LEGAL ADVISOR CASE
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Prisoner’s Visit to ED Cues Suit Inmate with hand bite was discharged without antibiotics or radiograph.
ANN W. LATNER, JD
Mr S is an inmate at a local prison. During an altercation with another prisoner, Mr S was bitten on his left hand. The bureau of prisons sent him to a local emergency department (ED), where he was seen by Mr N, a nurse practitioner, and Dr D, the supervising physician. The patient was described as agitated and complained about pain from the bite to his left pinkie. Mr N was instructed by Dr D to give the patient a tetanus vaccine and discharge him with a 3-day supply of antibiotics. As Mr N was cleaning and sterilizing the wound and bandaging the finger, the patient noted that he thought his finger was broken and requested an “x-ray.” Dr D, who was walking by, told Mr S that the hospital’s imaging machine was broken and a radiograph of the finger could not be performed. Mr S’s wound was cleaned and dressed but not sutured to avoid infection. Despite Dr D’s orders, no antibiotics were noted on the ED discharge report, and the patient was returned to prison without the prescription. In prison, Mr S continued to complain about pain in his finger, which he described as 10 on a
Patient claims hospital staff discharged him without properly screening and stabilizing him, violating EMTALA.
pain scale of 1 to 10. Six weeks after his visit to the ED, Mr S’s finger was radiographed, which revealed a displaced dorsal rotated fracture through the distal shaft of the left fifth middle phalanx. The radiologist’s report also noted that “there is surrounding soft tissue swelling without joint space malalignment.” Mr S was taken to a hand specialist who noted that he had a “fracture through the middle phalanx with displacement and angulation.” The specialist recommended surgery; specifically,“left small finger P2 fixation with DIP arthrodesis.” Mr S underwent the surgery, but he remained angry about how he was treated initially by the hospital and staff. Dr D and Mr N were unaware of Mr S’s condition until they were notified by the hospital’s attorney that the hospital was being sued by Mr S, pro se (representing himself without an attorney). The basis of the claim was violation of the federal Emergency Medical Treatment and Active Labor Cases presented are based on actual occurrences. Names of participants and details have been changed. Cases are informational only; no specific legal advice is intended. Persons pictured are not the actual individuals mentioned in the article.
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