In a case of first impression, the Sixth Circuit recently held that the estate of a person murdered by a psychiatric patient discharged before the hospital met its EMTALA stabilization obligation could pursue damages under EMTALA for the patient's murderous acts. In this case, the hospital admitted the patient to its psychiatric ward following an emergency room screening, but arguably failed to stabilize the patient.

The court expressly held that EMTALA permits an injured third party to recover damages from a hospital for any personal harm the third party may suffer as a direct result of a hospital's EMTALA violation, in accordance with state personal injury law. In this case, the court held that the murder was the direct result of the hospital's failure to stabilize the patient's emergency mental health condition. In reaching the result, the court largely rejected portions of the EMTALA legislative history in a House Judiciary Committee Report which provided that the only individual who can sue is the "individual patient who suffers harm as a direct result of the hospital's failure."

The court also rejected CMS's interpretation contained in 42 C.F.R. 489.24(d)(2)(i) which provides that a hospital satisfies its EMTALA obligations once it "admits [an] individual as an inpatient in good faith in order to stabilize the emergency medical condition." The court held that CMS's interpretation was in direct conflict with the statutory text which requires that the hospital provide "such treatment as may be required to stabilize the medical condition." Under the Sixth Circuit's standard, a hospital may not discharge an EMTALA patient "without first determining that the patient has actually [been] stabilized." Actual stabilization will be required for a hospital to satisfy its EMTALA obligations rather than mere admission as an inpatient for stabilization.

While it is unclear whether other circuits will follow the Sixth Circuit's broad interpretation of EMTALA, this decision is significant for the broad range of potential plaintiffs who may bring an action against a hospital for losses sustained as a result of a patient's actions following discharge, particularly mental health patients and the increased discharge responsibilities associated with EMTALA patients.

The court, however, followed other circuits and held that the physician involved with the patient's care could not be sued for EMTALA violations under the EMTALA statute.