A federal investigation found that Ascension Seton Williamson Hospital broke the law by failing to give a woman timely medical care for an emergency pregnancy condition.
Kyleigh Thurman filed a complaint against the hospital in August after seeking care for an ectopic pregnancy — when a fertilized egg implants somewhere outside the uterus. Ectopic pregnancies cannot be brought to term and are life-threatening when not treated early.
Thurman and her lawyers at the Center for Reproductive Rights said Ascension Seton Williamson delayed care to end the nonviable pregnancy, risking Thurman's life and compromising her future fertility. They argued that the hospital violated the federal Emergency Medical Treatment and Labor Act (EMTALA), which requires emergency rooms that receive Medicare funding to provide stabilizing treatment to patients experiencing medical emergencies.
“What happened to Kyleigh Thurman shouldn’t have happened,” said Molly Duane, a lawyer with the Center for Reproductive Rights, in a statement Wednesday.
According to Thurman’s complaint, she visited a Burnet emergency room in 2023 while experiencing cramping, dizziness and continuous bleeding. Tests performed at the ER showed that an ectopic pregnancy was likely. Her OBGYN advised the medication methotrexate to end the pregnancy, so Thurman drove to Ascension Seton Williamson, a larger facility that would stock the medication.
But although tests at the larger hospital also indicated a likely ectopic pregnancy, the hospital did not immediately provide methotrexate, according to Thurman’s complaint. Instead she was sent home with instructions to return in two days. Upon return, Thurman was only given the medication after her OBGYN intervened on her behalf.
The treatment did not come in time to prevent detrimental health effects. Thurman’s ectopic pregnancy ultimately ruptured, and doctors had to remove one of her fallopian tubes.
An investigation by the Centers for Medicare and Medicaid Services confirmed Thurman’s story. As first reported by The Associated Press, CMS said in a report that Ascension Seton Williamson had violated EMTALA.
“The hospital's failure to provide an appropriate medical screening examination … placed the patient at risk for deterioration of her health and wellbeing,” CMS said in its report, which was dated to January but only recently released to the public.
Representatives for the hospital said they could not speak to the specifics of Thurman's case.
"Ascension is committed to providing quality care to all who seek our services," a representative for Ascension Texas said in a statement.
It is legal under Texas’ near-total abortion ban for ectopic pregnancies to be terminated. But Thurman and her lawyers argued in their complaint that many medical facilities in Texas are hesitant when presented with cases like Thurman’s due to confusion around the state’s laws.
Despite the CMS decision affirming Thurman's complaint, her lawyers said they are concerned that a recent decision about EMTALA from the Trump administration could muddy the waters for others in her situation.
In 2022, the Biden administration released guidance specifying that hospitals must provide an abortion if one is needed to treat a pregnant patient with an emergency condition. States including Texas challenged that guidance, saying it amounted to an illegal abortion mandate.
But although courts had not finally decided the issue, the Trump administration announced Tuesday that it would rescind the Biden-era guidance. CMS released a statement saying it would “work to rectify any perceived legal confusion and instability caused by the former administration’s actions.”
“CMS will continue to enforce EMTALA, which protects all individuals who present to a hospital emergency department seeking examination or treatment, including for identified emergency medical conditions that place the health of a pregnant woman or her unborn child in serious jeopardy,” the agency said.
Duane, with the Center for Reproductive Rights, said the decision by the Trump administration will sow confusion about the requirements for treating pregnant patients under EMTALA.
“Doctors are already struggling to figure out when they can treat their patients, and too many in Texas and every state where abortion is banned are being turned away from care,” she said. “The decision to rescind the guidance is not protecting anyone. But make no mistake, EMTALA is still law of the land and requires hospitals to provide their patients with emergency care — and that includes patients that need emergency abortions.”
In Texas, the issue of when emergency abortion care is permitted has been a hotly discussed topic. This spring, the state legislature passed The Life of the Mother Act, a bill aimed at clarifying when doctors can offer the procedure; it is allowed only when a woman’s life or a “major bodily function” is at risk.
The bill is now at the governor’s desk.
