5-2

FACTS:Katherina LeDoux worked as an EMT for Tess Corners Volunteer Fire Department. Julie Pachowitz worked as an employee of West Allis Memorial Hospital.

On April 21, 2000 LeDoux responded to the home of Pachowitz for a possible overdose. She was found to be unresponsive and had poor vital signs. Because Pachowitz worked at West (?) Allis Memorial Hospital, her husband requested that she be sent to Waukesha Memorial hospital instead "to avoid disclosing her need for emergency medical care to her fellow employees."

Pachowitz and LeDoux had a mutual acquaintance; Sally Slocomb. LeDoux thought that Pachowitz and Slocomb were good friends and that Pachowitz might need the help of a good friend. LeDoux called Slocomb on the telephone informing her about what happened. Pachowitz filed an invasion of privacy and defamation lawsuit against LeDoux and the Tess Corners Volunteer Fire Department.

ISSUE:Did LeDoux breach Pachowitz's privacy because of the telephone call she made to Slocomb?

RULE:The court ruled that the disclosure of private information depends on the giving and receiving of that information.The court found in favor of Pachowitz.

EMPHASIS:This case demonstrates that even though LeDoux may have been acting out of general concern, there are situations where privacy must be maintained.

Questions:

1. Do you think that LeDoux was acting out of general concern or was she just gossiping? Explain your answer.
2. Why did Pachowitz sue the Fire Department in addition to suing LeDoux? Explain your answer.

5-3

FACTS:Jose Proenza Sanfiel worked as a psychiatric nurse. He claimed that he purchased at a thrift shop for $20 a used computer that was previously owned by Charter Behavioral Health System. (Jose was not an employee of Charter, but worked for a different behavioral health company.) Jose claimed that the computer he purchased contained 526 patient records. Charter emphatically denied Jose's claim, testifying that they never sold or donated any used computer equipment.

At the time that Jose purchased the computer, Charter was being investigated for defrauding the government. Jose contacted various law enforcement agencies believing that a crime had been committed by Charter for leaving the patient information on the computer. Law enforcement declined because they didn't have jurisdiction.

Next, Jose contacted local news agencies and allowed them to view the computer and the patient information. Even though he requested that patient information be blurred out, when the report aired the patient information was not obscured. To supplement the story, some reporters attempted to contact the patients whose records were on the computer.

Upon learning about Jose's actions, the Florida state Medical Board issued an emergency suspension of Jose's license.They asked that Jose turn over the computer to them, which he refused to do. He did offer to sell the computer to Charter for $20,000.

When testifying, Jose admitted that he made the disclosure and that as a psychiatric nurse he could be disciplined for disclosing patient information. But he argued that he was a private citizen when he disclosed the information and therefore not a healthcare provider.

ISSUE:Did Jose disclose the information as a private citizen or as a healthcare provider?

RULE:"It is reasonable to characterize Proenza Sanfiel's actions as unprofessional conduct, even though Proenza Sanfiel was acting in a 'private capacity.'"

EMPHASIS: One of the important reasons for providing this case is to demonstrate that the actions that you take as a private citizen can still have professional repercussions. More relevant to our current discussion is the fact that medical information can be released only when the receiver of that information has a medical need for it.

Questions:

1. What isn't in dispute is that Jose had a computer with Charter's patient information on it. If Charter didn't sell the computer, how did you think that Jose get the information?Explain your answer.
2. Why do you think that Jose didn't just hand over the computer to Charter? Explain your answer.

5-4

FACTS:A physician referred to as Dr. John Doe was working at both Hershey Medical Center and Harrisburg Hospital.During an operation, John Doe was assisting another physician. During the operation, the other physician accidently cut Dr. John Doe on the finger.(Whether there was a transfer of blood from John Doe to the patient is unknown. Court records only indicate that "... apparently there was not.")According to protocol, Dr. John Doe took an HIV test, which came back positive. Upon learning about the positive test results, Dr. John Doe took a leave of absence.

Hershey Medical Center and Harrisburg hospital identified 447 patients who had received care from Dr. John Doe. The hospitals filed a petition to the court, citing "compelling need" to release information about Dr. John Doe's positive test result to those 447 patients and their physicians.

ISSUE:Can the hospital release private medical information to members of the public that may have been exposed or does the information need to be kept private?

RULE: "After weighing the competing interests in this case, we find that the scales tip in favor of public health, regardless of the small potential for transmittal of the fatal virus."

EMPHASIS:This is an example of how issues arise in healthcare that must be handled delicately. While the overriding principle is to keep information private, there are exceptions that must not be taken lightly.

Questions:

1. Even though the physician's name wasn't released to the patients to whom he provided care, don't you think they'd be able to figure out who it was? Explain your answer.
2. What do you think about employees taking a mandatory HIV test on employment and then yearly after that? Explain your answer.

5-5

FACTS:Richard Gibson worked as a phlebotomist at Seattle Cancer Care Alliance. Without medical need or authorization, Mr. Gibson accessed patient files to obtain PHI which he used to fraudulently apply for credit cards. Mr. Gibson was arrested for violating the Privacy Rule of HIPAA.

ISSUE:Can an individual be subjected to criminal punishment for violating HIPAA?

RULE:Most of the punishments for infractions related to HIPAA are monetary fines, but the drafters of HIPAA took the subject seriously when they instituted potential criminal charges.Because the legislature is granted the authority to create the law, and to determine whether it is a civil or criminal infraction, an individual can be criminally prosecuted for violating HIPAA.

EMPHASIS:HIPAA went into effect in 1996.After several years, no one had been criminally prosecuted, leaving some to wonder if there was any intention to do so or if it actually served as a deterrent. Gibson was the first person to serve jail time for violating the Privacy Rule. He entered a plea agreement for 16 months in jail and paying restitution to the credit card companies.

Questions:

1. HIPAA took effect in 1996, but the first person wasn't prosecuted until 2004. Why do you think it took so long before someone was arrested? Explain your answer.
2. Can the patients whose identity Gibson stole sue him for HIPAA violations? Explain your answer.