HIPPAA Dilemma: Pt Privacy vs. Suffering Animal

[HapkidoMedicine]

Hello all!

I was a member a few years back and recently started lurking again. It's good to be back!

Anyhow, I am wondering your thoughts on a recent situation. A patient was admitted after a severe beating by her significant other. Six days into her stay, she revealed that she had concerns about her dog, which she had left behind in the house. She said it only had access to toilet water and probably had run out of food. No A/C in the house and the temp had been in the 90's. She had no one to go check on the dog. We offered to notify animal control so they could retrieve the poor thing, but the patient refused, saying she knew they would seize the dog and fine her because it was not licensed and had no shots.

Of course we could call animal control 'as a concerned citizen', but that would be risky privacy-wise, as the call would show up as the hospital's number.

We agonized over what to do, worrying that the dog might already be dead of dehydration in the heat. The doctor ended up discharging the patient so she could check on the dog herself, but the next day, a family member said she never called to say she arrived home, and the patient could not be contacted. (The family member was recovering from surgery, which is why he could not check on the dog).

What would you do?

[TiredMD]

Of course we could call animal control 'as a concerned citizen', but that would be risky privacy-wise, as the call would show up as the hospital's number.

HIPPA and related laws cover medical privacy. I don't think notifying animal control about a patient's dog is covered anywhere in there. I would've called anyway.

[Tweety, BSN, RN]

The patient could have given you permission to call the police or animal control to check on the dog. So I'm not understanding the dilemma here. I would have asked the patient "Do I have your permission to notify the appropriate authorities to check on your dog? What was wrong with having the patient call them herself if she was concerned?

Often our trauma patients are flown in and have dogs home alone that need tending to.

[ktwlpn, LPN]

Several years ago when I worked at our small local community hospital several of us ran an informal pet rescue.We found homes for pets whose owners had died or moved to nursing homes-we fostered pets whose owners were too ill to care for them for a time.I would have offered to go to the house (accompanied by a co-worker) if it was a patient I knew (it was a 40 bed hospital-someone on staff knew everyone) Sad to say that today I would not get so involved-especially this situation in which the patient was assaulted by her s/o.You had no way to know if he was in the house.If she really cared about the dog and was a responsible pet owner the dog would have at least had it's shots.She would have had the dog die rather then pay a fine? I don't think she cared all that much...I think in this situation I would have turfed it to the social worker and left it up to them to notify animal control if they wished. I know I sound cold-I'll confess that years ago I ended up with a stinky mean little dog that no-one else wanted.I had seen her owner decline steadily over numerous hospitilizations and had promised him that I would take his little dog.So-he had a massive cva and a few weeks after he was placed in LTC someone found my name and number in his apartment.The dog was at a local kennel.Yippy and growling-it took months to get her to trust us.She had been his lap dog and had major separation anxiety for the rest of her years.Poor thing-I also got a suprise when I took her to my vet-she was not spayed.She lived with us almost 20 years-she went totally blind a few years before she died from doggie macular degeneration.Then she got doggy Alzheimer's and we had to end her suffering.Now you know the truth-I am a softy..

[GOMER42]

HIPPA and related laws cover medical privacy. I don't think notifying animal control about a patient's dog is covered anywhere in there. I would've called anyway.

I agree. This is no way affects her medical care nor has any bearing on her rights to medical confidentiality.

[Dolce, RN]

Poor dog.

[dream'n, BSN, RN]

What the OP described is animal cruelty. And that is just as illegal as breaking HIPPA. And I don't think in that situation it would be a HIPPA violation (of course I'm not an expert), but personally I couldn't handle knowing that a living creature was suffering because of its owners selfishness.

[BrokenRNheart]

I experienced a similar situation. We didn't know what to do.

We did know that in order to call animal control you have to be willing to tell them who you are on the complaint (in that city). That creates a dilemma as far as any anonymous call made.

Also, if she really cared, she should have agreed to something. No shots, not registered....who knows what else her lifestyle states. I think registering pets is just another way for a city to make money, but my dog is up to date on shots and treated for heartworm and worms.

Responsible pet ownership!

[TopazLover, BSN, RN]

Turf it to the Social Worker. We can't be all things to all people. And we can't fix what we are not allowed by the patient to do. The SW must have been involved so it would not be a huge stretch to have the nurse refer it. Perhaps a friend or neighbor could have been enlisted to help. That call could be from the SW after permission from the patient.

We don't know the home situation except for the domestic abuse. Too bad the police did not deal with the dog when they were involved. They should have called Animal Control of there was any question of care for the dog the same as they would for care for a child in the home.

[Scrubby]

I would call animal welfare, they don't have to know the details of the patient at all, in fact you wouldn't even have to tell them the person is in hospital.

[Katnip, RN]

The patient could have given you permission to call the police or animal control to check on the dog. So I'm not understanding the dilemma here. I would have asked the patient "Do I have your permission to notify the appropriate authorities to check on your dog? What was wrong with having the patient call them herself if she was concerned?

Often our trauma patients are flown in and have dogs home alone that need tending to.

Patient didn't want animal control called because he would have been fined and the dog removed from the home because of lack of shots and license. That's where the dilemma came in.

[Jules A, MSN]

Patient didn't want animal control called because he would have been fined and the dog removed from the home because of lack of shots and license. That's where the dilemma came in.

I understand the psychological implications of domestic violence but this just makes me sick. How selfish.