Bristol Regional Medical Center Agreed to Pay $150,000 for Allegedly Violating Patient Dumping Statute by Failing to Provide Appropriate Medical Screening Examinations

On August 15, 2025, Bristol Regional Medical Center (BRMC), Bristol, Tennessee, entered into a $150,000 settlement agreement with OIG. The settlement agreement resolves allegations that BRMC violated the Emergency Medical Treatment and Labor Act (EMTALA). Based on its investigation, OIG concluded that in July 2021 and May 2021, BRMC failed to provide an adequate medical screening examination for two patients who presented to BRMC.

Specifically in July 2021, a patient presented to BRMC’s Emergency Department (ED) complaining of back pain, flank pain, shortness of breath and chest pain. The patient reported that he had recently been treated for an upper respiratory infection and was prescribed medications. While the medications eased the pain initially, the pain had returned and it was now radiating around his lateral chest to his anterior chest. The patient reported that he did work on his truck and then tried to go to work that day and thought working on his truck may have exacerbated his symptoms. At BRMC’s ED, a nurse practitioner (NP) saw the patient and ordered a chest x-ray. The NP read the x-ray and documented “nonspecific changes” as the result. The NP diagnosed the patient with a pulled muscle and prescribed a muscle relaxer and pain medication. BRMC did not take the patient’s temperature. Later that day, a radiologist reviewed the patient’s chest x-ray and noted some acute changes suggesting some opacities with possible pneumonia which was worse on the left side. BRMC did not follow-up with the patient on those x-ray results. When the prescribed medications did not alleviate the patient’s symptoms, he presented to an urgent care center the next day and was referred to another hospital. There he was diagnosed with pneumonia with left lobe collapsed lung (which was not present on the scan the previous day), sepsis and a left pleural effusion. The patient was admitted, treated and discharged five days later.

In May 2021, a patient presented to BRMC’s ED complaining of 7 out of 10 chest pain, shortness of breath and numbness in both arms. He reported having chest pain on and off for two weeks. The patient had an extensive cardiac history that included a previous heart attack and two stent placements. Seven minutes after presentment, the patient had an electrocardiogram (EKG), after which an ED physician read it and determined that there were no findings of an acute heart attack and that the patient could wait in the waiting room. The patient was triaged by a nurse, assigned an ESI score of 2 (indicating emergent, needs requiring laboratory or radiological needs) and sent back to the ED waiting room to await bed placement. No further diagnostic testing was ordered and he had not been seen by a physician. Fifty minutes after presentment, an ED physician was assigned to the patient, however, when looking for the patient 100 minutes after presentment, he was listed as “off the floor”. The patient’s wife was reportedly very unhappy that her husband had yet to be seen by a doctor, reported that to the ED desk and told the person at the desk that they were leaving the ED. BRMC’s staff did not discuss leaving against medical advice or what services BRMC was planning to provide the patient. The patient was then discharged in the BRMC’s system. Later that day, the patient was evaluated by a cardiologist. This was pursuant to a previously scheduled appointment. Another EKG was performed which showed sinus rhythm poor R wave progression across the anterior leads. Cardiac catheterization was offered, but the patient wanted to wait and it was scheduled for four days later. The next day, however, the patient presented to another hospital’s ED with a chief complaint of chest pain. The patient received another EKG and his troponin I level was 0.16, indicating a potential heart attack. His chest pain was intermittent, but progressively worsened. The patient received a cardiac catheterization that day, which showed his right coronary artery was 99% occluded.