Table 1.
Characteristics of OIG Settlements Involving Individual Physicians
| Settlement Date | State | On-call Status |
Medical Specialty |
Settlement Amount |
Hospital Settlement, Amount |
Nature of Allegation |
|---|---|---|---|---|---|---|
| Apr 15, 2014 | Iowa | On-call | Surgery | $35,000 | No | Refusal to examine and treat patient with an EMC. |
| Dec 20 2011 | Tennessee | On-call | Neurosurgery* | $35,000 | Yes $45,000 |
Refusal to accept appropriate transfer of a patient with an EMC who required the specialized capabilities available at the physician’s hospital. The patient died. |
| Feb 25 2009 | Illinois | On-call | Orthopedics† | $35,000 | No | Failure to respond to a request to evaluate and treat an ED patient with an open leg fracture. |
| Feb 17 2006 | Texas | On-call | Obstetrics | $15,000 | No | Failure to respond to a request to evaluate and treat a pregnant patient in the ED with symptoms of preeclampsia and pulmonary edema. |
| Jun 23, 2004 | Louisiana | On duty | Emergency medicine‡ | $10,000 | Yes $15,000 |
Failure to provide MSE and stabilizing treatment to a pregnant 17-year-old in the ED with perineal numbness and vaginal bleeding. Refusal to treat reportedly based on erroneous belief that could not evaluate or treat a minor absent parental consent. |
| Apr 7, 2003 | Virginia | On-call | Obstetrics | $15,000 | Yes $35,000 |
Failure to provide appropriate MSE, stabilizing treatment, and transfer for a pregnant woman in labor. |
| Mar 3, 2003 | California | On-call | Surgery | $50,000 | Yes $7,500 |
Failure to respond to a request to evaluate and treat an ED patient. The patient died. |
| May 9, 2002 | Missouri | On-call | Ophthalmology | $10,000 | No | Failure to respond to a request to evaluate and treat an ED patient. |
EMC = emergency medical condition; EMTALA = Emergency Medical Treatment and Labor Act; MSE = medical screening examination; OIG = Office of the Inspector General.
Information regarding physician specialty obtained by cross-referencing physician name with news reports regarding reported EMTALA infraction (AIS Health, Vanderbilt Medical Center and Neurosurgeon Settle CMP Cases, Available 10 October 2016 at:https://aishealth.com/archive/rmc022012-03.)
Physician specialty inferred by nature of EMC (open leg fracture assumed to be an orthopedic specialist).
Physician specialty obtained from detailed text from the related 2567 investigation form obtained from the CMS (M. E. Palowitch, EmTaLA Technical Lead, CMS, personal communication, 2016).