What rights do hospitals have?

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PFDbadger

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I was recently on a squad call that involved a very sick lady that we transported to the hospital. Within the 24 hour duty day, she was transported, seen by the hospital, released. We received another call to her home several hours after her release, this time she was DOA.

The next morning I am being informed that the hospital was wanting a copy of the run report, via the EMS coordinator. The hospital thought the second run was a field termination. I informed them it was a DOA. Regardless, they still requested a copy of the squad report and the FD secretary gave them a copy.

What I have been trying to find out, is whether the hospital has the right to see the report, since the patient was DOA and the scene was turned over the the local police and Coroner, or if they were scrambling to cover their butts going out on a limb, asking for information that they should not have received.

What or where can I find out the true legal stand on this situation?

Thanks!
 
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It's a moot point

PFDbadger said:
What or where can I find out the true legal stand on this situation?
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It sounds like you are fire-based so your city or county attorney is the one who should make any determination whether the dept should be supplying copies of PCR's.

It's a moot point though since the hospital got what they wanted anyway.
 
Yes, you are right. We are a Fire-based EMS service and in the city.

It is moot point for this incident, but to prevent such an infraction occurring again, it helps to know as much as possible. Being able to legitimately justify refusing the hospital information, that is no concern of theirs, is what the goal is.

The whole situation is a tragedy and those who might be to blame need not bring in others to become victims.
 
Hospitals here are usually get a copy of the run report for every call that is transported to their ED.
 
In the future, refer them to the person with the brass on the collar and the gold badge. They can decide what is appropriate or not. But the department should have a policy in place.
 
PFDbadger said:
I was recently on a squad call that involved a very sick lady that we transported to the hospital. Within the 24 hour duty day, she was transported, seen by the hospital, released. We received another call to her home several hours after her release, this time she was DOA.

The next morning I am being informed that the hospital was wanting a copy of the run report, via the EMS coordinator. The hospital thought the second run was a field termination. I informed them it was a DOA. Regardless, they still requested a copy of the squad report and the FD secretary gave them a copy.

What I have been trying to find out, is whether the hospital has the right to see the report, since the patient was DOA and the scene was turned over the the local police and Coroner, or if they were scrambling to cover their butts going out on a limb, asking for information that they should not have received.

What or where can I find out the true legal stand on this situaion?
Thanks!
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Yeah, there is nothing wrong with hospital legal requesting a copy. It's going to happen anyway so, they may as well not make it a fight.
 
rescue99 said:
Yeah, there is nothing wrong with hospital legal requesting a copy. It's going to happen anyway so, they may as well not make it a fight.
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They may request it, but have no legal right to obtain it. The call had nothing to do with the hospital, so they have no right to a copy.
 
reaper said:
They may request it, but have no legal right to obtain it. The call had nothing to do with the hospital, so they have no right to a copy.
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Legal does have a right to request a copy and FD could have refused but, it was within the first 24 hours following discharge, why bother? FD could have made em wait until a court order was made for discovery but, chose to not do that. It isn't that big of a deal...and, it may actually be a matter of public record. EMSLaw would know more about this stuff.
 
Actually... as I understand it (at least in MA),

If the EMS personnel made a field determination of death (DOA, or the like), aren't they required to contact their medical control for permission (not to resuscitate)? In that case, is it possible you called medical control to that ER? In that case, the physician still needs to generate some paperwork, so they may have some right to access it. Whether once it's in the building, it goes only to the necessary personnel for the declaration of death, or also to legal, is another issue.
 
You have to contact med control to confirm death? Even on an obvious DOA?
 
Goes back to different strokes for different folks (Sorry, I couldn't resist)

Some areas you can call an obvious DOA on scene, at a BLS level; not even have to think about calling medical control.
Other areas you have to call medical control on anything
Worse; there are areas that make you transport, while working an arrest even if it is an obvious DOA: Medical Director does not trust his EMS to call a DOA: in eastern Indiana a few years ago, doc made the EMT-A crew transport a decapitation, and told them on the radio that they had better be working the patient when they walked into the ED.
 
A little more details...

It was determined as soon as we walked in the door that this was a DOA and no attempts were going to be made for obvious reason. the police were there and within a couple of minutes the Coroner was contacted and the squad was released from the scene with the police taking charge and it becoming a legal matter with the Coroner getting involved.

There was no transport or contact with medical control, so that pretty much excludes the hospital from needing the report, as they normally would for a field termination or a transport.

The brass was advised of my question and they haven't come to a conclusion or found a solid answer yet. The answer I got from the top dog, was that it is very interesting and it will be researched to find what the legal stance is or will be.

It is more of me wanting to know what to do the next time it happens, which hopefully that will be never... Or at least knowing how to handle this type of situation in a professional manner with consideration for professional courtesy between the hospital and medics. Sometimes the hospital forgets who they do not employ.

If they do have the right to the records, so be it. No problems on this end in providing information they request. Its just an area that has not been challenged or addressed.

There may be a policy needing to be created for such an event. Especially in this day and age of litigation.

I agreed to help try to find out as much as possible about this type of situation, so I appreciate the information you all are providing.

Thanks!
 
emt.dan said:
Actually... as I understand it (at least in MA),

If the EMS personnel made a field determination of death (DOA, or the like), aren't they required to contact their medical control for permission (not to resuscitate)? In that case, is it possible you called medical control to that ER? In that case, the physician still needs to generate some paperwork, so they may have some right to access it. Whether once it's in the building, it goes only to the necessary personnel for the declaration of death, or also to legal, is another issue.
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check the protocols.
-lividity
-rigor
-decapitation
-obvious signs of death[major organs out side of body]

If I remember right, those are the 4 criteria for calling a DOA in MA without med control.
 
mikeN said:
check the protocols.
-lividity
-rigor
-decapitation
-obvious signs of death[major organs out side of body]

If I remember right, those are the 4 criteria for calling a DOA in MA without med control.
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I quote the most recent MA DPH protocols, effective Jan 1, 2010 (simply because I cant find the current ones on my computer), page 142.

In all cases where EMTs have withheld or ceased resuscitative efforts in accordance with the requirements above, and left the person in the field, procedures must include notification of appropriate medical or medico-legal authorities, such as police.
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In the systems I work in, that includes contacting on-line medical control, who will actually sign the decleration of death, whether police is on scene or not. In fact, I am obligated to get a signed statement from the physician in one of the systems I work in.

Further, in the paramedic cesation of resus protocols, it says (also page 141):
An on-line medical control physician gives an order to terminate resuscitative efforts.
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reaper said:
You have to contact med control to confirm death? Even on an obvious DOA?
Click to expand...

These were my thoughts also , if the patient meets the criteria we dont contact med control.
 
It is a state, or protocol specific issue, sorry for dragging it out. There have been discussions here about it before... The whole issue of declaration of death/cessation of resus varies so widely... the regional variations are interesting, but unimportant.
 
It's nice to know other states' protocols. I am in Ohio and from the local protocols here, we are only required to contact the local authorities and/or the coroner for obvious DOAs. Fortunately in the case that took place where I am, the police were already on the scene and they have deputy coroners on the dept. We are extremely fortunate to be able to work closely with the police here and the coroner is very accessible to us.

The documentation that we keep on such a case is available for the authorities, but when the hospital started asking, that's when the red flags started appearing. Especially since the patient had been released just a few hours prior.
 
The release of the run sheet may have been (technically) a violation of HIPAA. While the hospital might have requested the sheet, it (possibly) shouldn't have been furnished to them as that particular run didn't involve them. The hospital might not have been legally allowed to get that sheet. Any info that they could have needed (for a dead, former patient) could have been supplied by the Coroner's Office.

Legal Counsel, versed in the intricacies of HIPAA, should be consulted to help generate a cohesive policy in the matter of run sheet release to ANY entity.
 
Thanks Akulahawk :excl:

What you have mentioned have been my concerns all along.

That's exactly what I am looking for as far as how much information a hospital can legally have.

HIPAA is a ton of reading, but I'm in there digging to see what I can find. I started this thread to see if anyone else may have been in this situation and may have already dug deep enough to find something. Never the less, I haven't quit and I will eventually find the answer to my question.
 
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