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Discussion

Advice of hipaa violation

My story is different. I asked a Dr that I worked with to consult on my mothers medical case as she was gravely ill, I work at a family practice my mother was hospitalized in a hospital within our organization. I am on my mothers hipaa form, I am her POA and was in charge of her care, she had full knowledge and I had consent from her to ask for the second opinion and consult. My company has terminated me for hipaa violation just for asking the Dr to consult on her case. I feel heartbroken and crushed, can't believe it. I feel I was wrongfully terminated. May i add 3 other people in the office also accessed my mother's chart. I myself never accessed the chart. But of the 4 people who did 2 were terminated in addition to myself,, 1 being the Dr the other being his nurse, yet 2 others were given a year probation. Might I add to my work record was spotless until then, so there were no other issues.

Please give me feedback, I'm lost

Featured Replies

  • Expert

I think that if you want some sort of action ... then you should speak to an attorney. But I suspect that if the Dr. was terminated, the group's attorneys have already reviewed the relevant laws before they acted against him.

I suspect (thought I am not a legal expert) that a part of the problem is that your mother was never registered as a patient of the group or of that physician. And a proper consult from your mother's physician to your colleague was never done. In other words, there was no official, legal paperwork for this consultation anywhere -- making it all an unauthorized access. How was the billing for this consultation being handled? That's another question. Was this physician providing his services as a consultant on the case without following the proper billing procedures so that the practice could be compensated for his time and any other resources he might use?

I suspect that what may have happened is that you "went through the back door" to get this consultation .... and in the process, all the paperwork wasn't done to make it legal and bill-able. Coming through the front door by making an appointment ... having records officially transferred ... consult orders written ... etc. might have provided the proper foundation for an official relationship needed for the doc and the staff to access the records. The fact they fired the doc is interesting. Perhaps this sort of thing has happened before with him and his partners had reached their limit of tolerance with him.

I am sorry that you are going through this and hope you find some peace soon.

  • Author

Thank you so much. None of the points you make were clear to me or known. I had no clue by just asking was wrong. The fact that 2 people were given probation tells me they had a choice in what action they too, and could have handled us the same or at least differently than they did. Seems very unfair and unjust.

How did anyone even find out about this?

Anyone could have said at any time "you need to talk to your mother's PCP, and get a referral" Which would have made this all "legal". The MD could have said the same "I need a referral". PCP's get their knickers in a twist when another MD is consulting on their patient of which they have no knowledge. It can change an entire course of care, battling orders, the whole 9 yards. So it becomes a process issue.

Additionally, if your mother has full knowledge of her decisions--in other words, still competent to make decisions, it doesn't matter if you would like her to be consulted by another MD. Even if she is agreeable and gives you consent. This all has to come from her. Even if you believe her PCP is not ideal, he or she is still the main provider in your mother's course of care and treatment. She needs to make those choices herself. Or the next best case scenario and a family meeting is called to discuss where she (and the rest of the family) would like to go in the treatment process. With the case manager, the social worker, and even the PCP.

Gone are the days that an MD you work for will pop in on your mom and order some stuff, follow the case with another MD, or otherwise. I am sure that having worked in an MD office, gone are the days that a patient calls and says "I have another UTI, can you call in that stuff that we did the last time?" and have that happen without a billable visit.

This sounds to me like a dog and pony show on the unit of which your Mom is a patient.

Sorry that this happened to you.

I would ASAP see if you can have a case review including your mother, to get to a place where decisions could be made about the course of her treatment. Because at the end of the day your mother continues to be gravely ill, and your goal is that she be able to function and get well.

Otherwise, speak to your malpractice and consult an attorney. HIPAA violations may or may not be a discipline on your license.

  • Author

I filed a complaint against the hospital because upon discharge to the nursing home they negligently pulled her picc line

, she was to be on antibiotics for 6 weeks, she traveled 2 hours, only for it to be realized the hospital had pulled it, was sent immediately back to the hospital another 2 hour trip to stay overnight to have it reinserted and then another 2 hour trip back to the nursing home.. From this complaint they audited the chart.

  • Author

The Dr never wrote orders or gave orders, He only gave me explanations and advice on what was happening with her and what questions to ask and what to do. Mom was aware but not making decisions at that time, she was physically unable to. Between my dad and myself were the decisions being made. I never once thought just asking for his help would jeopardize my job.

There are several other things the hospital did that was negligent. My mom is much better now, and if it wasn't for the clarifications my doctor gave me she would have died.

Are you a nurse? I never ever buy the "I didn't know" defense because this shizz is DRILLED into people during orientation, education, refreshers, etc. It sounds like you put MANY people in a very difficult position and they lost their jobs because of it---you included. I also suspect that the entire story may not be written here.

Thank you so much. None of the points you make were clear to me or known. I had no clue by just asking was wrong. The fact that 2 people were given probation tells me they had a choice in what action they too, and could have handled us the same or at least differently than they did. Seems very unfair and unjust.
  • Author

I am a nurse. This is indeed the entire story. It was never clear that asking for advice was a violation.

  • Author

Also, if it were clear on those points so you think t people would have jeopardized themselves. Not at all. And just asking apparently is just as punishable, but 2 received probation. Odd?????

Can I just have something clarified? You have a pending complaint against the hospital, and you and some people you work with accessed your mother's hospital chart without going through the proper channels? I can see where the hospital might be alarmed at that situation. It could appear to them that you are gathering info regarding your complaint. Not saying you are, but maybe they are interpreting it that way.

  • Author

No no no not at all, my mother's health crisis started in November 2014 through June. 2015, with many hospitalizations during that period it was during these months I asked a Dr I work with for advice, opinions and consult. I made my complaint on June 10 2015 when her picc line was negligently pulled, that was what my complaint was on. Let me be crystal clear, I never, never,,tnever accessed the chart, I never looked at it when anyone else did. I was terminated because I asked .

I don't get why you were terminated because you asked for a consult. You are right that doesn't make sense. Even if the doctor who looked into the case on your behalf was breaking HIPAA not sure why you'd get in trouble. The doctor could have refused your request if it was wrong. Did the doctor throw you under the bus? Did you leave a computer with your log in open? Did the hospital agree you did not access the chart? The whole situation seems pretty gray on the doctors part as well. Was the doctor on probation already for things in the past. Was this retaliation for the complaint you filed against the hospital? Have you called your malpractice insurance company? If not you should.

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