Is there a legal way to do this...

[BrnEyedGirl, BSN, MSN, RN, APRN]

Hope there is a HIPAA expert out there!

Here is the scenario,..very public, rape, murder of a 4 yr old in your town. The police have DNA that identifies the subject, his name and photo is on every TV station in town. He shows up in your ER, using a different name, but his tattoos ID him without a doubt. He is checked in as a pt. Is there any legal way to call the police?

This isn't homework. The story has been changed but the circumstances are similar to something that happened to a coworker recently. Is there a legal way to turn this creep in?

[SoldierNurse22, BSN, RN]

I'm not sure why you couldn't call the police.

HIPAA protects personal information. It's not like you're telling your best friend that you took care of this guy today or calling the news station and telling them about your day with this guy.

Alerting the police to the fact that there may be a felon in your hospital doesn't strike me as a violation of HIPAA. Conversely, I would imagine that not alerting them would be a violation of principle if nothing else.

Perhaps someone with more expertise could weight in on this one...

[nurseprnRN, BSN, RN]

Many times the police/other LEO have put out bulletins to all hospitals in the area that describe particularly wanted people. These are posted in the ER staff areas for a reason. While technically a HIPAA violation to identify someone who is in the hospital, the fact that he is in under a false name might be mitigating. And if that call were made anonymously ...

Call them, or call your security guy to take a discreet look at him and then make the call. While technically a HIPAA violation to identify someone who is in the hospital, the fact that he is in under a false name might be mitigating. And if that call were made anonymously ...

And if that call were made anonymously ...

[Krzysztof]

"Hello? Police? There's a guy here who looks like that bad man from the television. Come quick."

No HIPAA violation.

[Been there,done that, ASN, RN]

A public rape and murder of a 4 year old.. and you give a rat's patooty about HIPAA?

An example of how all good little nurses have been brainwashed in the allmighty name of HIPPA.

[morte, LPN, LVN]

commission of a crime takes away HIPAA expectations...I do believe.

[Krzysztof]

U.S. Department of Health & Human Services | Office for Civil Rights

Link: When does the Privacy Rule allow covered entities to disclose protected health information to law enforcement officials?

[MunoRN, RN]

It depends on how you (or more specifically your privacy officer) defines "imminent danger".

Example: The police department calls the emergency department asking if any patients match the description of a particular woman who is a witness to, and perhaps a suspect in, a car accident. The provider may not answer the questions unless the provider believes the disclosure is necessary to avoid or minimize an imminent danger to the health and safety of the patient or another individual. Even then, the provider may only release the minimum necessary information to minimize the imminent danger. If the police department has the patient’s name, then the hospital can provide directory information, including location and a one‐word condition regarding the patient. If, however, the patient has opted out of the directory, the hospital may not release any information about the patient.

Example: An emergency medical provider subject to the HIPAA regulation24 responds to a car accident and provides treatment to an individual involved in the accident. The provider smells alcohol on the breath of an individual and wonders if he should contact law enforcement. If the suspected intoxicated individual is someone other than the person being treated, the information is not PHI and the provider may disclose the information. If the suspected intoxicated individual is the person being treated, the provider may disclose the information if the provider believes the disclosure is necessary to avoid or minimize an imminent danger to the health and safety of the patient or another individual. Even then, the provider may only release the information necessary to minimize the imminent danger.

[BrnEyedGirl, BSN, MSN, RN, APRN]

A public rape and murder of a 4 year old.. and you give a rat's patooty about HIPAA?

An example of how all good little nurses have been brainwashed in the allmighty name of HIPPA.

Well,...this good little nurse asked the manager, and spoke with security and was told that unless this patient had a gunshot wound we could not report that he was in our hospital. Now,.if someone called asking for him by the name he used, we could say he was in the hospital. We were told that we have no right to inform Law enforcement just because he was wanted anymore than we aren't allowed to turn in drug abusers or drunk drivers. Now if he had a missing child with him or an endangered senior citizen or handicapped person than we can call. This was from security who knew who this man was.

[BrnEyedGirl, BSN, MSN, RN, APRN]

U.S. Department of Health & Human Services | Office for Civil Rights

Link: When does the Privacy Rule allow covered entities to disclose protected health information to law enforcement officials?

Thank you for the informative link! It looks like, if we could get something in writing,.....there should be a better way to do this. While I agree with the sentiment that this guy deserves to be locked up forever so who cares about HIPAA,....the nurse involved does have a mortgage a family to support so he needs his job :)

[Sam J.]

Whether the police have DNA or not (did they publicize that??), and whether or not he is guilty, or even a suspect, is up the system we have in place that includes a jury trial. I suspect that by reporting your suspicions, warranted or not, to the management (and security), that you complied with reporting requirements, and also protected the paycheck that pays for your mortgage.

The news is full of people that attempted to stop robberies or assaults in the workplace, and were terminated for violating company

policy.

There's another scenario here that defense lawyers may love- he may have been arrested on your suspicions, then found not guilty, then you might have faced all kinds of sticky legal issues. Not only that- we also always hear about truly vicious, guilty, nasty people getting 'off' on even minor technicalities. (Might have heard about the drunk Texas teen that killed 4 people, and was sentenced to a Country Club, because he was so rich, he didn't know any better?).

As far as HIPAA, it's not a simple plan, and there are plenty of loopholes to allow for reporting of many things- infectious diseases, fraud, and criminal activity, are some of them. I would assume your employer, and its legal team, formulated its reporting policy on their interpretation of HIPAA.

[MunoRN, RN]

Your dealing with three different types of rules; HIPAA, state privacy laws, and facility privacy rules.

HIPAA basically says you can't inform someone else that someone is in the Hospital/ER unless HIPAA specifically allows it through an exception. The 'Directory' exception allows you to confirm that someone is in the Hospital but only in response to a specific inquiry; if the police call and say "is so-and-so in the hospital?" then you can confirm that so long as the patient hasn't opted out of the directory.

There are other specific exceptions, such as if someone is in imminent danger and compromising a patient's privacy would avert harm to someone, but in general you can't just call the cops because you think you've got a 'bad man' as a patient.

Many states have laws that go beyond even the restrictions that HIPAA places on informing police of a patient's presence in the Hospital and many facilities even go beyond that in order to maintain patients' trust that they can seek care without having the cops called on them.