Posts Tagged ‘HIPAA’

“Laws Limit Options When a Student is Mentally Ill”

WashingtonPost.com’s “Think Tank Town” feature has a symposium on the policy implications of the Virginia Tech massacre, including contributions from Ted on fear of litigation and from me on the legal constraints on universities faced with problem students, as well as from Jim Copland (Point of Law, Manhattan Institute) on gun control.

This morning’s New York Times (Apr. 19) includes a must-read article by Tamar Lewin spelling out in more detail the problems I refer to in my short commentary. Writes Lewin:

Federal privacy and antidiscrimination laws restrict how universities can deal with students who have mental health problems.

For the most part, universities cannot tell parents about their children’s problems without the student’s consent. They cannot release any information in a student’s medical record without consent. And they cannot put students on involuntary medical leave, just because they develop a serious mental illness….

Universities can find themselves in a double bind. On the one hand, they may be liable if they fail to prevent a suicide or murder. After the death in 2000 of Elizabeth H. Shin, a student at the Massachusetts Institute of Technology who had written several suicide notes and used the university counseling service before setting herself on fire, the Massachusetts Superior Court allowed her parents, who had not been told of her deterioration, to sue administrators for $27.7 million. The case was settled for an undisclosed amount.

On the other hand, universities may be held liable if they do take action to remove a potentially suicidal student. In August, the City University of New York agreed to pay $65,000 to a student who sued after being barred from her dormitory room at Hunter College because she was hospitalized after a suicide attempt.

Also last year, George Washington University reached a confidential settlement in a case charging that it had violated antidiscrimination laws by suspending Jordan Nott, a student who had sought hospitalization for depression….

Last month, Virginia passed a law, the first in the nation, prohibiting public colleges and universities from expelling or punishing students solely for attempting suicide or seeking mental-health treatment for suicidal thoughts.

The article also refers to the role of the Buckley Amendment (FERPA), the HIPAA medical-privacy law, and disabled-rights law, which prohibits universities from inquiring of applicants whether they suffer serious mental illness or have been prescribed psychotropic drugs. Incidentally, the Allegheny College case, in which a Pennsylvania college came under fire for not notifying parents about their son’s suicidal thoughts, was discussed in a W$J article last month: Elizabeth Bernstein, “After a Suicide, Privacy on Trial”, Mar. 24. And Mary Johnson suspects that HIPAA will turn out to have played a role in the calamitous dropping of the ball regarding Cho’s behavior (Apr. 18). More: Raja Mishra and Marcella Bombardieri, “School says its options were few despite his troubling behavior”, Boston Globe, Apr. 19; Ribstein.

And: How well did privacy laws/policies work? Why, just perfectly:

Ms. Norris, who taught Mr. Cho in a 10-student creative writing workshop last fall, was disturbed enough by his writings that she contacted the associate dean of students, Mary Ann Lewis. Ms. Norris said the faculty was instructed to report problem students to Ms. Lewis.

“You go to her to find out if there are any other complaints about a student,” Ms. Norris said, adding that Ms. Lewis had said she had no record of any problem with Mr. Cho despite his long and troubled history at the university.

“I do not know why she would not have that information,” she said. “I just know that she did not have it.”

(Shaila Dewan and Marc Santora, “University Says It Wasn’t Involved in Gunman’s Treatment”, New York Times, Apr. 19). And Barbara Oakley, a professor at Oakland University in Michigan, has an op-ed in today’s Times, recounting her experience with a disturbing student: “It must have seemed far more likely that Rick could sue for being thrown out of school, than that I — or anyone else — could ever be hurt.” (“The Killer in the Lecture Hall”, Apr. 19). The tease-quote from the Times’s editors: “Do universities fear lawsuits more than violent students?”

January 4 roundup

Usually it’s Ted who posts these, but I don’t see why he should have all the fun:

  • Latest ADA test-accommodation suit: law school hopeful with attention deficit disorder demands extra time on LSAT [Legal Intelligencer]

  • John Stossel on Fairfax County (Va.) regulations against donating home-cooked food to the homeless, and on the controversy over Arizona’s Heart Attack Grill

  • More odd consequences of HIPAA, the federal medical privacy law [Marin Independent Journal via Kevin MD; more here, here]

  • UK paternalism watch: new ad rules officially label cheese as junk food; breast milk would be, too, if it were covered [Telegraph; Birmingham Post]; schoolgirl arrested on racial charges after asking to study with English speakers [Daily Mail via Boortz]; brothers charged with animal cruelty for letting their dog get too fat [Nobody’s Business]

  • Stanford’s Securities Class Action Clearinghouse reports impressive 38 percent drop in investor lawsuit filings between 2005 and 2006, with backdating options suits not a tidal wave after all [The Recorder/Lattman]

  • Ohio televangelist/faith healer sued by family after allegedly advising her cancer-stricken brother to rely on prayer [FoxNews]

  • Legislators in Alberta, Canada, pass law enabling disabled girl to sue her mom for prenatal injuries; it’s to tap an insurance policy, so it must be okay [The Star]

  • California toughens its law requiring managers to undergo anti-harassment training, trial lawyers could benefit [NLJ]

  • Family land dispute in Sardinia drags on for 46 years in Italian courts; “nothing exceptional” about that, says one lawyer [Telegraph]

  • “For me, conservatism was about realism and reason.” [Heather Mac Donald interviewed about being a secularist]

NYC plans “interventions” with diabetics

More scary paternalism in the name of public health from the Bloomberg crew: the New York City government has begun “legally requiring laboratories that do medical testing to report to the Health Department the results of blood-sugar tests for city residents with diabetes — along with the names, ages, and contact information on those patients. City officials are not only analyzing these data to assess patterns and changes in diabetes prevalence in the city, but are planning ‘interventions.’ … If you wish to keep your medical data confidential, you cannot.” Coercive public-health techniques originally seen as needed to combat communicable and infectious disease will now be deployed in hopes of correcting less-than-healthy individual behavior. Where’s HIPAA, the manically overbroad federal patient-privacy law, now that it might actually do some good? (Elizabeth Whelan, “Big Brother Will See You Now”, National Review Online, Apr. 25).

Deep Pocket Files: Anthony Pellicano fallout

Like libertarian blogger Amber Taylor, I’ve been enjoying the DVD of the show “Veronica Mars.” Kristen Bell plays a perky private eye who uses bugs and stolen medical records to solve cases. I just have to suspend my disbelief, and understand that Mars lives in a fictional world like that of Bruce Wayne where the laws that would have her sued into oblivion for her wiretapping and HIPAA violations don’t exist.

The Pellicano scandal (Apr. 3 and links therein) shows the real-world results. It’s natural that wiretapping victims are suing Pellicano and the law firms that hired him over his alleged wiretapping and bribery tactics.

But plaintiffs’ lawyers aren’t stopping with the egregious wrongdoers. For example, Craig Stevens pled guilty to taking bribes to run searches on Pellicano clients—a sign of Pellicano incompetence, since the data would be available from public databases on the Internet. (Want to know who’s in jail?) Stevens has resigned from the Beverly Hills Police Department, but the city (along with Los Angeles, who allegedly had their own bribed cops) is being sued for failure to stop their officer from being bribed. Los Angeles attorney Kevin McDermott predicts that the telephone company will also be sued for not doing enough to stop Pellicano wiretapping and, sure enough, Lisa Bonder Kerkorian has sued AT&T. In the Vanity Fair article, don’t miss the bit about how Daniel and Abner Nicherie allegedly used a blizzard of over a hundred lawsuits to protect a $40 million swindle. (Bryan Burrough and John Connolly, “Inside Hollywood’s Big Wiretap Scandal”, Vanity Fair, June 2006; Gabriel Snyder, “Names take aim at Pellicano article”, Variety, Apr. 28 (via Defamer); Greg Krikorian and Andrew Blankstein, “Filmmaker Says He Lied in FBI Probe”, Los Angeles Times, Apr. 18).

Pain management — at the doc’s own risk

“Doctors want to provide relief, but they also want to keep people safe and stay out of trouble themselves — since doctors have been sued for undertreating pain and jailed for overtreating it.” (Lois M. Collins and Elaine Jarvik, “Doctors walk narrow line in treating pain”, Deseret Morning News/Casper Star Tribune, Jan. 5). Commenters at Kevin Pho’s (Jan. 6) get specific about some of the legal headaches that an emergency room doctor may face when a chronic pain patient shows up claiming to need immediate relief: calling other local practitioners to check on whether the patient is known for “drug-seeking activity” is now a violation of the federal HIPAA health-privacy law, while giving a day or two’s worth of medication to tide them over risks litigation from family members accusing the doctor of enabling their relative’s narcotic habit.

Why object to HIPAA?

Why get annoyed at the federal medical privacy law (discussed in this space Mar. 16, Feb. 5, 2004, etc.)?

*Because it means your patients at the VA hospital often have no names on their doors? (MedRants, Mar. 31);

* Because it keeps you from talking about a patient’s condition when members of his extended family call to express concern? (Virginia A. Smith and Dawn Fallik, “Questions remain two years after medical privacy act”, Jewish World Review, Mar. 5);

* Because it brings out the worst in editorial writers at papers like the Philadelphia Inquirer? (Jeff Drummond’s HIPAA blog, Mar. 23).

And: MedRants has more (May 2).

Rogers v. Merck

Until today it looked as if the first Vioxx wrongful-death action to go to trial against Merck & Co. since the painkiller’s withdrawal from the market would be Cheryl Rogers’ lawsuit in an Alabama state court over the death of her late husband Howard. Now, at the request of a federal judge who is presiding over other Vioxx cases, the parties have agreed to postpone trial in the Rogers case, which had been set to start next month. (Theresa Agovino, “First Vioxx trial to be postponed”, AP/Business Week, Apr. 28). That’s a pity, since it would have been illuminating to get to the bottom of the allegations about the case aired in recent weeks. Per AP:

Read On…

HIPAA and small towns

What were once thought of as neighborly acts of kindness now pose too great a risk of medical privacy violations under federal law (Joe Ruff, “Communities Adjust To Medical Privacy Laws”, AP/ABC News, Mar. 12; via KevinMD). For more on the Health Insurance and Portability and Accountability Act, see Feb. 5, 2004 and links from there. More: the Michigan Medical Malpractice blogger says the hospitals are overreacting and a little gathering of permissions from patients/families should fix most of the problems (Mar. 17).

Death of a Red Sox fan

A pepper-ball injury to the eye is a very, very unlikely way to die, but those who know most about what happened to Victoria Snelgrove on Oct. 21 aren’t talking. CodeBlueBlog thinks some combination of fear of tort liability and HIPAA, the federal medical privacy law, explains much of authorities’ reticence (Oct. 30, Oct. 28).

HIPAA and the clergy

Among the many other effects of the new federal medical privacy law (see Oct. 23, Nov. 9, Jan. 21): clergy “now can look in on only those patients who have requested visits”. Result: if a longtime parishioner is admitted to the hospital unconscious, or just doesn’t realize that an affirmative request is required, the clergyman may be barred from entering the room to pray with or for them. “Before HIPAA, [Father Casey] Mahone said he could look at a list of Catholic patients and visit the ones he knew. ”People kind of had the mentality that they were going to be “discovered” by their priest in the hospital,’ he said. ‘If we didn’t find them, they were disappointed.'” “[Rev. Jack] Flint said he wanted to pray with a woman before she died from injuries suffered in an automobile accident. ”But because (the hospital) couldn’t release her name, I was lost,’ he lamented. ‘I didn’t get to do that.’ Instead of his calling her family to pray at her bedside, her family called him to pray at her funeral.” (“Health privacy law hinders clergy visits at hospital”, AP/Morgantown, W.V. Dominion Post, Feb. 3). More: GruntDoc, Feb. 5 (and see reader comments).