The gravesite of Amber Thurman, at Rose Garden Cemetary in McDonough, Georgia on August, 13th 2024.

The Georgia hospital that failed to save Amber Thurman may have broken a federal law when doctors there waited 20 hours to perform a procedure criminalized by the state’s abortion ban, according to Sen. Ron Wyden, chair of the Senate Finance Committee.

The Emergency Medical Treatment and Labor Act, or EMTALA, requires hospitals to provide emergency care to stabilize patients who need it — or transfer them to a hospital that can. Passed nearly four decades ago, the law applies to any hospital with an emergency department and that accepts Medicare funding, which includes the one Thurman went to, Piedmont Henry in suburban Atlanta. The finance committee has authority over the regulatory agency that enforces the law.

In a letter sent Monday, Wyden, an Oregon Democrat, cites ProPublica’s investigation into Thurman’s death, which was found preventable by a state committee of maternal health experts. The senator’s letter asks Piedmont CEO David Kent whether the hospital has delayed or denied emergency care to pregnant patients since Georgia’s abortion ban went into effect. (Kent did not respond to requests for comment.)

“It is my duty to conduct oversight of potential violations of patients’ rights under these laws,” Wyden wrote. The senator asked for the hospital’s policies covering treatment of patients with emergencies that require abortion care. He also asked for a list of personnel involved in making those decisions. He gave the hospital a deadline of Oct. 24 to provide those and other requested records and answers.

Wyden sent the same letter citing ProPublica’s reporting on Thurman to seven hospitals in North Carolina, Florida, Missouri, Louisiana and Texas. One letter seeks information from a Texas hospital where Yeniifer Alvarez-Estrada Glick died in 2022 from complications of pregnancy including hypertension, as reported by The New Yorker. Other letters seek information from hospitals where women have reportedly been turned away or experienced delayed care.

The hospitals’ answers could lead to proposed legislation or executive actions to strengthen compliance. The federal Centers for Medicare and Medicaid Services investigates complaints and can take actions including levying fines against hospitals that violate EMTALA.

Wyden’s committee held a hearing Tuesday morning, saying in a news release it would “examine how Donald Trump’s successful overturn of Roe v. Wade and subsequent state abortion bans have threatened access to life-saving medical care for women nationwide.”

Piedmont did not respond to multiple requests seeking comment about Wyden’s letter or whether it is aware of an investigation into an EMTALA violation. Doctors who handled Thurman’s care have previously declined to explain their thinking and did not respond to questions from ProPublica.

A spokesperson for the U.S. Department of Health and Human Services, which oversees the regulatory agency that enforces the law, said in an email: “No woman or her family should have to worry that she could be denied life-saving treatment. While we can’t comment on complaints or investigations, we are committed to ensuring that every woman gets the care she needs.”

But some hospitals in abortion-ban states continue to deny or delay emergency care to pregnant women.

A recent Associated Press review of federal investigations found that more than 100 pregnant women in medical distress who sought help from emergency rooms were turned away or treated negligently since 2022, when the Supreme Court overturned Roe v. Wade. Last year, a federal investigation found that hospitals in Missouri and Kansas involved in the care of a patient, Mylissa Farmer, violated the law.

Vice President Kamala Harris has singled out Thurman’s case as evidence that a national law is needed to restore the right to abortion. Harris’ office didn’t respond to ProPublica’s questions about what federal actions she might pursue as president apart from signing a law, which would have to be passed by a divided Congress.

Former President Donald Trump has bragged about appointing three Supreme Court justices who voted to overturn Roe. Project 2025, the controversial playbook and policy agenda for a right-wing presidential administration, calls for doing away with Biden administration guidance that EMTALA requires hospitals to provide abortion care in emergency situations, even in states that ban it, or transfer the patients to a hospital that can provide the needed care.

Trump’s campaign pointed to previous statements by the former president that Project 2025 does not represent his plans for a second term. Leavitt said the former president “has always supported exceptions for rape, incest and the life of the mother, which Georgia’s law provides. With those exceptions in place, it’s unclear why doctors did not swiftly act to protect Amber Thurman’s life.”

Georgia Gov. Brian Kemp, too, has said his state’s six-week ban has clear exceptions to protect the “life of the mother.” In a statement, he blamed “partisan activists and so-called journalists” for spreading “misinformation and propaganda that fostered a culture of fear and confusion.”

But doctors have warned for years that these laws use language not rooted in science and begged for clearer exceptions. The confusion is apparent: In the wake of the bans, some hospitals have refused to even issue written policies informing doctors when and how to provide emergency abortions.

Legal reproductive rights scholars told ProPublica they believe Thurman’s treatment is a clear violation of EMTALA.

“It’s not even a question,” said Sara Rosenbaum, a George Washington University health law and policy professor and former adviser to President Bill Clinton. She helped develop EMTALA while at the Children’s Defense Fund. “I think the hospital, like all hospitals in these situations, is caught between violating EMTALA and state prosecution,” she said.

Thurman was rushed to the hospital on Aug. 18, 2022, in need of immediate care. Days earlier, she had taken abortion medication to end her pregnancy but was facing a rare complication: Some of the tissue remained inside her body, causing a grave infection.

To clear the infected tissue, she needed a dilation and curettage, or D&C, a procedure used to empty the uterus for both abortions and routine miscarriage care. Medically speaking, Thurman’s pregnancy had already ended. But the state’s abortion ban had criminalized performing a D&C and threatened doctors with up to 10 years in prison if prosecutors decided they violated it.

Records obtained by ProPublica show doctors discussed the procedure at least twice as Thurman’s condition deteriorated over 20 hours. Experts on the state maternal mortality review committee agreed there was a “good chance” Thurman would have survived if the D&C was provided sooner.

After the Supreme Court overturned the constitutional right to abortion, the federal government reminded hospitals and doctors they had to follow EMTALA and provide abortion procedures to patients if necessary in emergency situations, regardless of abortion bans. Some Republican officials have aggressively pushed back and said hospitals do not need to follow EMTALA, even for high-risk situations.

In Texas, Attorney General Ken Paxton threatened to prosecute a doctor for providing an emergency abortion to a woman with a high-risk pregnancy, whose fetus had a fatal anomaly and whose pregnancy threatened her health and future ability to have children.

He argued in court that she did not meet the state ban’s criteria. He also filed a lawsuit arguing the federal government cannot force Texas to follow the guidance on providing emergency abortions to patients.

In an opinion written by a Trump-appointed judge, a federal appeals panel agreed. That means enforcement of EMTALA in emergency abortion cases is barred in that state.

The Supreme Court last summer considered a lawsuit brought by the Biden administration challenging Idaho’s abortion ban, which lacks health exceptions and appears to conflict with EMTALA. A lawyer for the state acknowledged that Idaho’s abortion ban was written to prevent doctors from offering abortions even if the woman could suffer a serious medical complication like losing an organ.

Conservative justices in that case raised arguments about the rights of the fetus. The court issued a ruling that meant the case would be returned to a lower court, which upheld EMTALA while the case continues.

Rosenbaum said the federal government is not doing enough to require hospitals to follow EMTALA in states that banned abortion: “The federal government has no resources. It was only recently that the Biden administration has made it clear how to file complaints. The complaints go uninvestigated or poorly investigated.”

Wyden’s letters sum up the perilous landscape for patients and doctors.

“Across the country, there are reports that women are being turned away by emergency departments when they seek emergency reproductive health care, even in instances where medical professionals determine that, without such care, the patient is at risk of serious complications, infection, or even death. These women are caught between dangerous state laws that are in clear conflict with — and preempted by — EMTALA.”

On Tuesday, Thurman’s sister, Cjauna Williams, visited Thurman’s grave near Atlanta. She arrived to find fresh flowers and birthday balloons left there by people she and her family had never met. Thurman would have turned 31 the day before, and the story of her desperate wait for the medical care she needed had reverberated across the country.

“Hopefully her death won’t be in vain and something good can come of it,” Williams said.