What would be the legal implications of allowing a patient to be transferred from an ED to a higher level of care facility, such as for specialty orthopedic needs, in a private vehicle if a patient has a heplock in place?
Dear Nancy replies:
It is a little unclear why the option of transporting an ED-admitted patient to another facility in a private car has been raised. Under the Emergency Medical Treatment and Active Labor Act, you must evaluate and stabilize a patient who comes to the ED before a transfer can occur. Since it is assumed this was done with this type of patient, the next step is an appropriate transfer if the current facility cannot provide care for the patient based on his/her medical condition and needs.
Using a private car driven by an employee of the facility or another driver with a private car does not seem consistent with EMTALA requirements. In fact, the act speaks to the use of an appropriate, qualified transfer team and equipment, such as an ambulance, a helicopter or a more specialized transfer arrangement (e.g., ambulance with neonatal capabilities).
You might want to refer this issue to your facility’s legal counsel for his or her opinion. In preparation for meeting with the attorney, review the act for more information so that any transfer is handled consistent with EMTALA and does not give rise to any breaches of its mandates. Go to (http://Emtala.com) where the statute and its regulations can be reviewed. The site also has additional information, such as FAQs and additional references on the act.