EMTALA: Screening Can Satisfy EMTALA, Despite Misdiagnosis

2003 ◽  
Vol 31 (1) ◽  
pp. 169-170 ◽  
Author(s):  
Hemanth Gundavaram
Keyword(s):  
Blood Pressure ◽  
Medical Treatment ◽  
Emergency Room ◽  
Urinary Retention ◽  
Court Of Appeals ◽  
Statutory Duty ◽  
Active Labor ◽  
Summary Judgment ◽  
De Medicina ◽  
The U.S

In Del Carmen Guadalupe v. Agosto, the U.S. Court of Appeals for the First Circuit held that a hospital fulfills its statutory duty to screen patiens in is emergency room if it provides for a “screening examination reasonably calculated to identify critical medical conditions” that may be afflicting symptomatic patients and if it “provides that level of screening uniformly to all those who present substantially similar complaints.” The First Circuit affirmed the lower court's decision to grant summary judgment to the hospital in a claim raised under the Emergency Medical Treatment and Active Labor Act (EMTALA).Maria del Carmen Guadalupe brought her husband, Narciso Figueroa, to the Hospital Interamericano De Medicina Avanzada, Inc., (HIMA) on October 3, 1998, with symptoms of urinary retention, edema in the legs, high blood pressure, pain, increased respiratory difficulty, a dry cough, fever, and drowsiness.

Medicare: Ninth Circuit Limits Rates Providers Can Charge Medigap Insurers

2003 ◽  
Vol 31 (1) ◽  
pp. 159-160
Author(s):  
Ed Caldie
Keyword(s):  
Medical Treatment ◽  
District Court ◽  
Insurance Company ◽  
Insurance Policy ◽  
Breach Of Contract ◽  
Ninth Circuit ◽  
Court Of Appeals ◽  
Medicare Coverage ◽  
Summary Judgment ◽  
The U.S

In Vencor, Inc. v. National States Insurance Co., the U.S. Court of Appeals for the Ninth Circuit held that a Medigap insurance provider was only obligated to pay the rates that Medicare would have paid for the same care.Clarence Rollins purchased a Medigap insurance policy from National States Insurance Company (NSIC) to supplement his Medicare coverage. When Rollins became ill and required care beyond that which Medicare would cover, he received his medical treatment from Vencor Hospital-Phoenix (Vencor). Upon Rollins's death, NSIC paid Vencor $38,760. Vencor claimed that NSIC owed an additional $132,438 because NSIC was not entitled to the lower care rates established by Medicare. NSIC refused to pay Vencor's higher rates. As a result, Vencor sued NSIC for breach of contract.The U.S. District Court for the District of Arizona held, on a motion for summary judgment, that no breach occurred, and that NSIC was obligated to pay only the lower rates established by Mediare. The Ninth Circuit affirmed this decision.

Disability & ADA: Disparate Insurance Coverage for Physical and Psychological Disabilities Does Not Violate ADA

2000 ◽  
Vol 28 (1) ◽  
pp. 92-94
Author(s):  
Nicklas A. Akers
Keyword(s):  
Title I ◽  
Americans With Disabilities Act ◽  
Insurance Coverage ◽  
Disability Insurance ◽  
Insurance Plan ◽  
Court Of Appeals ◽  
Physical Conditions ◽  
Summary Judgment ◽  
Different Levels ◽  
The U.S

In Kimber v. Thiokol Corp., 196 F.3d 1092 (10th Cit. 1999), the U.S. Court of Appeals for the Tenth Circuit upheld a U.S. District Court's grant of summary judgment against an employee's claim that an employeroperated disability insurance plan, which offered different levels of compensation for disabilities due to mental and physical conditions, violated Title I of the Americans with Disabilities Act (ADA). The Court of Appeals found that (1) the Thiokol plan administrator's interpretations of the plan were not arbitrary and capricious, and that (2) the plan's different treatment of disabilities caused by physical and mental conditions did not violate the ADA.

Medicaid & Medicare: D.C. Appellate Court Denies Claim for Medicare Reimbursement of GME Cost

1999 ◽  
Vol 27 (2) ◽  
pp. 205-205
Author(s):  
choeffel Amy
Keyword(s):  
Medical Center ◽  
Federal District ◽  
Federal Court ◽  
University Of Pennsylvania ◽  
District Court ◽  
Appellate Court ◽  
Court Of Appeals ◽  
Department Of Health ◽  
Administrative Proceedings ◽  
Summary Judgment

The U.S. Court of Appeals for the District of Columbia upheld, in Presbyterian Medical Center of the University of Pennsylvania Health System v. Shalala, 170 F.3d 1146 (D.C. Cir. 1999), a federal district court ruling granting summary judgment to the Department of Health and Human Services (DHHS) in a case in which Presbyterian Medical Center (PMC) challenged Medicare's requirement of contemporaneous documentation of $828,000 in graduate medical education (GME) expenses prior to increasing reimbursement amounts. DHHS Secretary Donna Shalala denied PMC's request for reimbursement for increased GME costs. The appellants then brought suit in federal court challenging the legality of an interpretative rule that requires requested increases in reimbursement to be supported by contemporaneous documentation. PMC also alleged that an error was made in the administrative proceedings to prejudice its claims because Aetna, the hospital's fiscal intermediary, failed to provide the hospital with a written report explaining why it was denied the GME reimbursement.

Antitrust: U.S. Supreme Court Affirms FTC Jurisdiction but Vacates Scope of Analysis on CDA Policy

1999 ◽  
Vol 27 (2) ◽  
pp. 197-198
Author(s):  
Joseph R. Zakhary
Keyword(s):  
Public Relations ◽  
Supreme Court ◽  
Federal Trade Commission ◽  
Ninth Circuit ◽  
Court Of Appeals ◽  
For Profit ◽  
Rule Of Reason ◽  
Antitrust Analysis ◽  
Business Financing ◽  
The U.S

In California Dental Association v. FTC, 119 S. Ct. 1604 (1999), the U.S. Supreme Court reviewed a decision by the U.S. Court of Appeals for the Ninth Circuit that a nonprofit affiliation of dentists violated section 5 of the Federal Trade Commission Act (FTCA), 15 U.S.C.A. § 45 (1998), which prohibits unfair competition. The Court examined two issues: (1) the Federal Trade Commission's (FTC) jurisdiction over the California Dental Association (CDA); and (2) the proper scope of antitrust analysis. The Court unanimously held that CDA was subject to FTC's jurisdiction, but split 5-4 in its finding that the district court's use of abbreviated rule-of-reason analysis was inappropriate.CDA is a voluntary, nonprofit association of local dental societies. It boasts approximately 19,000 members, who constitute roughly threequarters of the dentists practicing in California. Although a nonprofit, CDA includes for-profit subsidiaries that financially benefit CDA members. CDA gives its members access to insurance and business financing, and lobbies and litigates on their behalf. Members also benefit from CDA marketing and public relations campaigns.

Crystallex Int'l Corp. v. Bolivarian Rep. Venez. (3D Cir.)

2021 ◽  
pp. 1-21
Author(s):  
Kevin D. Benish
Keyword(s):  
United States Supreme Court ◽  
The United States ◽  
United States Supreme ◽  
Decision To Leave ◽  
Court Of Appeals ◽  
The Third ◽  
To Come ◽  
Alter Ego ◽  
Oil Company ◽  
The U.S

On May 18, 2020, the United States Supreme Court denied a request by the Bolivarian Republic of Venezuela and its state-owned oil company, Petróleos de Venezuela, S.A. (PDVSA), to review the merits of Crystallex Int'l Corp. v. Bolivarian Republic of Venezuela, a decision by the U.S. Court of Appeals for the Third Circuit. In Crystallex, the Third Circuit affirmed a trial court's determination that PDVSA is the “alter ego” of Venezuela itself, thus permitting Crystallex to enforce a $1.4 billion judgment against Venezuela by attaching property held in PDVSA's name. Given the Supreme Court's decision to leave the Third Circuit's opinion undisturbed, Crystallex is a significant decision that may affect parties involved in transnational litigation for years to come—especially those pursuing or defending against U.S. enforcement proceedings involving the property of foreign states.

scholarly journals Penetrating Neck Injuries Treated at a U.S. Role 3 Medical Treatment Facility in Afghanistan During Operation Resolute Support

2020 ◽  
Author(s):  
John Breeze ◽  
William G Gensheimer ◽  
Joseph J DuBose
Keyword(s):  
Medical Treatment ◽  
Emergency Room ◽  
Neck Region ◽  
Neck Injuries ◽  
Treatment Facility ◽  
Medical Treatment Facility ◽  
Trauma Registries ◽  
Neck Wound ◽  
Major Injury ◽  
High Negative Predictive Value

ABSTRACT Introduction Military trauma registries can identify broad epidemiological trends from neck wounds but cannot reliably demonstrate temporal casualty from clinical interventions or differentiate penetrating neck injuries (PNI) from those that do not breach platysma. Materials and Methods All casualties presenting with a neck wound to a Role 3 Medical Treatment Facility in Afghanistan between January 1, 2016 and September 15, 2019 were retrospectively identified using the Emergency Room database. These were matched to records from the Operating Room database, and computed tomography (CT) scans reviewed to determine damage to the neck region. Results During this period, 78 casualties presented to the Emergency Room with a neck wound. Forty-one casualties underwent surgery for a neck wound, all of whom had a CT scan. Of these, 35/41 (85%) were deep to platysma (PNI). Casualties with PNI underwent neck exploration in 71% of casualties (25/35), with 8/25 (32%) having surgical exploration at Role 2 where CT is not present. Exploration was more likely in Zones 1 and 2 (8/10, 80% and 18/22, 82%, respectively) compared to Zone 3 (2/8, 25%). Conclusion Hemodynamically unstable patients in Zones 1 and 2 generally underwent surgery before CT, confirming that the low threshold for exploration in such patients remains. Only 25% (2/8) of Zone 3 PNI were explored, with the high negative predictive value of CT angiography providing confidence that it was capable of excluding major injury in the majority of cases. No deaths from PNI that survived to treatment at Role 3 were identified, lending evidence to the current management protocols being utilized in Afghanistan.

Abstract P261: Intensive Systolic Blood Pressure Lowering Will Prevent Over 100,000 Deaths Annually

Hypertension ◽  
2016 ◽  
Vol 68 (suppl_1) ◽  
Author(s):  
Holly Kramer ◽  
Adam Bress ◽  
Srinivasan Beddhu ◽  
Paul Muntner ◽  
Richard S Cooper
Keyword(s):  
Blood Pressure ◽  
Mortality Rate ◽  
Systolic Blood Pressure ◽  
Mortality Rates ◽  
Mortality Data ◽  
Blood Pressure Lowering ◽  
Cvd Risk ◽  
Pressure Lowering ◽  
Annual Mortality ◽  
The U.S

Background: The Systolic Blood Pressure Intervention Trial (SPRINT) trial randomized 9,361 adults aged ≥50 years at high cardiovascular disease (CVD) risk without diabetes or stroke to intensive systolic blood pressure (SBP) lowering (≤120 mmHg) or standard SBP lowering (≤140 mmHg). After a median follow up of 3.26 years, all-cause mortality was 27% (95% CI 40%, 10%) lower with intensive SBP lowering. We estimated the potential number of prevented deaths with intensive SBP lowering in the U.S. population meeting SPRINT criteria. Methods: SPRINT eligibility criteria were applied to the National Health and Nutrition Examination Survey 1999-2006, a representative survey of the U.S. population, linked with the mortality data through December 2011. Eligibility included (1) age ≥50 years with (2) SBP 130-180 mmHg depending on number of antihypertensive classes being taken, and (3) presence of ≥1 CVD risk conditions (history of coronary heart disease, estimated glomerular filtration rate (eGFR) 20 to 59 ml/min/1.73 m 2 , 10-year Framingham risk score ≥15%, or age ≥75 years). Adults with diabetes, stroke history, >1 g/day proteinuria, heart failure, on dialysis, or eGFR<20 ml/min/1.73m 2 were excluded. Annual mortality rates for adults meeting SPRINT criteria were calculated using Kaplan-Meier methods and the expected reduction in mortality rates with intensive SBP lowering in SPRINT was used to determine the number of potential deaths prevented. Analyses accounted for the complex survey design. Results: An estimated 18.1 million U.S. adults met SPRINT criteria with 7.4 million taking blood pressure lowering medications. The mean age was 68.6 years and 83.2% and 7.4% were non-Hispanic white and non-Hispanic black, respectively. The annual mortality rate was 2.2% (95% CI 1.9%, 2.5%) and intensive SBP lowering was projected to prevent 107,453 deaths per year (95% CI 45,374 to 139,490). Among adults with SBP ≥145 mmHg, the annual mortality rate was 2.5% (95% CI 2.1%, 3.0%) and intensive SBP lowering was projected to prevent 60,908 deaths per year (95% CI 26, 455 to 76, 792). Conclusions: We project intensive SBP lowering could prevent over 100,000 deaths per year of intensive treatment.

Collegial Courts: Panel Decision-Making and the U.S. Courts of Appeals

2021 ◽  
Author(s):  
Pamela C. Corley ◽  
Wendy L. Martinek
Keyword(s):  
Decision Making ◽  
Court Decision ◽  
Appellate Court ◽  
Courts Of Appeals ◽  
Court Of Appeals ◽  
Appeals Process ◽  
Almost All ◽  
The U.S

The three-judge panel mechanism by which the courts of appeals process almost all (though not quite all) of their cases affords scholars unique opportunities to explore how appellate court decision-making may transcend being merely the sum of its parts. Specifically, court of appeals judges pursue their decision-making responsibilities as part of a collegial group, and thus it is important to understand how being a member of a multimember court influences their behavior.

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