Letter from Louisiana: triage and EMTALA

Longtime reader C.G. Moore, a 3L at Tulane Law who lives in St. Tammany Parish outside New Orleans, writes in to say:

My wife, 4 mo. old son, and I survived [Hurricane Katrina] (we live in St. Tammany parish, about 10 miles from lake Pontchartrain). I noticed you had a link to WWL television’s plea for medical personnel to assist the victims. I was in a unique position during the storm and afterward: my wife is an ER doctor, and we sheltered at the hospital where she works.

The doctors and nurses were incredible. They worked non-stop, under incredibly stressful conditions. Many didn’t know where their loved ones were, or whether they had survived, and there was no way to contact the outside world. Many lost everything to the flood waters, tornadoes, and fallen trees. And still, they worked 12-hour shifts (sometimes longer).

But one of the first hurdles they had to contend with was the effects of EMTALA in a disaster situation. [EMTALA is a federal law under which hospitals can be sued if they turn away patients needing emergency medical treatment. — ed.] Under EMTALA, ER physicians are cautious to the point of absurdity. But as the hospital quickly filled to capacity with seriously ill and injured patients, the ER was able to attend to life-or-death situations only. Strict triage procedures were needed to separate the “worried well” from the dying. Medical care really was a limited commodity. Although the magnitude of the catastrophe was clear to all, some patients and their families couldn’t understand that minor boo-boos didn’t merit immediate care (much less admission to the hospital, where it was air-conditioned and they could get a hot meal).

So, my concern is this: once the rubble is cleared and the power restored, the plaintiffs’ lawyers will ooze back into the scene — that this was a disaster situation won’t matter one iota — and they’ll use EMTALA to file lawsuit after lawsuit.

I really hope I’m wrong. But only time will tell.

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