Wisconsin Supreme Court Affirms Federal Right of Newborns to Medical Screening

The Wisconsin Supreme Court has held that children born in hospital birthing facilities that receive federal funds must be given medical screening for emergency conditions under federal law, regardless of age or disability.  On July 13, 2005, the Wisconsin high court reversed lower court decisions holding that the screening requirement of  federal Emergency Medical Treatment & Labor Act (EMTALA) did not apply to newborns unless the infant arrived at a hospital emergency room.  Meriter Hospital of Madison, Wisconsin, claimed that it had no obligation to screen newborns in its birthing facility.

The case was brought by Shannon Preston and Charles Johnson, the parents of Bridon Preston, claiming medical malpractice and violations of EMTALA due to failure to screen or treat Bridon at birth.  In November of 1999, Shannon went to Meriter Hospital.  She was examined and told that her child would not survive at birth because of his early gestational age of 23 weeks, 2 days, and as a result of ultrasound evaluation.  The hospital's policy is not to treat infants less than 24 weeks in gestational age.  According to Preston, the hospital medical staff abandoned her, the child's father, and the child Bridon in the birthing facility.  Bridon died 21/2 hours after his birth  without any medical attention.

Bridon  was 1 ½ pounds or 700 grams at birth.  With treatment, children have a survival rate of 63% with birth weights of 601-700 grams and of 74% at 701-800 grams.  Ms. Johnson and Bridon relied on public assistance for their medical treatment.

After a Wisconsin circuit court entirely dismissed the case, the National Legal Center for the Medically Dependent & Disabled, Inc., agreed to represent the child and his parents on appeal.  "We thought an injustice had been done to his child and his parents, and we believed that an important federal law meant to protect against this sort of thing had been wrongly interpreted by the court," explained James Bopp, Jr., President of the National Legal Center. 

After the Wisconsin Court of Appeals upheld the circuit decision, the National Legal Center requested and received Wisconsin Supreme Court review of the lower courts' holding that EMTALA's screening requirement did not apply to Bridon.  Based on analysis of the language and regulatory history of EMTALA, the Court concluded that "[w]hen a baby is born in a hospital birthing center, the newborn has come to the emergency department for the purposes the EMTALA duty to provide a medical screening examination."  The Court then remanded the case to circuit court to "decide whether Meriter's response to Bridon's presence satisfied its duty to provide an appropriate medical screening."

According to Bopp, the decision was important for at least three reasons.  "It provides that there must be at least an evaluation of a newborn's actual condition and individual chances for survival.  It provides that this screening must occur regardless whether the child comes to an emergency room or is born in a birthing facility.  And it establishes a relationship between child and health care provider that is the basis of an obligation to treat the child," said Bopp.  "It means that hospitals can't turn their backs on kids born prematurely or with disabilities simply because they are premature or have disabilities."