Hungry Hungry HIPPA
February 16, 2012 1:17 PM   Subscribe

What do I do if I suspect a hospital patient may have been involved in a criminal act?

We have a patient at the hospital who came in with a very strange story (which includes several contradictions), no identification and no insurance. The patient states that they were the victim of a violent act, which may be true, but for a number of reasons, I suspect the patient may actually have been the perpetrator of a violent act or crime. (The patient's story and behavior would make a lot more sense in the context of perpetrator rather than victim.) On the other hand, they may well be an innocent person, or a victim of violence.

The patient is about to be discharged. They have declined permission to obtain their medical records from previous treatment. I don't have any evidence of wrongdoing, just a gut feeling that something is very wrong that some others who have worked with the patient seem to share. Others think the patient has a strange story but is non-violent. Nobody seems to think the patient is telling the truth.

Is there a way to check to make sure the patient is not actually wanted by the police before they are discharged? (Without violating patient confidentially or potentially accusing an innocent person of a crime.)
posted by ladypants to Law & Government (14 answers total) 2 users marked this as a favorite
Best answer: I would contact your Compliance or Privacy Officer and ask them this question.
posted by pecanpies at 1:22 PM on February 16, 2012 [12 favorites]

The hospital's lawyer is the only person who can answer this with any degree of authority.
posted by deadmessenger at 1:22 PM on February 16, 2012 [2 favorites]

Does your hospital have a privacy officer? Seems like this question would fall under their purview.
posted by mollymayhem at 1:23 PM on February 16, 2012

Response by poster: I'd never even heard of a privacy officer. Good call.
posted by ladypants at 1:24 PM on February 16, 2012

Their contact information should be in your handbook or on your employee website, if you have one.
posted by pecanpies at 1:26 PM on February 16, 2012

If a privacy officer isn't available, there is definitely a Risk Management department. They should be able to point you to the right answer or person.
posted by Mister Fabulous at 1:27 PM on February 16, 2012

Yes. The people you want are at Risk Management. They almost certainly have a 24-hour pager. Page them, now, before you do or say anything to the patient that might be a liability to the hospital.
posted by jesourie at 2:01 PM on February 16, 2012 [1 favorite]

Wouldn't you call the police if the patient was a crime victim (as he/she claims)?
posted by JenMarie at 3:09 PM on February 16, 2012 [2 favorites]

Best answer: Your job is to provide medical care, not to turn people into the police! Especially if you have nothing more than a "gut" feeling that a crime was committed in the PAST! It would be a different thing, perhaps, if you suspected that somebody was in danger. But that is not the case here.
posted by yarly at 3:20 PM on February 16, 2012 [8 favorites]

Isn't there a policy to call the police if a victim of a crime comes in?

The police can then determine if they were actually a victim or in fact a perpetrator. Talk to your boss. Many hospitals actually have a police force on site (especially if it's a public hospital).
posted by amaire at 3:37 PM on February 16, 2012

Seconding compliance or risk officer - might also fall under ethics or legal. Escalating up your management chain is another possibility.

And the compliance officer should be the one to talk to the cops, probably, if any such report is made. They'll know how to navigate any legal issues involved.
posted by bunderful at 4:27 PM on February 16, 2012

It's really scary that you're coming to AskMeFi for this kind of information. Get in touch with Risk Managment ASAP. These kinds of situations should have been heavily addressed in your training.
posted by OsoMeaty at 6:14 PM on February 16, 2012 [3 favorites]

IANYHL (I am not your hospital's lawyer). TINLA. In my jurisdiction, in most circumstances, there is no obligation for heath-care workers to report suspected criminal behaviour of patients. Your jurisdiction may vary. I recommend seeking further advice before disclosing ANY information about a patient to third parties.
posted by Defying Gravity at 6:37 PM on February 16, 2012

Response by poster: Follow up: I talked to my boss why explained why he didn't think the patient posed a threat to others or himself. My consern wasn't so much about the possibility of prior illegal acts, as that we may be releasing someone who poses a direct threat to others. But after talking it over with my experienced boss who I trust, I came to see why it was unlikely that the patient would hurt anyone, and with that out of the way was free to go.
posted by ladypants at 6:29 AM on September 14, 2012

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