When someone suffers a traumatic brain injury, every minute counts. Emergency room decisions about whether and when to transfer a patient to a specialized trauma center can mean the difference between recovery and permanent disability. Delays in transferring brain injury patients to facilities equipped to handle their complex needs can result in devastating consequences that might have been prevented with timely intervention.
Understanding trauma center transfer delays and their legal implications is crucial for protecting patient rights in New York.
Key Takeaways
- Transfer delays impact outcomes: Research shows 20.3% of TBI patients require transfer to Level I or II trauma centers, yet delays in transfer correlate with worse outcomes.
- Federal law mandates transfers: EMTALA requires hospitals to transfer patients when they lack capability to treat emergency conditions like traumatic brain injury.
- Time is critical: Studies indicate mortality increases with delayed trauma center admission, particularly in the first hours after injury.
- Facilities must meet standards: New York law requires written transfer agreements between hospitals and regional trauma centers for severely injured patients.
- Legal recourse exists: Patients harmed by inappropriate transfer delays may have grounds for medical malpractice claims based on breaches in the standard of care.
What Constitutes a Trauma Center Transfer Delay?
A trauma center transfer delay occurs when a hospital fails to transfer a brain injury patient to an appropriately equipped facility within a reasonable timeframe. According to research published in PMC, of 351,555 TBI hospitalizations studied, 20.3% involved transfers to Level I or II trauma centers. However, only 68.2% of hospitalized TBI patients received trauma center care, falling substantially short of the expected 90% based on U.S. population access to major trauma centers.
Trauma center transfer delays can occur for various reasons, including failure to recognize the severity of injury, lack of available beds at receiving facilities, inadequate communication between hospitals, or administrative barriers that prioritize costs over patient care. These delays represent a form of emergency room error that can have devastating consequences. Research from Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine identifies specific factors that correlate with delayed trauma center admission following traumatic brain injury.
The Critical Timeframes in Brain Injury Care
The concept of the “golden hour” has been central to trauma care since it was coined by R. Adam Cowley in the early 1980s. According to research on neurotrauma care, this first 60 minutes after injury determines the framework of trauma care including pre-hospital care, patient transport, emergency room management, and subsequent treatment protocols.
While research shows mixed results on the strict 60-minute window, studies demonstrate that even within two hours, shorter time to definitive care is positively associated with patient survival and functional outcomes, particularly in major trauma and traumatic brain injury groups.
How Transfer Delays Cause Brain Damage
Transfer delays allow secondary brain injuries to progress unchecked. When a patient with traumatic brain injury remains at a facility lacking specialized neurosurgical capabilities, several dangerous processes can worsen outcomes.
Progressive Brain Swelling
Traumatic brain injuries trigger cerebral edema that can rapidly increase intracranial pressure. Without immediate access to neurosurgical intervention capabilities like craniotomy or intracranial pressure monitoring, patients face risks of herniation and further brain tissue damage. Research indicates that 44.5% of consecutively studied TBI patients developed delayed brain injury, which was associated with higher mortality and poorer outcomes at six months.
Expanding Hematomas
Intracranial bleeding can expand during the hours following initial injury. Facilities without immediate neurosurgical coverage cannot intervene quickly when CT scans show expanding subdural, epidural, or intracerebral hematomas. These expanding bleeds compress brain tissue and increase intracranial pressure.
Inadequate Intracranial Pressure Management
Specialized trauma centers have protocols and equipment for aggressive intracranial pressure management, including continuous ICP monitoring, hyperosmolar therapy, sedation protocols, and controlled ventilation strategies. Hospitals lacking these capabilities cannot prevent secondary injury from elevated intracranial pressure.
Missed Opportunities for Early Intervention
Every hour of delay represents lost opportunity for life-saving interventions. Patients at non-trauma centers may not receive appropriate imaging, may lack access to neurosurgical consultation, and miss the window for interventions that could prevent permanent disability.
Statistics on Transfer Delays and Brain Injury Outcomes
Multiple studies have examined the relationship between transfer timing and patient outcomes in traumatic brain injury cases. The data consistently shows that delays impact survival and long-term function.
Direct vs. Transferred Patients
Research demonstrates that TBI patients directly transported to a trauma center have significantly lower mortality by 50% compared to patients transferred to a trauma center after initial evaluation at another hospital. This substantial difference highlights the critical importance of appropriate initial destination decisions by emergency medical services.
Transfer Rates by Age
According to PMC research, transfer rates vary significantly by age: patients 55+ had 38.1% transfer rate, ages 30-54 had 22.9% transfer rate, ages 18-29 had the lowest rate at 21.7%, while patients under 18 had 34.9% transfer rate.
| Patient Category | Transfer Statistic | Outcome Impact |
|---|---|---|
| Secondary transfers | Had later radiology and surgery than direct transfers | Delayed intervention increased risk |
| Delayed admission patients | 44.5% developed delayed brain injury | Associated with higher mortality and slower recovery |
| Overall trauma center access | Only 68.2% received trauma center care | Falls short of 90% expected based on population access |
| Polytrauma cases | Mortality increases 1% for every 3 minutes of delay | Time-critical nature of severe injuries |
Critical Finding
Research indicates that delay in transport to a Level I trauma center results in higher mortality rates for traumatic brain injury patients. The optimal transport time for TBI patients to a specialized trauma center is estimated between 90 and 120 minutes, beyond which outcomes worsen significantly.
EMTALA Requirements for Emergency Transfers
The Emergency Medical Treatment and Labor Act (EMTALA) is a federal law that governs when and how hospitals must transfer patients with emergency medical conditions. According to the American College of Emergency Physicians, EMTALA requires hospitals to provide a medical screening examination and stabilizing treatment regardless of a patient’s insurance status or ability to pay.
When Transfers Are Required
If a hospital does not have the capability to treat an emergency medical condition like traumatic brain injury requiring neurosurgical intervention, the hospital must arrange an appropriate transfer to a facility with the necessary capabilities. The EMTALA transfer requirements specify that an appropriate transfer must meet six key elements.
Elements of an Appropriate Transfer
An acceptable transfer under EMTALA requires the transferring hospital to provide treatment to minimize health risks, confirm the receiving facility has available capacity and qualified staff, provide all relevant medical documents, use qualified personnel and appropriate transportation, obtain physician certification for unstable patients, and comply with all Centers for Medicare and Medicaid Services requirements.
According to EMTALA guidelines, a medically unstable patient cannot be transferred unless the patient requests the transfer and a physician certifies that the benefits outweigh the risks. The law defines stabilized as no material deterioration of the condition is likely within reasonable medical probability to result from or occur during the transfer.
Receiving Hospital Obligations
Specialized facilities including trauma centers with neurosurgical capabilities have mandatory obligations under EMTALA. They cannot refuse transfers based on insurance status, must accept patients if they have available beds and appropriate personnel, cannot ask insurance questions when receiving emergency transfers, and must accept patients needing their specialized services.
EMTALA Penalties
Violations of EMTALA carry serious consequences. Individual violations can result in penalties up to $50,000 per physician or hospital. Hospital maximum penalties exceed $119,000 for facilities with 100+ beds or $60,000 for smaller facilities. These penalties are not covered by malpractice insurance and can include loss of Medicare and Medicaid funding for repeated violations.
New York Requirements for Trauma Center Transfers
New York State has established specific requirements governing trauma center designations and transfer protocols. According to New York State Department of Health trauma standards, all hospitals are required to have written transfer agreements with regional trauma centers and area trauma centers for the transfer of severely injured trauma patients.
Standards for Neurosurgeon Availability
For facilities designated as trauma centers in New York, regulations require a neurosurgeon available in the hospital 24 hours a day. This requirement may be fulfilled by an in-house neurosurgeon, surgeon, or post-graduate trainee with special competence in neural trauma who is capable of initiating measures directed toward stabilizing the patient and initiating diagnostic procedures.
Transfer Protocol Requirements
Regarding the standard of care for patients with head trauma, the first emergency room physician should know to either readily admit patients for care if the hospital has all the diagnostic tests and equipment required, or have them transferred to another more appropriate facility. New York’s medical treatment guidelines for traumatic brain injury emphasize that management should be based on clinical evaluation and anticipated functional gains.
Documentation and Communication Standards
New York hospitals must document transfer decisions, maintain communication logs between sending and receiving physicians, and ensure that all relevant imaging and medical records accompany the patient. Failure to meet these documentation standards can constitute evidence of substandard care in malpractice litigation.
Signs That a Transfer Delay Caused Harm
Certain clinical indicators suggest that a patient’s outcome was worsened by delayed transfer to an appropriate trauma center. Recognizing these signs is important for both medical professionals and families considering legal action.
Neurological Deterioration
Progressive decline in Glasgow Coma Scale score, new onset seizures, pupillary changes, or development of focal neurological deficits while awaiting transfer suggests evolving brain injury that needed more immediate specialized intervention.
Imaging Changes
Repeat CT scans showing expansion of intracranial hemorrhage, increased brain swelling, or development of herniation between initial imaging and arrival at the trauma center indicate progression that might have been prevented with earlier transfer.
Delayed Surgical Intervention
When surgical intervention occurs many hours after injury due to transfer delays, and imaging shows that the condition requiring surgery was present or developing at the initial hospital, this suggests the transfer delay prevented timely life-saving intervention.
Documentation Review Indicators
Medical records may reveal transfer delays through timestamps showing extended time between recognition of need for higher level care and actual transfer completion, lack of documented transfer communication attempts, delays in arranging ambulance transport, or administrative discussions about bed availability or insurance that delayed medically necessary transfers.
Medical Malpractice and Standard of Care Violations
When transfer delays result in patient harm, they may constitute medical malpractice based on violations of the standard of care. In New York, medical malpractice requires proving that healthcare providers deviated from accepted medical standards and that this deviation caused injury.
Elements of a Transfer Delay Claim
A successful claim for brain injury caused by trauma center transfer delay must establish several elements. First, the patient must show a duty of care existed, which is established when a hospital accepts a patient for evaluation and treatment. Second, the patient must prove breach of the standard of care by demonstrating that a reasonably competent emergency physician would have recognized the need for transfer sooner or would have expedited the transfer process.
Third, causation must be established by showing that the delay directly caused additional brain injury that would not have occurred with timely transfer. Finally, the patient must demonstrate damages including additional medical expenses, extended rehabilitation, lost wages, pain and suffering, or diminished quality of life resulting from the transfer delay.
Common Standard of Care Violations
Transfer delay cases often involve specific breaches in accepted medical practice. These include failure to recognize the severity of traumatic brain injury on initial evaluation, delays in obtaining necessary CT imaging, failure to consult neurosurgery in a timely manner, inadequate communication with potential receiving facilities, delays in arranging transport once transfer decision is made, and failure to provide appropriate stabilizing care while awaiting transfer.
Expert Testimony Requirement
New York medical malpractice cases require expert testimony establishing the applicable standard of care, demonstrating how the defendant deviated from that standard, and proving causation. Qualified experts typically include emergency medicine physicians, neurosurgeons, and trauma specialists familiar with transfer protocols and brain injury management.
Case Examples of Transfer Delay Brain Injuries
Understanding how transfer delays cause harm in real-world situations illustrates the importance of timely decision-making in traumatic brain injury cases.
Expanding Epidural Hematoma Case
A patient presented to a community hospital emergency department after a fall with head injury. Initial CT scan showed a small epidural hematoma, and the emergency physician consulted with a neurosurgeon by phone who recommended observation. However, the hospital lacked neurosurgical capabilities on site. Over the next four hours, the patient’s condition deteriorated with decreasing level of consciousness. Repeat CT scan showed the hematoma had tripled in size. Transfer was then arranged, but by the time the patient reached the trauma center and underwent surgery, significant brain damage had occurred. Expert review concluded that earlier transfer to a facility with immediate neurosurgical availability would likely have allowed intervention before the hematoma expanded to the point of causing permanent injury.
Delayed Recognition of Severe TBI
A young adult involved in a motor vehicle collision was taken to a Level III trauma center. Initial evaluation showed confusion and brief loss of consciousness, but CT scan interpretation by the emergency physician was read as showing only minor contusion. The patient was admitted for observation. Overnight, the patient became increasingly lethargic. When the radiologist provided an official read the next morning, it revealed significant subarachnoid hemorrhage and developing hydrocephalus that had been missed on the initial interpretation. Transfer was then initiated, but the 12-hour delay in recognition and transfer resulted in the patient requiring emergency ventriculostomy and experiencing permanent cognitive deficits that might have been minimized with immediate transfer to a Level I trauma center with 24-hour neurosurgical coverage.
Administrative Transfer Delays
According to the New York Injury Cases Blog, one case involved a patient with respiratory failure who needed specialized care. The case of Keimoneia Redish at St. Barnabas Hospital in the Bronx involved delays in providing appropriate treatment, resulting in a seizure that caused extensive brain damage. The jury found multiple doctors negligent and awarded $90 million in pain and suffering damages, illustrating how delayed appropriate intervention can result in catastrophic harm.
Building a Legal Case for Transfer Delay
Patients harmed by trauma center transfer delays need to understand the process of building a medical malpractice case in New York. The legal framework requires careful documentation and expert analysis.
Gathering Medical Records
Complete medical records from all involved facilities are essential. This includes emergency department records with timestamps, all imaging studies and radiology reports, transfer communication logs, ambulance run sheets, trauma center admission records, and all subsequent treatment documentation. Records often reveal the timeline of recognition, decision-making, and transfer execution that forms the factual basis for claims.
Obtaining Expert Review
New York requires expert testimony in medical malpractice cases. Qualified experts must review the records and provide opinions on whether the standard of care was breached. In transfer delay cases, this typically involves emergency medicine experts who can address the initial evaluation and transfer decision-making, neurosurgical experts who can explain the injury progression and treatment opportunities that were missed, and neuroradiology experts who can interpret imaging studies and explain when findings warranted immediate transfer.
Establishing Causation
Proving that the transfer delay caused additional injury requires demonstrating what would have happened with earlier transfer. This often involves comparing the patient’s neurological status at different time points, analyzing imaging studies to show injury progression during the delay period, and establishing that interventions available at the trauma center would have prevented or minimized the harm if the patient had arrived sooner.
In New York, medical malpractice claims generally must be filed within two and a half years from the date of the alleged malpractice, or from the end of continuous treatment by the defendant for the same condition. There are limited exceptions for discovery of injury. Consulting with an attorney promptly is essential to preserve legal rights.
Compensation Available in Transfer Delay Cases
Victims of brain injuries caused by trauma center transfer delays may be entitled to substantial compensation for the harm they have suffered. New York law allows recovery of both economic and non-economic damages.
Economic Damages
Economic damages compensate for actual financial losses and typically represent the largest portion of compensation in severe brain injury cases. These include past and future medical expenses for hospitalization, surgery, rehabilitation, therapy, medications, and adaptive equipment. Lost wages cover both past earnings lost during recovery and future earning capacity that is diminished by permanent brain injury. Home modifications and ongoing care costs may be necessary when brain injury results in permanent disability requiring assistance with daily living activities.
Non-Economic Damages
Non-economic damages compensate for losses that do not have a specific dollar value but significantly impact quality of life. Pain and suffering address the physical pain and emotional distress caused by the brain injury. Loss of enjoyment of life compensates for inability to engage in activities and hobbies that provided fulfillment before the injury. Loss of consortium claims may be available to spouses when brain injury impacts the marital relationship.
| Damage Category | Components | Calculation Method |
|---|---|---|
| Medical Expenses | Past and future treatment, rehabilitation, medications, equipment | Actual bills plus life care plan projections |
| Lost Income | Wages lost during recovery and diminished future earning capacity | Actual earnings plus vocational expert projections |
| Pain and Suffering | Physical pain, emotional distress, mental anguish | Jury determination based on severity and duration |
| Loss of Quality of Life | Inability to engage in previous activities and relationships | Evidence of functional limitations and lifestyle changes |
Factors Affecting Compensation Amounts
Several factors influence the value of transfer delay brain injury cases. The severity of permanent injury is perhaps most significant, with catastrophic injuries resulting in permanent disability commanding higher compensation than moderate injuries with good recovery. The strength of liability evidence matters, as cases with clear documentation of delay and obvious standard of care violations typically result in better settlement offers. The patient’s age and pre-injury earning capacity affect calculation of future lost income. The quality of life impact is assessed by examining how the brain injury affects daily activities, independence, and relationships.
Prevention of Transfer Delays
While legal recourse exists for patients harmed by transfer delays, preventing these delays is the ultimate goal. Hospitals and emergency departments can implement systems to minimize the risk of inappropriate delays in transferring brain injury patients.
Clear Transfer Protocols
Hospitals should maintain written protocols clearly defining criteria for trauma center transfer. These protocols should specify which brain injury findings on CT scan mandate immediate transfer, what Glasgow Coma Scale scores require neurosurgical capability, and time targets from decision to transfer completion. Protocols should include contact information for regional trauma centers and streamlined communication processes.
Early Neurosurgical Consultation
Emergency departments should have low thresholds for neurosurgical consultation in brain injury cases. Telemedicine capabilities can provide access to neurosurgical expertise even at facilities without on-site neurosurgeons. Early consultation helps ensure that the decision for transfer is made promptly based on expert input rather than delayed while the emergency physician attempts to manage the case beyond their expertise.
Rapid Transfer Coordination
Once the decision for transfer is made, execution should be rapid. This requires pre-existing transfer agreements with receiving facilities, dedicated transfer coordinators who can efficiently arrange bed availability and transport, and protocols that prevent administrative barriers from delaying medically necessary transfers. Insurance verification and billing discussions should never delay emergency transfers.
System-Level Solutions
Regional trauma systems should ensure adequate distribution of trauma center capabilities, maintain real-time bed availability information, provide telemedicine consultation access to facilities without on-site specialists, and conduct regular reviews of transfer cases to identify system problems that caused delays.
Quality Improvement
Hospitals should track transfer metrics including time from arrival to transfer decision and time from decision to transfer completion. Regular case reviews should identify delays and implement corrective actions. Staff education should emphasize the time-critical nature of brain injuries and the importance of efficient transfer processes.
What to Do If You Suspect a Transfer Delay Caused Harm
If you or a loved one suffered a brain injury and you believe delays in transfer to an appropriate trauma center contributed to the harm, taking prompt action can help preserve your legal rights and improve your understanding of what occurred.
Document Everything
Keep detailed records of the timeline of events as you understand them. Note when symptoms began, when you arrived at the first hospital, when you were told about transfer plans, and when transfer actually occurred. Save all discharge paperwork, billing statements, and correspondence from healthcare providers. Document the patient’s condition at various points and any changes you observed.
Request Complete Medical Records
Under federal HIPAA law, patients have the right to obtain copies of their medical records. Request records from all facilities involved in care, including the initial hospital, the receiving trauma center, and any rehabilitation facilities. Specifically request all imaging studies on CD, not just radiology reports. Ask for emergency department and nursing flow sheets that contain timestamped observations and interventions.
Consult an Experienced Attorney
Medical malpractice cases involving brain injury are complex and require specialized legal expertise. An attorney experienced in medical malpractice and brain injury cases can arrange for expert medical review to determine whether the standard of care was breached. Legal counsel can evaluate the strength of your case, explain the legal process and potential outcomes, and handle negotiations with insurance companies and defendants.
New York’s statute of limitations for medical malpractice requires action within two and a half years in most cases. Consulting an attorney promptly ensures that important deadlines are not missed and that evidence is preserved.
It is important not to rely solely on hospital explanations. Hospitals often provide explanations for treatment decisions that may sound reasonable but do not withstand scrutiny by independent experts. Independent expert review is necessary to determine whether the standard of care was met.
Role of Family Members in Transfer Decisions
Family members can play important advocacy roles when a loved one suffers traumatic brain injury. Understanding your rights and appropriate actions can help ensure patients receive timely appropriate care.
Asking About Transfer Plans
When a family member is diagnosed with traumatic brain injury, it is appropriate to ask whether the hospital has neurosurgical capabilities, whether neurosurgeons are immediately available, and whether transfer to a trauma center is being considered. If the answer is that the patient will be observed at the current facility, ask what specific criteria would trigger transfer and what the monitoring plan involves.
Requesting Second Opinions
Under EMTALA, patients have the right to request transfer even when physicians recommend against it. While this should not be done casually, if family members have concerns that a patient is not receiving appropriate care or that delay in transfer to a specialized facility is occurring, they can request that transfer be arranged. Documenting such requests is important.
Monitoring Patient Condition
Family members often notice changes in a patient’s condition. If a brain injury patient shows worsening confusion, increased headache, vomiting, changes in pupil size, weakness on one side, or decreasing alertness, these changes should be reported to nursing staff immediately and family members should ask whether these findings warrant transfer.
The Future of Trauma Transfer Systems
Ongoing research and system improvements aim to reduce transfer delays and improve outcomes for traumatic brain injury patients. Understanding these developments provides context for the current state of care and future directions.
Telemedicine Consultation
Telemedicine systems increasingly allow emergency physicians at community hospitals to consult in real-time with neurosurgeons at trauma centers. This technology can facilitate earlier recognition of injuries requiring transfer and provide guidance on stabilization measures while transfer is being arranged. Studies suggest telemedicine consultation can reduce time to transfer decision.
Updated Transfer Guidelines
Recent research in 2024 has examined applying updated Brain Injury Guidelines to interhospital transfers. These guidelines help stratify patients by risk level, with BIG1 and BIG2 patients without polytrauma potentially being safely managed without transfer, while BIG3 patients and those with polytrauma require transfer. This risk stratification can help ensure that transfer resources are directed to patients who most need specialized care while avoiding unnecessary transfers.
Regional Trauma System Coordination
Improved regional coordination aims to ensure trauma patients reach appropriate facilities efficiently. This includes real-time tracking of trauma center bed availability, pre-hospital protocols for field triage to appropriate facilities, and inter-facility transfer protocols that minimize delays in moving patients to higher levels of care when needed.
Protect Your Legal Rights After a Transfer Delay Brain Injury
If you or a loved one suffered brain damage that may have been caused or worsened by delays in transfer to an appropriate trauma center, our experienced legal team can help you understand your rights and options. We work with leading medical experts to thoroughly investigate whether the standard of care was met and pursue full compensation for the harm you have suffered.
Frequently Asked Questions
How long should it take to transfer a brain injury patient to a trauma center?
While the specific timeframe depends on clinical circumstances, research suggests optimal transport time for traumatic brain injury patients to a specialized trauma center is between 90 and 120 minutes. The decision to transfer should be made as soon as imaging or clinical findings indicate the patient needs neurosurgical capabilities not available at the current facility. Once the decision is made, transfer should occur as rapidly as possible with appropriate stabilization and communication.
Can a hospital refuse to transfer a brain injury patient?
Under EMTALA, a hospital cannot refuse to arrange an appropriate transfer when it lacks the capability to treat an emergency medical condition. If a hospital does not have neurosurgical services and a patient has a traumatic brain injury requiring such services, the hospital must arrange transfer to an appropriate facility. Hospitals that refuse medically necessary transfers can face significant federal penalties including fines up to $119,000 and loss of Medicare funding.
What if the trauma center says they have no beds available?
EMTALA requires specialized facilities like trauma centers to accept transfers if they have capacity and appropriate personnel. A trauma center with the specialized services needed cannot refuse a transfer based on lack of available beds if beds actually exist. However, if a trauma center is genuinely at full capacity, the transferring hospital must contact alternative facilities. Delays caused by multiple facilities claiming lack of capacity when patients need urgent specialized care can constitute a standard of care violation if the transferring hospital does not escalate appropriately.
How do I prove that a transfer delay caused additional brain damage?
Proving causation requires medical expert analysis comparing the patient’s condition at different time points. Experts review imaging studies to determine when injury progression occurred, analyze whether interventions available at the trauma center would have prevented the progression, and compare the patient’s neurological status before and after transfer. Documentation showing deteriorating Glasgow Coma Scale scores, expanding hematomas on repeat imaging, or development of complications while awaiting transfer provides evidence that the delay caused harm.
What is the statute of limitations for filing a medical malpractice case in New York for transfer delays?
New York generally requires medical malpractice lawsuits to be filed within two and a half years from the date of the alleged malpractice or from the end of continuous treatment for the same condition. There are limited exceptions, including the discovery rule for cases where the injury was not immediately apparent. Because these deadlines are strict and calculating them can be complex, consulting an attorney as soon as you suspect negligence is important to ensure your rights are preserved.
Will insurance pay for the costs of transfer to a trauma center?
EMTALA prohibits hospitals from delaying medically necessary transfers based on insurance status or ability to pay. Emergency transfers for unstable patients must occur regardless of insurance. However, the costs of transfer may later be billed to the patient or their insurance. Most insurance plans cover medically necessary emergency transfers, though patients may be responsible for deductibles and co-payments. If a transfer delay occurred because of insurance concerns, this could constitute an EMTALA violation and potentially support a malpractice claim.
Can family members request that a patient be transferred even if doctors recommend observation?
Patients or their legal representatives have the right to request transfer even when physicians believe continued care at the current facility is appropriate. Under EMTALA, if a patient requests transfer, the hospital must arrange it unless a physician certifies that the risks of transfer outweigh the benefits. However, such requests should be made carefully and ideally in consultation with medical personnel. If family members have serious concerns that a patient is not receiving appropriate care or that transfer delay is occurring, they should voice these concerns clearly and document them.
