Is there a legal way to do this...

Nurses HIPAA

Published

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?

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
Abiding by Federal and State privacy laws is not harboring.

They could face sanctions for violating HIPAA and state privacy laws, but not for abiding by all pertinent laws.

I get the desire to call in this case and it's hard to criticize someone who would, but the law is actually pretty clear here.

No, it's really not all that clear. Privacy laws allow for "reasonable limits" which means that if the patient, another innocent person, or public safety is at risk of being harmed by respecting patient privacy, it is within ethical and legal limits to break privacy.

Specializes in Emergency/Trauma/Critical Care Nursing.

Why is it okay if someone calls the ED looking for their loved one, for us to tell them that they are indeed there (unless there's a specific reason to make them confidential), however calling the police to tell them someone they're publicly searching for is in the ED, is illegal? In neither case are you divulging medical info, its really not much different than when you announce a pts name in the waiting room when you're calling them back. I would expect that to be the same level of privacy...

Specializes in Cardiac, ER.
Why is it okay if someone calls the ED looking for their loved one, for us to tell them that they are indeed there (unless there's a specific reason to make them confidential), however calling the police to tell them someone they're publicly searching for is in the ED, is illegal? In neither case are you divulging medical info, its really not much different than when you announce a pts name in the waiting room when you're calling them back. I would expect that to be the same level of privacy...

The problem here was that the patient was using a different name. I was completely within policy to divulge the name the patient used, which of course was not helpful to law enforcement.

Specializes in Home Health (PDN), Camp Nursing.

I guess my question for all the people who would tip the police, myself included, is what crime would you NOT make the call to the police. Child rape is pretty emotionally charged, but what if one of the Enron CEOs was a fugitive in your ED? A person who assaulted a minority in a hate crime? It's worth a think.

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
I guess my question for all the people who would tip the police, myself included, is what crime would you NOT make the call to the police. Child rape is pretty emotionally charged, but what if one of the Enron CEOs was a fugitive in your ED? A person who assaulted a minority in a hate crime? It's worth a think.

Any crime that would suggest the alleged suspect does NOT pose a danger to others if he is not apprehended. And that is also the yardstick by which they measure if it's appropriate to break confidentiality laws - is the patient in imminent danger to himself, to other people, or public health by maintaining his privacy?

Specializes in ER, ICU.

Don't forget that you are a citizen as well as a nurse. If in doubt, punch out, call the police, then punch back in.

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
Don't forget that you are a citizen as well as a nurse. If in doubt, punch out, call the police, then punch back in.

I don't think that would fly if it's determined to be a HIPAA violation. Nurses busted for posting private information on Facebook are not usually doing while on the clock.

Specializes in NICU, PICU, Transport, L&D, Hospice.

I am not convinced that notifying the police that a wanted 'at large' suspect in a violent crime is present in your health care facility violates any HIPAA or other privacy concerns.

I don't see where PII or PHI was given to anyone. A person matching the description of a suspect was reported to the authorities. What about GSW? Are you required to call police for every GSW that walks into the ED? If so, is that a release of PHI?

Specializes in SICU, trauma, neuro.
I guess my question for all the people who would tip the police, myself included, is what crime would you NOT make the call to the police. Child rape is pretty emotionally charged, but what if one of the Enron CEOs was a fugitive in your ED? A person who assaulted a minority in a hate crime? It's worth a think.

Physical danger to others. So Enron CEO, no...assault, yes.

Specializes in SICU, trauma, neuro.
The problem here was that the patient was using a different name. I was completely within policy to divulge the name the patient used, which of course was not helpful to law enforcement.

"That guy who's wanted for the rape of a little girl" would have worked without using a name--real or alias--if you're worried about name-as-PHI.

Specializes in NICU, PICU, Transport, L&D, Hospice.

your name is not protected health information...

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