As the pregnant woman’s contractions rolled in every two minutes, staff at Our Lady of the Lake Regional Medical Center in Baton Rouge, Louisiana, dispatched an ambulance to send her elsewhere.

Just two minutes later, she gave birth to a 6-pound baby girl in the cab of the ambulance down the road from the 900-bed hospital.

The incident, government investigators concluded last year, was a violation of a federal law that requires emergency rooms to stabilize patients in medical distress before discharging or transferring them.

Yet, Our Lady of the Lake has never been been penalized for that incident or any of its other violations of the law. Few emergency rooms ever are.