Not a lawsuit but a federal complaint about improper emergency care.
Two women have filed complaints with the federal government alleging that Texas hospitals denied them abortion care necessary to treat their ectopic pregnancies.
The complaints were filed August 6 by Kelsie Norris-De La Cruz and Kyleigh Thurman against Texas Health Arlington Memorial Hospital and Round Rock-based Ascension Seton Williamson Hospital, respectively. Both women are represented by the Center for Reproductive Rights.
Both say the hospitals denied them appropriate stabilizing medical care, which hospitals that accept federal Medicare funding are required to do under the Emergency Medical Treatment and Labor Act, also known as EMTALA.
Ectopic pregnancies, which happen when a fertilized egg implants outside the pregnant person’s uterus, can be fatal to them and cannot result in birth. Both women had ectopic pregnancies that implanted in their fallopian tubes, which connect ovaries to the uterus.
The women say that they were initially sent home without receiving appropriate care, which in this case should have been terminating the pregnancy. The women say they continued to seek follow-up care: Norris-De LaCruz sought a second opinion hours later with a different doctor who diagnosed her ectopic pregnancy and had her brought in for surgery. Thurman returned days later after experiencing continued vaginal bleeding. But by the time both could receive abortions, their pregnancies had ruptured. Both women had to have their affected fallopian tube removed.
These are administrative complaints filed with the US Department of Health and Human Services, which if upheld could result in penalties against the hospitals. I have no idea how this sort of thing proceeds or on what timeline, so we’ll go on this journey together.
The Associated Press had a long story on these complaints, including this key bit.
In Texas, where doctors face up to 99 years of prison if convicted of performing an illegal abortion, medical and legal experts say the law is complicating decision-making around emergency pregnancy care.
Although the state law says termination of ectopic pregnancies is not considered abortion, the draconian penalties scare Texas doctors from treating those patients, the Center for Reproductive Rights argues.
“As fearful as hospitals and doctors are of running afoul of these state abortion bans, they also need to be concerned about running afoul of federal law,” said Marc Hearron, a center attorney. Hospitals face a federal investigation, hefty penalties and threats to their Medicare funding if they break the federal law.
[…]
Conclusively diagnosing an ectopic pregnancy can be difficult. Doctors cannot always find the pregnancy’s location on an ultrasound, three separate doctors consulted for this article explained. Hormone levels, bleeding, a positive pregnancy test and ultrasound of an empty uterus all indicate an ectopic pregnancy.
“You can’t be 100% — that’s the tricky part,” said Kate Arnold, an OB-GYN in Washington. “They’re literally time bombs. It’s a pregnancy growing in this thing that can only grow so much.”
Texas Right to Life Director John Seago said the state law clearly protects doctors from prosecution if they terminate ectopic pregnancies, even if a doctor “makes a mistake” in diagnosing it.
“Sending a woman back home is completely unnecessary, completely dangerous,” Seago said.
But the state law has “absolutely” made doctors afraid of treating pregnant patients, said Hannah Gordon, an emergency medicine physician who worked in a Dallas hospital until last year.
“It’s going to force doctors to start creating questionable scenarios for patients, even if it’s very dangerous,” said Gordon. She left Texas hoping to become pregnant and worried about the care she’d get there.
Gordon recalled a pregnant patient at her Dallas emergency room who had signs of an ectopic pregnancy. Because OB-GYNs said they couldn’t definitively diagnose the problem, they waited to end the pregnancy until she came back the next day.
“It left a bad taste in my mouth,” Gordon said.
Both complaints call for a complete investigation of the two hospitals, remediation of any violations of the rules, penalties as appropriate, monitoring the resulting agreements to ensure continued compliance, and whatever else may be needed. Again, I don’t know how this will play out, but I will keep an eye on it.
Couple things to keep in mind. One is the ongoing EMTALA litigation, which is very much in the atmosphere here. Technically, as noted in the first story, Texas law expressly allows for ectopic pregnancies to be terminated, so in that sense EMTALA is not in play. But the uncertainty surrounding it, both in terms of what SCOTUS will eventually say and the egregious risk that doctors and hospitals face when confronted with these situations given the harshness of Texas’ law, will surely be a big part of the defense.
Do not get caught up in the forced-birthers’ rationale that all of this is the doctors’ responsibility, because they claim the law is clear and they should just do their jobs. The law is quite deliberately broad and vague in addition to be extremely punitive, and the so-called guidance provided by the Texas Medical Board is no help. I want to see these plaintiffs win, but it’s not the doctors or the hospitals we should be mad at, even if we ultimately agree that in these instances they acted with too much caution at the plaintiffs’ expense. It’s the Lege, and Greg Abbott, and Ken Paxton, and both SCOTUS and the State Supreme Court that are ultimately at fault.
We can do something about all that this November, and again in two years. You know what we need to do. The Trib, the Chron, and the Current have more.