An administrative lawsuit over the 2023 death of a teenage severe trauma patient in Daegu has ended unfavorably for Daegu Catholic University Medical Center.

The hospital abandoned its appeal to the Supreme Court after both the first and second trials rejected its defense that it was unable to accept the patient due to a lack of backup medical care at the time of the incident.

According to legal sources, a lawsuit to revoke dispositions -- including corrective orders -- filed against the Minister of Health and Welfare by the foundation operating the hospital was dismissed on June 3 due to the hospital’s failure to pursue the appeal.

On May 15, the Seventh Administrative Division of the Seoul High Court dismissed the hospital’s appeal and upheld the trial court’s ruling, which found the Health and Welfare Ministry’s action justified.

Daegu Catholic University Medical Center was the last emergency facility to which a teenage girl -- who had fallen from a four-story building on March 19, 2023 -- was transferred. While paramedics searched for a hospital that could accept her, the girl suffered cardiac arrest. Although she was eventually transferred to Daegu Catholic University Medical Center, she died later that day.

According to the court ruling, the hospital told the 119 ambulance service at around 3:24 p.m. that it was “difficult to accept” the girl. The emergency medical center director explained that “neurosurgery (treatment) is not available” and that “there are no medical staff available to treat her.”

When the paramedics called again at 4:10 p.m. to inquire about acceptance, the director repeated that “we don’t have any neurosurgery staff” and “we can’t handle [the patient] right now.” However, around 25 minutes later, at 4:36 p.m., he was informed that the girl had gone into cardiac arrest during a transfer attempt to another hospital. He then agreed to accept her. She arrived at the emergency center at approximately 4:59 p.m. and received emergency care but was pronounced dead at around 6:27 p.m.

In May of that year, the Health and Welfare Ministry issued a corrective order and suspended subsidy payments for six months to four hospitals -- including Daegu Catholic University Medical Center -- for failing to justify their refusal to confirm patient capacity. The ministry stated that the hospital “refused to accept the patient due to the absence of neurosurgery staff in a situation where it was difficult to determine what kind of treatment the patient required. This cannot be recognized as a legitimate reason.”

The hospital argued that the ministry’s decision was unfair. It contended that recommending transfer to another hospital did not constitute “refusal or avoidance of emergency medical care” and was instead an effort to prevent the patient -- suspected of having a traumatic brain injury -- from missing timely treatment, given the hospital’s inability to provide appropriate care. It claimed that accepting the patient in that condition would have been a “medical error.”

The hospital further asserted: If the girl did not have a traumatic brain injury, she was not an “emergency patient” under the Emergency Medical Act. If she did have one, then prompt, specialized care was required, which the hospital was not in a position to provide. Accepting her without the necessary resources would have amounted to medical malpractice, it said, maintaining that “even if the hospital refused or avoided emergency medical treatment, a justifiable cause exists.”

Court: The patient should have been accepted and given basic care

The court held that the hospital should have accepted the patient and provided at least basic medical care. The emergency room director, it said, had made a judgment based solely on verbal information from paramedics without conducting a basic examination.

On September 26, 2024, the 12th Division of the Seoul Administrative Court -- the trial court -- rejected the hospital’s request to cancel the ministry’s corrective order and subsidy suspension. It ruled that “failure to conduct a basic examination to determine whether a patient is an emergency patient constitutes ‘refusal or avoidance’ of emergency medical care.”

“The director of the emergency medical center should have met face-to-face with the person requesting emergency medical care or suspected of being an emergency patient, determined whether the person was an emergency patient, and provided appropriate care or refrained from treatment according to the results of the consultation and diagnosis based on his professional knowledge,” the court said.

“However, the director, without even basic primary medical care, decided whether she was an emergency patient and the type of medical treatment required based solely on the emergency patient status reported by the paramedics, and then refused to accept her. It is difficult to assess that this was the best action required under the circumstances.”

The court emphasized that the Health and Welfare Ministry’s decision was based on the hospital’s failure to even assess whether the patient needed emergency care—regardless of the eventual outcome. It also stated that at the time of the incident, the hospital had sufficient facilities and staffing to handle an emergency case. The unavailability of a neurosurgeon alone was not a valid reason to refuse acceptance from the outset.

The hospital appealed the decision, but the result remained unchanged. The Seoul High Court dismissed the appeal and ordered the hospital to pay legal costs. Since the hospital did not appeal to the Supreme Court within the deadline, the ruling is now final.

Daegu Fatima Hospital also lost in court

In a similar case, Daegu Fatima Hospital -- the first hospital to which the girl was transferred -- also lost in the first trial on April 24. It had claimed that it was unable to accommodate the patient due to a lack of backup medical care, but the court rejected this argument.

Daegu Fatima Hospital was the first regional emergency medical center where the girl was taken following her fall. Because she was conscious and able to converse, the paramedics did not initially classify her as a severe trauma patient. The hospital recommended transfer to a university hospital with mental health and backup care services, suspecting that the fall may have been a suicide attempt. When asked again whether they could accept the patient, the hospital said psychiatric care and hospitalization were not possible.

The hospital argued that an emergency room specialist had examined the patient face-to-face, taken her medical history, asked about symptoms, and checked her physical condition. It claimed that while the physical trauma did not appear severe, the psychiatric condition seemed serious, justifying the recommendation to transfer.

However, the court ruled that Daegu Fatima Hospital also made its determination about the patient’s emergency status and required medical department based solely on paramedics’ information and initial impressions, and upheld the Health and Welfare Ministry’s action. Daegu Fatima Hospital has appealed the ruling, and the case is currently under review by the 6-2 Administrative Division of the Seoul High Court.