Cambridge Health Alliance in Massachusetts has agreed to settle a civil monetary penalty (CMP) case for an alleged violation of the Emergency Medical Treatment and Labor Act (EMTALA) after an asthmatic woman collapsed at the locked, unattended doors of the ambulance bay on the Somerville Hospital campus, even though a nurse was told of her plight by a 911 operator, according to the HHS Office of Inspector General. The woman died less than a week later.

The hospital will pay $90,000 because it allegedly failed to provide the patient with an appropriate medical screening exam (MSE) when she presented to the emergency department (ED), according to the settlement.

“OIG’s enforcement in this case was based on the knowledge that an emergency patient was in [the hospital’s] reach. It didn’t act in what we believe was a reasonable manner,” says Sandra Sands, senior counsel with OIG. “Emergencies are the business of people who work in the ED. They could have responded much more proactively, so why is it they didn’t?”

The case also is a reminder of the importance of ED workflow because it extends outside of the ED doors, says Austin, Tex., attorney Kathy Poppitt, with King & Spalding. “You not only look at what’s happening inside your ED, but what can happen outside of it.”