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.
your name is not protected health information...

No, but it's an identifier, and if it's linked to health information (such as a person's presence in the hospital), then it's a HIPAA violation.

Specializes in Emergency/Trauma/Critical Care Nursing.
No, but it's an identifier, and if it's linked to health information (such as a person's presence in the hospital), then it's a HIPAA violation.

How is that any different than calling their name in a crowded ED waiting room or confirming over the phone that a pt is indeed in your hospital? I don't see how their name is protected in that situation.

presence in a hospital does no mean being t.....reated

No, but it's an identifier, and if it's linked to health information (such as a person's presence in the hospital), then it's a HIPAA violation.
Specializes in NICU, PICU, Transport, L&D, Hospice.
No, but it's an identifier, and if it's linked to health information (such as a person's presence in the hospital), then it's a HIPAA violation.

And as an identifier we must treat it with care.

In my view that does not include protecting the owner of the name from law enforcement when there is a city/state wide search for the person including details which include name, DOB, address, photographs, etc.

Knowingly harboring a dangerous criminal is not something that I prefer to be professionally engaged in.

As I said before, if my employer was aware of the situation and prohibited staff from notifying law enforcement, I would accomplish the notification on my personal phone during my personal break. The burden of proof would fall upon the employer to discover who the anonymous informant was.

In my view, that is the correct action for a citizen in a civil and social community.

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

And I agree with you - HIPAA laws allow for "reasonable limits" and if it's a matter of safety of life and/or public safety, then a provider should not be expected to maintain privacy.

My only point was in disagreement that someone's name is not private information - while it's not PHI per se, it is one of the dozen or so patient identifiers that should not be linked to PHI in order to comply with HIPAA laws.

My only point was in disagreement that someone's name is not private information - while it's not PHI per se, it is one of the dozen or so patient identifiers that should not be linked to PHI in order to comply with HIPAA laws.

Exactly the name falls under PII

HIPAA Disclosures to Law Enforcement - Holland & Hart Health Law Blog

Fugitive. A Provider may disclose information to law enforcement to identify or apprehend an individual who appears to have escaped from lawful custody. (45 CFR 164.512(j)(1)(ii)(B)).

164.512 Uses and disclosures for which an authorization or opportunity to agree or object is not required.

........

(2) Other uses and disclosures under this section. The provisions of this paragraph do not supersede other provisions of this section that otherwise permit or restrict uses or disclosures of protected health information.

(f) Standard: Disclosures for law enforcement purposes. A covered entity may disclose protected health information for a law enforcement purpose to a law enforcement official if the conditions in paragraphs (f)(1) through (f)(6) of this section are met, as applicable.

(1) Permitted disclosures: Pursuant to process and as otherwise required by law. A covered entity may disclose protected health information:

(i) As required by law including laws that require the reporting of certain types of wounds or other physical injuries, except for laws subject to paragraph (b)(1)(ii) or ©(1)(i) of this section; or

(ii) In compliance with and as limited by the relevant requirements of:

(A) A court order or court-ordered warrant, or a subpoena or summons issued by a judicial officer;

(B) A grand jury subpoena; or

© An administrative request, including an administrative subpoena or summons, a civil or an authorized investigative demand, or similar process authorized under law, provided that:

(1) The information sought is relevant and material to a legitimate law enforcement inquiry;

(2) The request is specific and limited in scope to the extent reasonably practicable in light of the purpose for which the information is sought; and

(3) De-identified information could not reasonably be used.

(2) Permitted disclosures: Limited information for identification and location purposes. Except for disclosures required by law as permitted by paragraph (f)(1) of this section, a covered entity may disclose protected health information in response to a law

enforcement official's request for such information for the purpose of identifying or locating a suspect, fugitive, material witness, or missing person, provided that:

(i) The covered entity may disclose only the following information:

(A) Name and address;

(B) Date and place of birth;

© Social security number;

(D) ABO blood type and rh factor;

(E) Type of injury;

(F) Date and time of treatment;

(G) Date and time of death, if applicable; and

(H) A description of distinguishing physical characteristics, including height, weight, gender, race, hair and eye color, presence or absence of facial hair (beard or moustache), scars, and tattoos.

(ii) Except as permitted by paragraph (f)(2)(i) of this section, the covered entity may not disclose for the purposes of identification or location under paragraph (f)(2) of this section any protected health information related to the individual's DNA or DNA analysis, dental records, or typing, samples

Report him, not a moment's hesitation. The fact that the police have asked for the public's help in apprehending this man counts for "law enforcement official's request ... for the purpose of identifying or locating..."

Hmmm...what would haunt you more, seeing that he murdered another 4 year old the next day, or violating hipaa? I'm just sayin'

Specializes in Telemetry, Case Management.

Like someone else said...an anonymous phone call.....Hello, police? I'm at Blahblah ER and that child rapist dude is HERE saying he's some John Doe. For God's sake get here before they let him go!!!!!.....click. My conscience would be clear and HIPAA be d*mned. Of course I've been a nurse since God was a kid and YMMV.

Specializes in ER.

Know what I might have done? I may have gone in there and say, "by the way, you look like so and so" but then I would walk out. If he panics and take off with an IV in their arms, then I'd call the police due to the IV since that was our policy.

If this patient were hanging in the waiting room, perhaps someone else also in the waiting room would notice that this guy looks really, really familiar?

And I would assume that he was on the loose, and that the cops have not found him? Or is he awaiting trial. That is were I am confused.

Equally as confusing is that WHY would he show up in an ER if his face is blasted all over the news? Because he believes he is protected there? (and we have had more than one who use their "hospitalization" as a ploy to get out of jail, to avoid court...the list goes on).

"Gosh, I am in the parking lot of XYZ hospital, and there is a guy that looks just like who is wanted on the TV. He is driving a blah blah car, plate number blah blah". That is all.

Usually, if someone comes into an ED, they need a license or some other form of ID. You can't just give out some rando name and it not be caught. So that is another interesting part of this scenario.

And remember, there are all sorts of groups that all strive to look alike--same mannerisms, same look, same tattoos. All with a purpose of not being identified.

HIPAA is HIPAA, but before the person checks in, or once the person is discharged and hits the parking lot, all bets are off.

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