Freeman Health System – Freeman West Agreed to Pay $250,000 for Allegedly Violating Patient Dumping Statute by Failing to Provide Stabilizing Treatment

On December 4, 2024, Freeman Health System – Freeman West (Freeman), Joplin, Missouri, entered into a $258,464 settlement agreement with OIG.  The settlement agreement resolves allegations that Freeman violated the Emergency Medical Treatment and Labor Act (EMTALA).  Based on its investigation, OIG concluded that in August 2022, Freeman failed to provide stabilizing treatment for a pregnant patient who had presented to Freeman’s labor and delivery unit seeking care after experiencing serious complications including bleeding, leaking amniotic fluid, abdominal pressure and abdominal cramping.  The patient had a medical history that included a miscarriage in the first trimester of pregnancy and recent deep vein thrombosis (DVT).  Freeman provided a medical screening exam, diagnosed the patient with preterm premature rupture of membranes at 17 weeks and 5 days gestation, and treatment options of (1) continued observation or (2) inducing labor were discussed with the patient. Freeman informed the patient that the fetus, if born that day, was not viable and that her chances of continuing to carry the fetus to a gestational age for survival were extremely low.  In addition, Freeman informed the patient that she was at risk for the following conditions without the appropriate stabilizing treatment of inducing labor: maternal thrombosis (given her history of DVT), infection, sepsis, severe blood loss, hysterotomy, hysterectomy and death. When the patient requested stabilizing treatment for her emergency medical condition, i.e., medical assistance in inducing labor, Freeman offered to hold the patient at the facility for observation in order to monitor the deterioration of the patient’s condition before it would provide the stabilizing treatment she needed.  Given the potential risks to her health if stabilizing treatment were delayed, the patient left Freeman to go to another hospital for stabilizing treatment.

The patient did not receive stabilizing treatment at the second hospital where she presented. The patient returned to Freeman the next day.  The patient reported continued complications as well as increased cervical dilation.  She stayed at Freeman overnight for observation.  Freeman again offered to continue to monitor her condition to some point of deterioration when it would then provide the stabilizing treatment she needed.  Again, fearful of the risks involved in waiting for her condition to deteriorate before Freeman would provide the needed stabilizing treatment, the patient left Freeman to pursue treatment elsewhere and was discharged home. Senior Counsel Sandra Sands represented OIG.

Visit The Emergency Medical Treatment and Labor Act (EMTALA) featured topics page for more information on OIG’s role in enforcing EMTALA.

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