Inappropriate Pics Found on PT

[nwhitney]

I had a situation the other day at work and I'm curious how others would have handled it. I'll tell you what happened and then later how I dealt with it.

I work as an EMT for what is essentially the county drunk tank. In addition to the police bringing in intoxicated individuals we also drive around the city limits and transport people to the drunk tank. So two of our EMT's picked up a man and after admitting him we began to go through his property like we do with everyone. While going through his bag I found a book from the library about beginning ballet. The book was marked to pictures of little girls stretching. Inside the book were photos ripped from books. These pics were of unclothed minor girls. If I had to guess I would say the youngest was 8-10.

How would you have handled this?

 

[Wes]

Depending on your state's laws, you might find yourself in a mandatory reporting situation.

 

[DesertMedic66]

Contact PD and let them deal with it.

 

[Clipper1]

If you work for a county facility you should have a policy for reporting inappropriate behavior and incidents which may require law enforcement involvement. If you do not know the policy, contact your supervisor, HR department or a Social Worker. Some states have a mandated reporting time if you know about possible child abuse. Don't go over that reporting time by wasting it on an anonymous forum. Seek the correct answers in your own workplace.

 

[MedicBender]

Contact PD and let them deal with it.

This. Immediately.

 

[nwhitney]

I am a mandatory reporter. Here's the thing those pictures were torn out from a library book.

 

[nwhitney]

Contact PD and let them deal with it.

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.

 

[Clipper1]

This. Immediately.

If the person is a patient at the facility and is not an immediate threat, it is best to inform the supervisors first. Without having the paperwork to show this person arrived with the photos or some warning the police are coming, this could backfire on the op. Yes you would need to give the patient's name for the possession of property. Follow policy unless you know the children in the photos which then would be a child abuse issue for mandated reporting.

 

[nwhitney]

Here's a little bit more to the story. An officer came down and viewed the pictures. He said that while the pics are obviously inappropriate they are considered "artistic" and without knowing the name of the PT he can't run his name to see if he is a SO and if possession of these pics violate and parole/probation conditions. The officer contacted the on-call sex offender detective and she reiterated what the officer said.

 

[nwhitney]

This. Immediately.

If the person is a patient at the facility and is not an immediate threat, it is best to inform the supervisors first. Without having the paperwork to show this person arrived with the photos or some warning the police are coming, this could backfire on the op. Follow policy.

I did contact my supervisor first which is policy.

 

[Summit]

If the person is a patient at the facility and is not an immediate threat, it is best to inform the supervisors first. Without having the paperwork to show this person arrived with the photos or some warning the police are coming, this could backfire on the op. Follow policy.

This.

Particularly since the OP says the pictures were from a library book and thus presumably from some library educational book (and thus presumably not the mandatory reportable child abuse), though the patients purposes were clearly not educational. This issue could complicate the medical privacy protections vs mandatory reporting. It is best to let a supervisor figure that out for you.

 

[medicdan]

I work as an EMT for what is essentially the county drunk tank.

HIPAA is widely misunderstood... if you are not working for a "covered entity", i.e. a company that bills CMS, the law does not apply to you. Your department may have their own medical privacy or confidentiality policies, but I highly doubt it would in this case...

Even if HIPAA applied, this may be considered an appropriate release of information... but that decision lies with your supervisors, I presume.

I guess i'm a little confused... and apparently not well versed in child pornography law... do you have any evidence that this individual has done anything illegal, i.e. a "hands on crime"? Presumably possessing these materials as a part of the complete books isn't problematic... so why is it when ripped out? Is this a legal issue or one which you just find morally problematic?

As with may things here, we aren't giving you legal advice, and it seems you have already contacted your supervisors...

 

[nwhitney]

HIPAA is widely misunderstood... if you are not working for a "covered entity", i.e. a company that bills CMS, the law does not apply to you. Your department may have their own medical privacy or confidentiality policies, but I highly doubt it would in this case...

Even if HIPAA applied, this may be considered an appropriate release of information... but that decision lies with your supervisors, I presume.

I guess i'm a little confused... and apparently not well versed in child pornography law... do you have any evidence that this individual has done anything illegal, i.e. a "hands on crime"? Presumably possessing these materials as a part of the complete books isn't problematic... so why is it when ripped out? Is this a legal issue or one which you just find morally problematic?

As with may things here, we aren't giving you legal advice, and it seems you have already contacted your supervisors...

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.

 

[Clipper1]

HIPAA is very misunderstood and some will use it as an excuse to not report abuse or illegal activity. Mandated reporting of abuse (child, elder) and HIPAA should have been covered THOROUGHLY at hire and reviewed at least yearly. This should also be in writing in the P&P manual. Any questions should be addressed up the chain of command with the knowledge for your state and agency. HIPAA has some very specific exemptions when it comes to reporting abuse and PD with criminal activity. Time review your own manual. This applies to everyone.

 

[Mariemt]

Why would a library book had undressed girls, even for ballet? To me that's strange.

Hipaa is thought of as a need to know sort of thing. If someone is endangering others , it is a need to know. As a mandated reporter, it is your job to report illegal activity. It is law that you do. You would be stuck here if hipaa didn't have allowance for this. Now whispering to your neighbor about this patient would be a violation of hipaa, but contacting the correct authorities would not.

Now, were these pictures considered child pornography? I don't know, I didn't see them. I guess you could ask yourself if any children were harmed in the making of them, would the possession of them put children at harm? National Geographic has pics in their magazines that are not considered pornographic.

In our state, we may alert our supervisor but we are not to leave it there. If we feel any sort of abuse, neglect etc is taking place it is our responsibility to make sure the proper authorities are alerted and if the supervisor does not agree with your accusations, they may decide not to turn it in. Then it is your butt. You were the mandated reporter. The supervisor is not the proper authority..
I think in this case I would have went ahead, told PD, if he had prior record in this, the pics would have been a violation of his probation.

 

[nwhitney]

Why would a library book had undressed girls, even for ballet? To me that's strange.

Hipaa is thought of as a need to know sort of thing. If someone is endangering others , it is a need to know. As a mandated reporter, it is your job to report illegal activity. It is law that you do. You would be stuck here if hipaa didn't have allowance for this. Now whispering to your neighbor about this patient would be a violation of hipaa, but contacting the correct authorities would not.

Now, were these pictures considered child pornography? I don't know, I didn't see them. I guess you could ask yourself if any children were harmed in the making of them, would the possession of them put children at harm? National Geographic has pics in their magazines that are not considered pornographic.

In our state, we may alert our supervisor but we are not to leave it there. If we feel any sort of abuse, neglect etc is taking place it is our responsibility to make sure the proper authorities are alerted and if the supervisor does not agree with your accusations, they may decide not to turn it in. Then it is your butt. You were the mandated reporter. The supervisor is not the proper authority..
I think in this case I would have went ahead, told PD, if he had prior record in this, the pics would have been a violation of his probation.

The ballet book didn't have the pics of undressed girls. The photos were tucked in between the pages of the book. The cop and detective said the pictures themselves were not considered child pornography but "artistic". The problem is the cop doesn't know if possession constituted a crime without know the PT's name and I couldn't give his name because as the cop said the pics were "artistic". The photos weren't some Polaroids the of kids that were in danger. I'm glad I called the cops to come down and take a look at what I found. I just don't know how I could have released the mans info without violating HIPAA.

Had the police brought the man in then when I searched the bag I could have done it in front if the cop. That's our plan for next time the guy comes in by the cops.

 

[xrsm002]

Child pornography refers to pornography depicting sexually explicit activities involving a child. (Wikipedia definition)
If they were just nude pictures of kids in non sexually explicit ways then they are "artistic" there are family nudist camps throughout the U.S.

 

[nwhitney]

Thanks for all the comments I found them useful and interesting.
In a nutshell besides calling my supervisor and the police I don't feel there was anything I could really do but you all gave some good things to think about.

 

[mycrofft]

I am a mandatory reporter. Here's the thing those pictures were torn out from a library book.

Call the library.

I think it's been covered adequately.

Unless I was law enforcement I'd be keeping my hands out of personal belongings. They have to catalog them and if the arrestee/detainee declares stuff is missing, guess who's going to catch the mudpie on that one.

 

[Achilles]

Call the library.

I think it's been covered adequately.

Unless I was law enforcement I'd be keeping my hands out of personal belongings. They have to catalog them and if the arrestee/detainee declares stuff is missing, guess who's going to catch the mudpie on that one.

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.