HIPAA Oops

I wrote up a doctor. I didn't want to. The house supervisor made me.

What happened is that an 18 year old guy used cocaine for the first time, according to him. As sometimes happens with illegal drugs, something bad happened. He vomited for a couple of days and had severe abdominal pain. He came to the ER and was found to also be in renal failure. He was admitted.


His symptoms could have been caused by cocaine, but we couldn't be sure without ruling out other possible problems. Over several days, he had one test after another. Everything came back normal, except for the blood tests showing failing kidneys. It had to be the cocaine.


His family was worried. They were constantly at his bedside and were becoming increasingly demanding in wanting to know what was wrong. We couldn't tell them because the patient is an adult and is entitled to his privacy and he was adamant that we not tell his parents. We just pretended that we didn't know what was wrong with him. It made us look like fools, but we're used to that.

Things began to go very badly on my shift. He began going into respiratory failure. We kept increasing the oxygen and he steadily worsened. The doctor decided to send him to ICU. He was going to need to be put on a vent if he continued the downward trend.

The patient's father demanded to know what was wrong. He went through the list of tests that had been done over the last several days and implied that we didn't know what we were doing. The doctor was indignant. He said of course we knew what's wrong with him; this was a side effect of cocaine.

The dad's face fell and he said what?!!! The patient just winced. I left the room. The damage was done.

The house supervisor was on the floor, so I told her what happened. Half-jokingly, I asked if we should call our lawyers now or wait until morning. She called our risk manager at home to discuss the HIPAA violation and told me that the risk manager wanted me to write up the doctor. I sure hope that he doesn't hold grudges.

When the doctor came out of the room, I did as instructed and told him that the patient was an adult and that he had violated HIPAA by telling the patient's family about the cocaine use. The doctor looked stricken. He said that the patient was a kid. I told him that the patient was 18 and that he was an adult. The doctor asked if the patient worked. I said that it didn't matter. At 18, he's an adult. We went back and forth until the doctor realized that he had screwed up. As instructed, I suggested that later when the patient was alone, he talk to the patient. The doctor agreed.

I feel sorry for the doctor. He was just the on call doctor and had no idea he was walking across a mine field. The doctor meant no harm, I'm sure. The patient's parents are furious with their son and they should be. I'm not sorry that they found out, but I do hope that we don't get sued.

One other thing, when the kid turned 18, he lost his health insurance and no one bought him another policy. He could have gone to a private college for what our bill is going to be. He'll be paying his bill for the next 10 or 20 years. When people complain about the cost of cocaine, they don't know the half of it.