Inappropriate Pics Found on PT

[NJEMT95]

Giving a pt's name to LEO is not a violation of HIPAA. JEMS had an article about this recently: http://www.jems.com/article/administration-and-leadership/pro-bono-reporting-drugs-illegal-activit

 

[Tigger]

If they're going in a psych ward, they should be taken away. You don't want a 5150 PT carrying a 9 Mm through the ED.

Hopefully the ED is searching these patients as well.

Heck at our big hospital every pt and family member gets searched.

 

[mycrofft]

If they're going in a psych ward, they should be taken away. You don't want a 5150 PT carrying a 9 Mm through the ED.

The OP's job description might include going through belongings, but if it doesn't, then ought not to, just separate the pt from the thingies. Pockets examined too? Lean on the wall and cough while unrobed? (Be surprised what can drop loose then).:blink:

Before being "drunk tanked" or psych-held the belongings would be (ought to be) taken (along with shoe strings, belts, ties, hats, handkerchiefs, maybe socks*); if admitted or incarcerated, clothes are removed as well. But EVERYTHING gets cataloged.

"Wristwatch, men's, Timex, digital on plain silver colored metal stretch band".

"Check".

"Pictures of naked little kids".

Check...Wha?!". h34r:



* EDIT: Socks. I've seen them used to plug up drains or toilets. I cut a guy down who hung himself with socks. I saw a guy coshed by an inmate who put two socks into the toe of another, soaked the toe section in water, then used it like a "lock in a sock" club to smack the guy in the back of the head.

 

[nwhitney]

Update

Part of my job is to go through and inventory the pt's property and give them a copy at discharge. The city I work in decriminalized public intoxication so when the police bring people to use the are not under arrest but placed on a civil detox hold. Unless the cops have PC they can't search a pt's bag only their person for valuables. That came directly from the police.

Anyways I called the state dept. of human services child abuse division for guidance on the issue. I explained the circumstances and the child abuse office agreed that I couldn't give the pt's info to the police without violating confidentiality. So unfortunately it doesn't sound like I could have really done anything more.

 

[nwhitney]

Giving a pt's name to LEO is not a violation of HIPAA. JEMS had an article about this recently: http://www.jems.com/article/administration-and-leadership/pro-bono-reporting-drugs-illegal-activit

It would have been for me since there was no indication of illegal activity.

 

[Clipper1]

It would have been for me since there was no indication of illegal activity.

This is why most facilities have a policy for a supervisor or administrator to be notified for police involvement unless someone is in immediate danger.

 

[Rialaigh]

Part of my job is to go through and inventory the pt's property and give them a copy at discharge. The city I work in decriminalized public intoxication so when the police bring people to use the are not under arrest but placed on a civil detox hold. Unless the cops have PC they can't search a pt's bag only their person for valuables. That came directly from the police.

Anyways I called the state dept. of human services child abuse division for guidance on the issue. I explained the circumstances and the child abuse office agreed that I couldn't give the pt's info to the police without violating confidentiality. So unfortunately it doesn't sound like I could have really done anything more.

I guess I am thoroughly confused by this whole situation.

So your an EMT that can bring people to a location against their will without law enforcement for something that is not considered a medical emergency and hold them against their will and search their property?

You can hold them against their will for something that your city decriminalized?

You can search their property for something that is not even associated with a crime or a medical emergency?


I guess I am confused by the concept of a civil detox hold and what rights you guys have to hold and search people while admitting they are not being held for a crime or being treated for a medical emergency...just seems odd to me

 

[nwhitney]

I guess I am thoroughly confused by this whole situation.

So your an EMT that can bring people to a location against their will without law enforcement for something that is not considered a medical emergency and hold them against their will and search their property?

You can hold them against their will for something that your city decriminalized?

You can search their property for something that is not even associated with a crime or a medical emergency?


I guess I am confused by the concept of a civil detox hold and what rights you guys have to hold and search people while admitting they are not being held for a crime or being treated for a medical emergency...just seems odd to me[/QUOTE

I know it might seem odd but yes to all of that.

If the cops bring people in then the cop places them on a civil detox hold. If we pick them up then we place them on a civil detox hold. We're deputized by the county sheriff's office so we can legally do this. We can legally hold people up to 48 hours but typically its 4-8 hours. It's a fairly unique setup. I don't really think many other metropolitan cities have anything like this.

Initially EMT's weren't employed here but after a couple of deaths from DT's and opiates it was decided it would be in the best interest to have some medical staff on hand. We're a weird mixture of law enforcement, EMS, and alcohol/drug counselor.

The idea is to keep intoxicated people who really haven't committed a crime out of jail and out of the hospitals. Try to keep those resources free for people who actually need them. We don't put a civil detox hold on just anyone who is intoxicated, there are some criteria that have to be met. It's not only drunk people who are brought here. We have people who are on meth, prescription drugs, heroin, methadone, and any other drug or combination.

We're a non-profit and also run a 10 day detox program that works to get people into long term rehab. Plus a lot of other programs such as housing and employment.

 

[Rialaigh]

I know it might seem odd but yes to all of that.

If the cops bring people in then the cop places them on a civil detox hold. If we pick them up then we place them on a civil detox hold. We're deputized by the county sheriff's office so we can legally do this. We can legally hold people up to 48 hours but typically its 4-8 hours. It's a fairly unique setup. I don't really think many other metropolitan cities have anything like this.

Initially EMT's weren't employed here but after a couple of deaths from DT's and opiates it was decided it would be in the best interest to have some medical staff on hand. We're a weird mixture of law enforcement, EMS, and alcohol/drug counselor.

The idea is to keep intoxicated people who really haven't committed a crime out of jail and out of the hospitals. Try to keep those resources free for people who actually need them. We don't put a civil detox hold on just anyone who is intoxicated, there are some criteria that have to be met. It's not only drunk people who are brought here. We have people who are on meth, prescription drugs, heroin, methadone, and any other drug or combination.

We're a non-profit and also run a 10 day detox program that works to get people into long term rehab. Plus a lot of other programs such as housing and employment.

I think its a great idea, If your acting as law enforcement during the hold (by holding them, etc...) and your deputized then I would assume any searches would have to follow all state laws and your departments (law enforcement agency) policy for such things. I would be wary that anything found during a search would not be admissible in court because they were searched while they are not suspected of a crime (your admitting to hold them for something thats not a crime).



As far as the original question, I would document in detail everything that was found including the pictures (on the document belongings). I would report it to the immediate supervisor, and I would immediately drop it after that and not worry about it. Specifically tell the supervisor your unsure if this is legally reportable to other law enforcement and that you will wait for their decision, then document the conversation. Personally I wouldn't bother reporting this, but to CYA you have to have the conversation with a supervisor and you have to document that you are unsure what is legally applicable and you will await their direction.

 

[Aidey]

I would think the searches are kosher, since it is a detox center they have a legitimate interest in making sure no drugs or alcohol are being brought in.

 

[mycrofft]

I think its a great idea, If your acting as law enforcement during the hold (by holding them, etc...) and your deputized then I would assume any searches would have to follow all state laws and your departments (law enforcement agency) policy for such things. I would be wary that anything found during a search would not be admissible in court because they were searched while they are not suspected of a crime (your admitting to hold them for something thats not a crime).



As far as the original question, I would document in detail everything that was found including the pictures (on the document belongings). I would report it to the immediate supervisor, and I would immediately drop it after that and not worry about it. Specifically tell the supervisor your unsure if this is legally reportable to other law enforcement and that you will wait for their decision, then document the conversation. Personally I wouldn't bother reporting this, but to CYA you have to have the conversation with a supervisor and you have to document that you are unsure what is legally applicable and you will await their direction.

1. You can't "act as a law enforcement officer". You are, or you aren't.
2. A chain of custody needs to be established to make most physical evidence admissible as more than hearsay (as in "Yes, I saw that property in this person's possessions", versus having something logged in by evidence number and description under two signatures).

nwhitney, I am assuming your employer is the LE department?

At any rate, done good. Watch out for sharps in property , also infections filth.

 

[nwhitney]

1.

nwhitney, I am assuming your employer is the LE department?

At any rate, done good. Watch out for sharps in property , also infections filth.

Not part of the LE department, we are a nonprofit agency.

 

[mycrofft]

Be sure to raise this question with your managers.

 

[tacitblue]

I would think the searches are kosher, since it is a detox center they have a legitimate interest in making sure no drugs or alcohol are being brought in.

The search is kosher but only to look for dangerous items and to catalog contents. Since there is no probable cause, I would think that any evidence of criminal activity found during such a search couldn't be used legally against the patient.

A note to the OP, HIPAA and other privacy laws/policies do not apply when you think the patient could hurt themselves or others through criminal activity.

 

[JPINFV]

A note to the OP, HIPAA and other privacy laws/policies do not apply when you think the patient could hurt themselves or others through criminal activity.

Except no one is in direct danger. Sick, disgusting, and foul? Sure, but if he's ripping them from legal books than the worst thing he's done is theft and vandalism. You can argue gateway, but if we want to argue that someone getting off on ballet girls (regardless of how sick and demented that is), than what does that say about people who play Grand Theft Auto?

 

[tacitblue]

Except no one is in direct danger. Sick, disgusting, and foul? Sure, but if he's ripping them from legal books than the worst thing he's done is theft and vandalism. You can argue gateway, but if we want to argue that someone getting off on ballet girls (regardless of how sick and demented that is), than what does that say about people who play Grand Theft Auto?

In this case, no. Unless of course the pictures showed children actually being harmed and there was reason to believe the patient was responsible.

 

[exodus]

I did contact PD and they came down to view the pictures but I couldn't give them the PT's name without violating HIPAA.

And exactly, which part of HIPAA would that violate? (Hint: None.)

Edit: There are also exemptions for LE conducting an investgation

 

[DesertMedic66]

And exactly, which part of HIPAA would that violate? (Hint: None.)

Edit: There are also exemptions for LE conducting an investgation

That's what I was thinking. I'm just going to give the officer the patients name, not anything medically related about that.

 

[Handsome Robb]

I suppose I should make this clear, I am not asking for legal advise. Just curious how others would respond in a similar situation.

HIPAA does apply to us and a similar state law and agency policy. It was a tough situation because while we don't know if a crime had been committed it's pretty clear those pics are inappropriate. When our EMT's were on scene picking this guy up the cops were initially there but took off and his bag wasn't searched until he got to me.The cops were sympathetic to our situation.

This bothers me both on moral and legal grounds. I think we may have found a work around for the future as this guy is a regular.

I bolded an important point. Maybe it's just me and experiences that I have but the patients that are going for psych or to the alcohol recovery center always get a quick run through of their stuff on scene before they get transported. I've found too many weapons and had too many of them go ballistic on me. Anything I seem dangerous either goes in my possession or the entire bag stays in my possession until we get to wherever we are going.

A note to the OP, HIPAA and other privacy laws/policies do not apply when you think the patient could hurt themselves or others through criminal activity.

Definitely a valid point but I don't think intent can be implied. Is it morally wrong? Yes. Is it legally wrong to possess it in the assumed intent? Questionably yes. Can you prove intent to harm other through simple possession in an intoxicated man's bag? Definitely not.

 

[nwhitney]

I bolded an important point. Maybe it's just me and experiences that I have but the patients that are going for psych or to the alcohol recovery center always get a quick run through of their stuff on scene before they get transported. I've found too many weapons and had too many of them go ballistic on me. Anything I seem dangerous either goes in my possession or the entire bag stays in my possession until we get to wherever we are going.



Definitely a valid point but I don't think intent can be implied. Is it morally wrong? Yes. Is it legally wrong to possess it in the assumed intent? Questionably yes. Can you prove intent to harm other through simple possession in an intoxicated man's bag? Definitely not.

On scene we search their person for dangerous items. Their belongings go in a plastic bag and ride upfront away from the pt.