Medical Legal Aspects

2020 ◽  
pp. 656-658
Author(s):  
Madeline Joseph
Keyword(s):  
Emergency Department ◽  
Juvenile Justice ◽  
Medical Treatment ◽  
Children And Adolescents ◽  
Day Care ◽  
Juvenile Justice System ◽  
Medical Condition ◽  
School Personnel ◽  
Legal Aspects ◽  
Emergency Medical

Children and adolescents may present to the emergency department (ED) without a guardian for several reasons, such as emergencies occurring during school or lack of guardian availability so that relatives, family friends, or day care or school personnel must accompany children to the ED. Concern about providing evaluation and treatment without formal consent is one of the challenges that emergency physicians face when minor patients present to the ED without parents or guardians. The Emergency Medical Treatment and Labor Act mandates that all patients, including minors, presenting to the ED receive a medical screening examination to determine if an emergency medical condition exists. This chapter reviews who can provide consent for minors; cases in which minors can be treated without consent in the ED, including minors involved in the juvenile justice system; and adolescent emancipation.

scholarly journals Penalties for Emergency Medical Treatment and Labor Act Violations Involving Obstetrical Emergencies

2020 ◽  
Vol 21 (2) ◽  
pp. 235-243
Author(s):  
Sophie Terp ◽  
Brandon Wang ◽  
Elizabeth Burner ◽  
Sanjay Arora ◽  
Michael Menchine
Keyword(s):  
Medical Treatment ◽  
Medical Condition ◽  
The United States ◽  
State Of Emergency ◽  
Current State ◽  
Emergency Medical ◽  
Active Labor ◽  
The Law ◽  
Title One

Introduction: The Emergency Medical Treatment and Labor Act (EMTALA) was intended to prevent inadequate, delayed, or denied treatment of emergent conditions by emergency departments (ED). While controversies exist regarding the scope of the law, there is no question that EMTALA applies to active labor, a key tenet of the statute and the only medical condition – labor – specifically included in the title of the law. In light of rising maternal mortality rates in the United States, further exploration into the state of emergency obstetrical (OB) care is warranted. Understanding civil monetary penalty settlements levied by the Office of the Inspector General (OIG) related to EMTALA violations involving labor and other OB emergencies will help to inform the current state of access to and quality of OB emergency care. Methods: We reviewed descriptions of all EMTALA-related OIG civil monetary penalty settlements from 2002-2018. OB-related cases were identified using keywords in settlement descriptions. We described characteristics of settlements including the nature of the allegation and compared them with non-OB settlements. Results: Of 232 EMTALA-related OIG settlements during the study period, 39 (17%) involved active labor and other OB emergencies. Between 2002 and 2018 the proportion of settlements involving OB emergencies increased from 17% to 40%. Seven (18%) of these settlements involved a pregnant minor. Most OB cases involved failure to provide screening exam (82%) and/or stabilizing treatment (51%). Failure to arrange appropriate transfer was more common for OB (36%) compared with non-OB settlements (21%) (p = 0.041). Fifteen (38%) involved a provider specifically directing a pregnant woman to proceed to another hospital, typically by private vehicle. Conclusion: Despite inclusion of the term “labor” in the law’s title, one in six settlements related to EMTALA violations involved OB emergencies. One in five settlements involved a pregnant minor, indicating that providers may benefit from education regarding obligations to evaluate and stabilize minors absent parental consent. Failure to arrange appropriate transfer was more common among OB settlements. Findings suggesting need for providers to understand EMTALA-specific requirements for appropriate transfer and for EDs at hospitals without dedicated OB services to implement policies for evaluation of active labor and protocols for transfer when indicated.

Does the Emergency Medical Treatment and Labor Act Affect Emergency Department Use?

2013 ◽  
Vol 44 (1) ◽  
pp. 209-216 ◽  
Author(s):  
William M. McDonnell ◽  
Christopher A. Gee ◽  
Nancy Mecham ◽  
Jessica Dahl-Olsen ◽  
Elisabeth Guenther
Keyword(s):  
Emergency Department ◽  
Medical Treatment ◽  
Emergency Department Use ◽  
Emergency Medical

scholarly journals Balancing Patient Care and Force Protection at Military Medical Treatment Facilities

2020 ◽  
Vol 185 (Supplement_1) ◽  
pp. 562-564
Author(s):  
Sean Nardi ◽  
Brian Ferguson ◽  
Sean Peck ◽  
Elliot Ross ◽  
Benjamin Walrath
Keyword(s):  
Medical Treatment ◽  
Medical Condition ◽  
Security Protocols ◽  
Unauthorized Access ◽  
Access Points ◽  
Medical Treatment Facility ◽  
Emergency Medical ◽  
Hospital Access ◽  
Treatment Facilities ◽  
Sensitive Conditions

ABSTRACT Objectives This study aimed to identify delays of care due to base access security protocols at a stateside military medical treatment facility (MTF) for patients with a time-sensitive medical condition who are seeking emergency medical care at the MTF. Methods We retrospectively analyzed emergency medical services (EMS) run reports from January 1, 2017 to November 12, 2017 to hospital access points to assess patients who were initially denied access to the MTF. Time from EMS activation until patient delivery at the emergency department, number of time-sensitive complaints, number of time-sensitive conditions, and number of unauthorized access attempts are reported. Results During the 11-month period of review, 42 delays of care related to EMS activation by the sentry at hospital access points were identified. Of the 42, 14 were associated with a time-sensitive complaint, 2 with time-sensitive conditions, and none were unauthorized access attempts. Conclusion We identify the potential for patient harm due to delays in care resulting from the security protocols at our MTF. A review of force protection requirements with consideration for their impact on patient safety, especially in cases of time-sensitive conditions, has been conducted.

Legal Socialization in the Family

2017 ◽  
Author(s):  
Tom R. Tyler ◽  
Rick Trinkner
Keyword(s):  
Juvenile Justice ◽  
Children And Adolescents ◽  
Justice System ◽  
Juvenile Justice System ◽  
Childhood And Adolescence ◽  
Legal Authority ◽  
Legal Socialization ◽  
The Family ◽  
Pass Through

The chapters in Part III take up the discussion of legal socialization across the spheres of childhood and adolescence. As they move through their early lives, children and adolescents pass through three spheres of authority: the family, the school, and the juvenile justice system. In each of these they can either experience coercive and consensual authority systems. Consensual systems promote the development of internal beliefs in the legitimacy of law and legal authority and because of such beliefs, encourage voluntary deference. Coercive systems lead to a risk orientation toward law, with people complying when the risk of being caught and punished is high.

Child Delinquency, ACEs, and the Juvenile Justice System: Does Exposure to ACEs Affect Justice System Experiences for Children?

2021 ◽  
pp. 154120402110631
Author(s):  
Abigail Novak ◽  
Vitoria De Francisco Lopes
Keyword(s):  
Juvenile Justice ◽  
Children And Adolescents ◽  
Justice System ◽  
Juvenile Justice System ◽  
School Problems ◽  
Childhood Experiences ◽  
Florida Department ◽  
Adverse Childhood ◽  
Older Youth ◽  
Using Data

Thousands of children ages 12 and under are referred to juvenile justice systems each year, and little is known about how their experiences may differ from those of older youth. The purpose of this study was to compare risk factors associated with juvenile justice referral between children and adolescents and examine differences in adjudication and disposition of referred children and adolescents. The moderating role of adverse childhood experiences (ACEs) was also examined. Using data from the Florida Department of Juvenile Justice, results suggest children referred to the juvenile justice system are more likely to have experienced greater numbers of ACEs, have family and school problems, and be referred by schools. Results also indicate children and adolescents differ in their experiences within the juvenile justice system, and that experiences vary according to exposure to ACEs. Results suggest juvenile justice system officials should consider the unique needs of children referred to the system and be cognizant of the influence of non-legal factors in decision-making for this population.

The Reluctant Consultant

2020 ◽  
pp. 97-104
Author(s):  
Sara R. Zaidi ◽  
Jeremy R. Simon
Keyword(s):  
Emergency Department ◽  
Medical Treatment ◽  
Emergency Physicians ◽  
Unstable Patient ◽  
Emergency Medical ◽  
Active Labor

This chapter discusses the obligations under the Emergency Medical Treatment and Active Labor Act (EMTALA) of both emergency physicians and on-call consultants to patients who present to the emergency department with a medical complaint. Whereas emergency physicians, by the nature of their work, cannot avoid being present to treat patients when they arrive, consultants may be reluctant to fulfill their obligation and come to the emergency department to treat an unstable patient who cannot be discharged without their services. Techniques for avoiding and resolving such impasses are discussed, as well as what to do in the case of true intransigence.

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