Facts

Donna Hoffman presented to emergency room physician Kent Tonnemacher at Memorial Medical Center's Emergency Department complaining of chills with hyperventilation, nasal congestion, cough, chest pain, nausea/vomiting, abdominal pain and numbness in her hands for one day. She also had a fever of 106 degrees prior to arrival at the ER and reported that she had previously undergone a splenectomy and repair of a ventrial hernia. She had a past medical history of Hodgkin's lymphoma at age 12 and occasional bronchitis and a heart murmur. She was examined by Tonnemacher and a review of her systems fell within normal limits, which included a urinalysis and a chest X-ray, which came back negative. Tonnemacher's diagnosis was fever and bronchitis with a differential diagnosis of possible pneumonia. She was given 10 milligrams of morphine IM and Reglan. She was discharged and prescribed an antibiotic. The next morning she was rushed to the ER by ambulance where she was diagnosed with a bacterial infection and listed in critical condition.

Hoffman sued Tonnemacher and the Medical Center as well as the other physicians that attended to her for medical malpractice. Tonnemacher settled out prior to the first trial and the other physicians were dismissed. A partial summary judgment was granted as to the Medical Center and the only issue left for trial was whether there was a violation of the Emergency Medical Treatment and Active Labor Act (EMTALA).

Hoffman argued that EMTALA was violated because Tonnemacher failed to comply with the policies in place at the Medical Center. The Medical Center contended that Tonnemacher performed appropriate screening examination consistent with its policies and the requirements under EMTALA.

Injuries

Hoffman claimed she did not feel better after her discharge and that her condition continued to worsen the next morning. She, however, did not fill the antibiotic prescription until early the following afternoon. Upon arrival at the ER she had oral cyanosis, diaphoresis, hypotension and was in respiratory distress. She was found to have pneumoccal sepsis, a serious bacterial infection which left her with significant residual scars and difficulty walking. She developed purpura fulminans, septic skin lesions and ischemia of her feet and toes. She utlimately required toe amputations and debridement. She eventually lost her ability to work due to immobility and continued to need periodic podiatric care and will need lifelong care.

Result

The case was tried three times, twice resulting in hung juries. On the third trial, the jury found for the defense and found that Hoffman received a medical screening exam in compliance with EMTALA.

Deliberation

three hours

Poll

8-0

Length

eight days