Just curious- When pt's are drug tested..

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Specializes in Med/Surg, Geriatric, Hospice.

And they come back positive for something illegal, is the MD or facility required to report it to authorities? Or are they protected under HIPAA? Possibly this varies state to state, but I'm curious anyway.

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Specializes in Trauma Surgical ICU.

Not in my state..

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Specializes in FNP.

No, not unless it is a court ordered screen.

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We do not usually report it. If an OB tested positive in the office then usually they have already been reported to a social worker by the doc. We test them again and if they test positive when they come in to deliver then usually the LD nurse or doc calls in and they do not get to leave with their baby. We are mandated reporters. I have often wondered why we do not report all these 20 something y/o men whose teenage girlfriend delivers.

The psych patients we stabalize and usually within 24 hours we ship them to rehab or make them an appointment with community counciling. Now if they show out at the hospital and a policeman has to come keep watch I have seen a few end up infront of a judge I guess because of the police report.

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Specializes in ER.

If there is no clear chain of custody, the results are not evidence that can be used by law enforcement. If there is no chain of custody, it is only used for medical evaluation. There also must be consent given for legal drug screens, where there is no consent required for medical drug screens.

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Specializes in PICU, SICU.

reported in mine worked trauma ICU all admits tested. Had a pt read miranda rights ? on spelling, while intubated and on propofol

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Specializes in ICU/ER.
reported in mine worked trauma ICU all admits tested. Had a pt read miranda rights ? on spelling, while intubated and on propofol

What?! What state are you in?

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Specializes in ER.

Been in the ER only a couple months now, but we don't. We might test to give us an idea of they're actually on something or to help us determine how to treat them, but other than that, we could care less. If their alcohol level is too high, they're stuck with us until it goes down before discharge unless they have a ride.

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Specializes in tele, oncology.
If there is no clear chain of custody, the results are not evidence that can be used by law enforcement. If there is no chain of custody, it is only used for medical evaluation. There also must be consent given for legal drug screens, where there is no consent required for medical drug screens.

:yeahthat:

Same at my place.

Plus there may be false positives...had a pt test positive for PCP due to ingesting a helluva lot of Nyquil. Ah, the things my pts teach me. :)

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reported in mine worked trauma ICU all admits tested. Had a pt read miranda rights ? on spelling, while intubated and on propofol

Wow. I can't believe that was legal.

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It's illegal NOT to read their rights.

How man times have you been told to watch what you say around an intubated patient?

It's been this way in every state I've worked in. It's perfectly legal.

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Specializes in Infectious Disease, Neuro, Research.

To clarify:

For Miranda to be, "in effect", the individual must be able to state that they acknowledge and understand the warning. Its Informed Consent for a process that revolves around the individual's rights under the 4th and 5th Amendments. Do not pass go, do not collect $200.

Miranda is pro-forma when the individual is clearly(as documented on AV record) incapacitated, but incapacitation r/medical intervention is not the same as a roadside DUI arrest. Know the law, don't blindly let the Po-Po tell you "its legal". They have a job to do. I have helped with evidence colletion. I understand that codes and statutes are so numerous that it is very hard to keep things straight, but sometimes "arousal incentive" leads to some squirrelly stuff that can get lab techs (and RNs) in trouble.

Under some State laws, obtaining a BAC/EDS/UDS w/o consent(for evidence) is legal in the event of a motor-vehicle collision. Most generally, EDs obtain drug screens for the purposes of treatment, not evidence, and so the results cannot be "reported" to LE, though they may be subpoenaed. The validity of these tests is variable, and there are only a handful of NIDA certified labs in the country.

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