Patient-Dumping Case Before Court

The Supreme Court Tuesday struggled over the meaning of a federal law that bars hospitals from "dumping" patients who need emergency care.

CBS News Correspondent Stephanie Lambidakis reports that the lawyer for a Kentucky woman who was hit by a truck asked the high court to revive her lawsuit that alleges a hospital prematurely transferred her to a nursing home.

"Her condition got substantially worse" because of the transfer, said Joseph H. Mattingly III, the lawyer for Wanda Johnson of Bardstown, Ky. "She almost died."

Lower courts dismissed her case, saying people can sue under the federal anti-dumping law only if they show a hospital acted with an improper motive.

The hospital's lawyer, Carter G. Phillips, conceded the law doesn't require proof of an improper motive. But he asked the justices to bar Johnson from suing on other grounds not initially raised before the high court.

The hospital had determined, he said, that she needed the kind of skilled care that the nursing home could best provide.

The 1986 Emergency Medical Treatment and Labor Act applies only to a hospital's initial decision on whether to admit a patient for emergency treatment, Phillips said. Because Johnson was transferred to the nursing home after two months in Humana Hospital-University of Louisville, she could not sue under the federal law, he said.

Justice Sandra Day O'Connor expressed reservations about the hospital's late switch of legal arguments.

"That makes it awfully hard for this court to deal with," she said. Johnson's lawyers and Clinton administration lawyers who support her appeal had little chance to address the new argument, O'Connor added.

Mattingly and Justice Department lawyer James A. Feldman urged the justices to revive Johnson's lawsuit and have a lower court consider the other grounds raised by Phillips.

Feldman said Health and Human Services Secretary Donna Shalala planned to consider new rules on how long a hospital's obligations extend under the law.

Phillips argued that once a hospital admits a patient needing emergency treatment, its obligation under the federal anti-dumping law ends. From that point, he said, patients are protected by state medical malpractice laws.

But Mattingly said Johnson has been barred from suing the hospital under state malpractice law because a court decided the hospital was not responsible for a medical student's decision to order her transfer.

Johnson suffered brain damage and other severe injuries when she was hit by a truck while walking home from work on May 9, 1992. That July, Humana officials transferred Johnson, who had no health insurance, to an Indianapolis nursing home.

Her lawyers said that the day before her transfer she ran a fever and showed symptoms of infection, and one of her lungs collapsed. After arriving at the nursing home, her condition worsened and she was rushed to hospital.

Johnson's aunt, Jane Roberts, sued the hospital on her behalf. A federal judge dismissed the case, and the 6th U.S. Circuit Court of Appeals agreed. Patients must prove a hospital acted with an improper motive to recover damages under the federal law, the appeals court said.

Johnson's Supreme Court appeal argued that requiring her to prove such a motive would make it almost impossible to recover damages.

Lawyers for the hospital, now owned by Galen of Virginia, conceded the federal anti-dumping law does not require proof of an improper motive. But they also said the law does not apply once a hospital has completed initial emergency treatment.