Re: EMTALA
From: Robert J. Carpenter, Jr. MD (zygote@icsi.net)
Thu Jul 28 22:06:53 2005
Remember EMTALA has several components. The first is a person presenting to an
emergency room must be given a screening medical exam and if an emergency
medical condition is present, then the person must be stabilized.
Part two is a person wwho presents to the hospital with an emergency medical
condition >>>>. A 12 or 18 or 22 week fetus is evaluated by knowing that information
and then the same care is provided as would be provided generally.
An EMTALA will not lie in that scenario. Now if you violate proper care provision as
occurred in Lopez (Puerto Rico) the 1st CT of appeals held that EMTALA was
violated. Clearly different issues.
On 28 Jul 2005 at 6:35, Efrain Ramirez wrote:
> Agree-- problem is that someone in LDR will pronounce the fetus alive
> - and might become the famous EMTALA "whistle blower"...
>
> >At Thu, 28 Jul 2005, Robert J. Carpenter, Jr. MD wrote:
> >
> >Not withstanding the Bush Congress mandate that all fetuses must be
> >attended, it is clear from both science and the Pediatric society and
> >multiple writing since that the standard for neonatal evaluation and
> >resuscitation remain at 24 weeks. If your specific unit is routinely
> >salvaging most 23 week fetuses then that may change in your locale.
> >For the rest of us it is 24 weeks. The reg was passed to make sure
> >any born alive abortion was attended.
> >
> >You do NOT have to go pronounce a 12 weeker.
> >
> >Yes, hopefully saner heads will prevail after the Bush reign.
> >
> >On 27 Jul 2005 at 23:14, Garry E. Siegel, M.D. wrote:
> >
> >> Horribly sad that common and clinical sense have been thrown out
> >> the window so that they can be mandated by law.
> >>
> >> Unfortunately, you can't legislate common sense.
> >>
> >> Garry
> >>
> >> At Wed, 27 Jul 2005, Efrain Ramirez wrote:
> >> >
> >> >>At Wed, 27 Jul 2005, art fougner, md wrote:
> >> >>
> >> >>I can envision the look on the face of the pediatrician, called
> >> >>to the ER for the viability screen ... Folks get paid to write
> >> >>these regs?
> >> >>
> >> >>art
> >> >>
> >> >>At Wed, 27 Jul 2005, rmodugno@aol.com wrote:
> >> >>>
> >> >>>Not entirely Dan - everyone knows a 12 weeker cannot survive -
> >> >>>you however must document your "screening exam" and reasons for
> >> >>>not proceeding with resuscitation.
> >> >>>
> >> >>>Robert Modugno MD MBA FACOG
> >> >>>Marietta, GA
> >> >>>
> >> >>>-----Original Message-----
> >> >>>From: R. Daniel Braun <rd.braun@gmail.com>
> >> >>>To: Multiple recipients of list OB-GYN-L
> >> >>><ob-gyn-l@dns.obgyn.net> Sent: Wed, 27 Jul 2005 11:16:42 -0500
> >> >>>Subject: Re: EMTALA
> >> >>>
> >> >>>Yeah, well now it is VIABLE by LAW if it has any kind of sign of
> >> >>>life at Delivery. If a 12 weeker comes out with a heart beat or
> >> >>>movements "All efforts must be made to sustain its life(?) as
> >> >>>long as possible" That is according to my understanding of the
> >> >>>law. Help me out if I am wrong. Dan
> >> >>>
> >> >>>On 7/27/05, Larry Glazerman <l.glazerman@rcn.com> wrote:
> >> >>>Viability at 20 weeks?????????
> >> >>>
> >> >>>Larry R. Glazerman, MD
> >> >>>Ob-Gyn at Trexlertown, PC
> >> >>>larry.glazerman@lvh.com
> >> >>>
> >> >>>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf
> >> >>>Of Stmidwife@aol.com Sent: Wednesday, July 27, 2005 11:19 AM To:
> >> >>>Multiple recipients of list OB-GYN-L Subject: Re: EMTALA
> >> >>>
> >> >>>I always seen 20 weeks here in So CA.
> >> >>>
> >> >>>Sue
> >> >>>
> >> >>>In a message dated 7/27/05 6:44:56 A.M. Pacific Daylight Time,
> >> >>>ob-gyn-l@obgyn.net writes:
> >> >>>
> >> >>>."and 22 weeks is within the standard that most hospitals use
> >> >>>for viability
> >> >>>
> >> >>>--
> >> >>>R. Daniel Braun
> >> >>> Kinky for Governor
> >> >>>
> >> >>--
> >> >>art fougner, md
> >> >>
> >> >> "If you don't know where you are going, you will wind up
> >> >> somewhere else."
> >> >>Lawrence Peter Berra
> >> >>
> >> >This is getting nonsensical isn't...?
> >> >
> >> >They "section" a patient at 20 weeks for "fetal indications" --
> >> >that's Kalifornia...??
> >> >
> >> >Dan is right - viability should be a medical term not a legal term
> >> >-
> >> >
> >> >Ef
> >> >
> >> >These EMTALA "guidelines" have -IMHO- far reaching consequences
> >> >...
> >> >
> >> >--
> >> >"Character may be manifested in the great moments, but it is made
> >> >in the small ones."
> >> >
> >> > - Phillip Brooks
> >> >
> >> > ~walt whitman~
> >> >
> >>
> >> --
> >> Garry E. Siegel, M.D.
> >> Private Practice
> >> Roswell, GA
> >>
> >--
> >Robert J. Carpenter, Jr. MD
> >6624 Fannin, #2720
> >St. Luke's Medical Tower
> >Houston,TX 77030-2339
> >713-795-4600
> >
>
> --
> "Character may be manifested in the great moments, but it is made in
> the small ones."
>
> - Phillip Brooks
>
> ~walt whitman~
>
--
Robert J. Carpenter, Jr. MD
6624 Fannin, #2720
St. Luke's Medical Tower
Houston,TX 77030-2339
713-795-4600
