Urban v. King, 43 F.3d 523, 1994 U.S. App. LEXIS 36051 (10th Cir. 1994)

The patient was pregnant with twins and she presented to the OB department at the hospital for a stress test on the advice of her doctor. The stress test was nonreactive, but the nurse simply informed the patient to come back the next morning for another test. A biophysical profile was performed after consistent abnormal stem test results, and no movement or breathing was noted for either fetus. A cesarean section was performed that day; one fetus was stillborn and the other was born with severe brain damage. The patient brought an EMTALA claim for being sent home after the first stress test.

In discussing and eventually adopting the actual knowledge requirement for failure to stabilize claims, the court found that the hospital did not have knowledge of an emergency medical condition. Although the hospital saw concerning results from the stress test, the patient “was not in pain, and she had not displayed acute symptoms of severity at the time she was sent home from the obstetrics department.” Id. at 526. Because there was no actual knowledge, the Court held that summary judgment was appropriate.