Miss. 185, 146 So. 2d 882 (1962).
15. Letourneau, Legal Aspects of the Hospital Emergency Room, 16 Clev.-Mar. L. Rev. 50, 60 (1967)Google Scholar.
16. Citizens Hospital Assoc, v. Schoulin, 48 Ala. 101, 262 So. 2d 303 (Ala. App. 1972). See also Thomas v. Corso, 265 Md. 84, 288 A.2d 379 (1972).
17. O'Neill v. Montefiore Hosp., 202 N.Y.S.2d 436 (1960).
18. McEachern v. Glenview Hosp., 505 S.W.2d 386 (Tex. Civ. App. 1974); and see Modave v. Long Isl. Jewish Medical Center, 501 F.2d 1065A (2d Cir. 1974), and Olson, Be Ready for Out-of-Control EW Patient, HOSPITAL MED. STAFF (Nov. 1978) at 20.
19. Jones v. City of New York, 134 N.Y.S.2d 779 (Sup. Ct. 1954), modified, 143 N.Y.S.2d 628 (App. Div. 1955).
20. Methodist Hosp. v. Ball, 50 Tenn. App. 460, 362 S.W.2d 475 (1961). See also Mulligan v. Wetchler, 332 N.Y.S.2d 68 (Sup. Ct. 1972).
21. 42C.F.R. §405.191 (b)(2) (1973).
22. Brewerton v. Finch, 320 F. Supp. 68 (N.D. Miss. 1970).
23. LeJeune Rd. Hosp. v. Watson, 171 So. 2d 202 (Dist. Ct. App. Fla. 1965).
24. N.Y. PUB. HEALTH LAW. §2805-b (1) (1973).
25. Mercy Medical Center of Oshkosh v. Winnebago County, 206 N.W.2d 198, 201 (Wis. 1973).
26. Harper v. Baptist Medical Center, 341 So. 2d 133 (Ala. 1976). And see Nance v. James Archer Smith Hosp., 329 So. 2d 377 (Fla. App. 1976).
27. Reported in American Medical News, Jan. 19, 1979, at 11. See also Medical World News May 15, 1978, at 39-40, discussing refusal of entry case involving a $500 deposit. Woman died of meningitis complications a few days later. A verdict of $950,000 was returned against the physician who turned the patient away. Cf. Kucera, Narrow Definition of Emergency Can Spell Litigation, HOSPITAL MED. STAFF (Sept. 1978) at 21, 22-23.
28. Annas, , Law & Medicine: Myths and Realities in the Medical School Classroom, 1 Am. J. Law & Med. 195 (1975)Google ScholarPubMed.
29. Regulations of the Massachusetts Board of Registration in Medicine, 243 CMR 2.06 (10) (a).
30. See generally Zaremski, , Good Samaritan Statutes: Do They Protect the Emergency Care Provider? 7 (1) Medicolegal News 5 (Spring 1979)CrossRefGoogle ScholarPubMed; and see Scanlon, , The Malpractice Aspects of Emergency Care by Non-Physicians, 12 Gonz. L. Rev. 676 (1977)Google Scholar.
31. Zaremski, supra note 34, at 6.
32. Id.
33. Guerrerov. Copper Queen Hosp., 112 Ariz. 104,527 P. 2d 1329 (1975); Hamburger v. Henry Ford Hosp., 91 Mich. App. 580, 284 N.W.2d 155 (1979). Contra, McKenna v. Cedars of Lebanon Hosp., 155 Cal. Rptr.3d 631 (Ct. App. 1979).
34. Report of the Secretary's Commission on Medical Malpractice (HEW, DHEW Pub. No. [OS] 73-88,1973) at 16.
35. Id.
36. Id.
37. See Annas, , Editorial; Negligent Samaritans Are No Good, 7(1) Medicolegal News 4 (Spring 1979)CrossRefGoogle ScholarPubMed; Annas, , Beyond the Good Samaritan, 8(2) Hastings Center Rpt. 16 (April 1978)Google ScholarPubMed, and Segal, , Editorial, In Emergencies Is Consent Necessary? J. Legal Med. (Oct. 1975) at 4Google Scholar.