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Tuesday, February 8, 2011

Texas Hospital Under Fire for Allegedly Discharging Surgical Patient Due to Immigration Status

John Sealy Hospital in Galveston, Texas

A Texas hospital is under fire for allegedly telling a surgical patient she had to leave the hospital immediately because she was an illegal immigrant.

Maria Sanchez, 24, told the Houston Chronicle that she had been at John Sealy Hospital -- part of the University of Texas Medical system -- for six days when a doctor told her on Jan. 12 that she should go to Mexico to have surgery on her growing spinal tumor. The hospital discharged her that day, the paper reported.

Sanchez's husband, Luis Aguillon, a legal U.S. resident, told the paper his wife is now getting medical care in Houston. But the couple's case is sparking a nationwide ethics debate.

A former surgeon in the University of Texas medical system who reviewed Sanchez's medical records told the Chronicle that even though Sanchez, who'd already lost use of her right hand, would likely worsen as she waited for surgery, her discharge wasn't that unusual.

"This is a practice that takes place at other hospitals," said Dr. Bill Nealon, now at Vanderbilt University Medical Center in Nashville, Tenn.

The Federation for American Immigration Reform says that's because it's perfectly reasonable for a state to refuse to provide health care to a non-resident unless it's an immediately life-threatening situation.

"We all know there's a finite amount of money available to provide needed health care to people in this country…it doesn't appear that in this case it's a matter of life and death right this minute," Ira Mehlman, the groups media director, told FoxNews.com.

Mehlman says without that immediate danger, states have every right to consider whether taxpayers should pay for an illegal immigrant's health care or whether that person should seek care in their home country -- even if that person is married to a legal resident.

"Very often illegal aliens have relatives who are legal residents, very often citizen kids. The fact that her husband is a legal resident does not change the fact that she is an illegal alien," he said.

Arthur Caplan, Chair of the Department of Medical Ethics and Director of the Center for Bioethics at the University of Pennsylvania, agrees.

"The need to stabilize people who are immediately at risk of dying is clear cut -- whatever country they're from, whatever their insurance status. Beyond that, each hospital makes its own decision of what it will do and how it will distribute its charity," he told FoxNews.com.

Caplan says that decision normally hinges on the stance that "charity begins at home."

"I think that is the ethically responsible stance, you should care for people in your neighborhood, in your area, and ultimately in your nation first," he said. "… And they have to come ahead of people that are in the country illegally."

But Immigration Attorney Francisco Hernandez says Sanchez's he would argue Sanchez's condition was emergent.

"I disagree that she was stable as there was an obvious risk of loss of limb, this trumps all of the rules. She should have been treated to include the surgery by the accepting surgeon who agreed to provide her care," Hernandez told FoxNews.com.

Immigration Attorney and Former Federal Prosecutor Michael Wildes agrees, saying the hospital could be liable for any harm that came to Sanchez as result of the tumor after leaving the hospital.

"Any skilled lawyer would be able to show a timeline and any action that would be taken that would disturb this spinal tumor that would lead to death or injury would be actionable against that facility," he told FoxNews.com.

Caplan also says that once a hospital accepts a patient it must provide them with information on where else they can seek care, which can include their home country, if they are discharged prematurely.

Whether the hospital fulfilled that obligation is unclear.

Aguillon told the Chronicle he received no other referral beyond Sanchez's discharge order, which stated she was to follow-up, "with PCP (primary care physician) in one week, NS (neurosurgery) as scheduled in Mexico."

John Sealy Hospital said in a statement that HIPAA rules and regulations prohibit it from discussing the medical records of individuals but that providing the best medical care to patients is its highest priority.

All patients with emergent, life-threatening conditions "are provided with treatment until they are stable and admitted, or are transferred to another hospital," the statement read. "Neither the initial medical screening nor life-saving treatment is impeded by inquiries about the individual's method of payment or insurance status."

In non-emergency situations, the hospital says patients are financially screened, but "the timing at which the screening occurs may differ depending upon the patient's medical condition when admitted. In cases of financial hardship, patients are referred to several potential sources of financial assistance."

Aguillon said after his wife's discharge the couple visited at least five hospitals and three clinics before finally moving to Houston, where she qualified for care and is now being treated at Ben Taub General Hospital .

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