Sen. Ron Wyden (D-OR), the chairman of the Senate Finance Committee, wrote to Piedmont Henry Hospital CEO David Kent on Monday and inquired whether a Georgia state law prohibiting abortion after six weeks of pregnancy inhibited the hospital’s ability to provide medical treatment to Thurman, who experienced severe complications from abortion pills. The federal Emergency Medical treatment and Labor Act, also known as EMTALA, is a 1986 law that requires hospitals that receive Medicare funding to provide necessary stabilizing treatment to any person with an emergency medical condition. Since the Supreme Court overturned federal abortion protections under Roe v. Wade in June 2022, abortion rights groups have argued that state laws prohibiting elective abortions have also prevented healthcare professionals from terminating a pregnancy or removing deceased fetal tissue from a mother during severe emergencies. “Across the country, there are reports that women are being turned away by emergency departments when they seek emergency reproductive healthcare, even in instances where medical professionals determine that, without such care, the patient is at risk of serious complications, infection, or even death,” Wyden wrote. “These women are caught between dangerous state laws that are in clear conflict with — and preempted by — EMTALA.” Amber Thurman and abortion complications Wyden’s letter does not refer to Thurman’s case using her name but references medical details about her case that were made public by ProPublica last week. Thurman, a 28-year-old aspiring nursing student with a 6-year-old son, was nine weeks pregnant with twins in August 2022. But in 2019, Georgia passed a law banning abortion after six weeks gestation, approximately when fetal cardiac activity can be detected via ultrasound. Thurman traveled to an abortion clinic in North Carolina, where she was given the abortion pills mifepristone and misoprostol to take at home. Five days after taking the misoprostol to induce contractions, Thurman presented at the Piedmont Henry emergency department with heavy bleeding, vomiting, foul-smelling vaginal discharge, and a critically elevated white blood cell count. These were likely signs of a severe infection due to being unable to expel all of the pregnancy tissue in her uterus — or what is called medically “retained products of conception.” Thurman had to wait for three hours before being given antibiotics to treat the infection, and she waited nearly 20 hours to receive a dilation and curettage, a procedure that involves dilating the woman’s cervix and surgically removing the retained products of conception by scraping the inside of the uterus. By the time Thurman was taken into surgery to complete the dilation and curettage, she had already experienced organ failure, and she died on the operating table. Piedmont Henry Hospital did not respond to the Washington Examiner’s request for comment. Consequences of abortion bans Anti-abortion medical and legal experts have been vocal following the announcement of Thurman’s death, arguing that Georgia state law did not restrain doctors from treating Thurman or other women experiencing abortion or miscarriage complications. “Georgia bans procedures that cause the death of an unborn child whose heart is beating without a lawful justification,” Katie Daniel, the state policy director for SBA Pro-Life America, told the Washington Examiner last week. “It did not ban any particular procedure. A D&C can always be performed if it is medically indicated to treat miscarriages or to treat abortion complications.” Dr. Christina Francis, the CEO of the American Association of Pro-Life Obstetricians and Gynecologists, said in a statement on Friday that Thurman’s death was a textbook case of complications from a chemical abortion, which occur for every 1 in 25 women who undergo the procedure, according to data from the Food and Drug Administration. “Deaths due to legal abortion drugs are the expected result of deregulating and falsely promoting them as safe, both of which the Biden-Harris administration has led efforts to do,” Francis said. “All state pro-life laws allow physicians to save the lives of pregnant women.” The American College of Obstetricians and Gynecologists, which backs the removal of all gestational limitations on abortion, has not responded to the Washington Examiner’s request for comment on the Thurman case. Abortion and EMTALA Abortion rights advocates have argued since the overturning of Roe that because dilation and curettages are used in both elective abortions and miscarriage, physicians who perform the procedure could be prosecuted under state abortion bans. The federal Supreme Court in April heard oral arguments in Moyle v. U.S., a case brought by the Biden-Harris administration against Idaho’s near-total abortion ban with the narrow exception to prevent the death of the mother. The Biden-Harris administration argued that abortion can constitute stabilizing medical treatment under EMTALA. The office of Idaho Attorney General Raul Labrador, by contrast, argued that the state law only applied to ending the life of an unborn child outside of an emergency context where it was impossible to save both the mother and fetus. In June, the Supreme Court ruled in a 6-3 decision to dismiss the case, not evaluating the merits of the issue and striking down Idaho’s abortion ban at least temporarily. Wyden’s letter addresses the Idaho EMTALA case along with the similar case against Texas’s abortion ban that faces pending litigation. “In the face of this uncertainty, providers and patients continue to suffer and there continues to be significant confusion on the ground,” Wyden wrote to Kent at Piedmont Henry. The Senate Finance Committee, which has primary jurisdiction over EMTALA since it is a requirement of federal Medicare funding, is slated on Tuesday to hold a hearing on abortion-related deaths and medical malpractice since the overturning of Roe. Wyden’s letter requires a response outlining the hospital’s compliance with EMTALA by Oct. 22.
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