When Should Hospitals Report Crime?
At a recent LHA seminar, a participant asked us about what types of crimes a hospital should report to the authorities. The following is a laundry list of what our research uncovered.
Fraudulent Prescriptions. Every practitioner may, if he has a good faith belief that a crime has been committed on the premises, notify local law enforcement authorities when it is believed that an individual has obtained a fraudulent prescription for any controlled dangerous substance or any person has attempted to obtain a fraudulent prescription for any controlled dangerous substance.
Practitioner includes physicians, dentist, veterinarians, scientific investigators, hospitals or other persons licensed, registered or otherwise permitted to distribute, dispense, conduct research with respect to, or administer a controlled dangerous substance in the course of professional practice or research in this state. La. R.S. 40:971(D).
Rape. These guidelines apply to all licensed hospitals in Louisiana in the event that any person presents himself or is presented at the hospital for treatment as a victim of rape, attempted rape, carnal knowledge, or crime against nature. It is the victim who makes the decision of whether or not the incident will be reported to law enforcement officials. No hospital may require a person to report the incident in order to receive medical attention. La. R.S. 40:2109.1.
- Victim does not wish to report. If the victim does not wish to report the incident to law enforcement officials, the victim must be examined and treated as a regular emergency room patient. Any examination and treatment shall include the preservation, in strict confidentiality, for a period of thirty (30) days from the time the victim is presented for treatment, of tests or procedures, or both, and samples that may serve as potential evidence. The patient shall be informed of the length of time for which the specimens will be preserved.
- Victim wishes to report. If the victim wishes to report the incident to law enforcement officials, the hospital staff shall contact the appropriate law enforcement agency. After the incident has been reported, the victim shall be examined and treated as a regular emergency room patient, and any injuries requiring medical attention will be treated in the standard manner, and specimens shall be kept for evidence. Such evidence shall be turned over to the law enforcement officers when they arrive to assume responsibility for investigation of the incident.
- 16 or younger or Physically or Mentally Incapable. If any person 16 or younger, or physically or mentally incapable of making an intelligent decision, presents himself or is presented at a licensed hospital for treatment as a victim of any of the alleged crimes listed in this Section (i.e., rape, attempted rape, carnal knowledge, or crime against nature), the hospital staff shall immediately notify the appropriate law enforcement official.
Gunshots. In every case of a gunshot wound or injury presented for treatment to a medical professional, practitioner, or associate person, that person shall make an oral notification to either the sheriff of the parish in which the wounded person was presented for treatment, or the chief or superintendent of police in the municipality in which the wounded person was presented for treatment for emergencies, and before the wounded person is released from the hospital. A written notation of this action shall be made on the emergency record. Any person who fails to report shall be fined not more than 500 dollars or imprisoned for not more than 6 months, or both. Any person who knowingly files a false report shall be fined not more than 500 dollars or imprisoned for not more than 6 months or both. La. R.S. 14:403.5.
Burns. In every case of a burn injury or wound in which the victim sustains second or third degree burns to five (5%) percent or more of the body or any burns to the upper respiratory tract or laryngeal edema due to the inhalation of super-heated air, and every case of a burn injury or wound that is likely to or may result in death shall be reported to the office of the state fire marshal, code enforcement and building safety. That office shall immediately notify the appropriate local or state investigatory agency or law enforcement agency of the receipt of such report and its contents. An oral report shall be made within 24 hours of the examination or treatment of the victim. The report shall be made by the physician attending or treating the case, or by the manager, superintendent, director or other person in charge whenever such case is treated in a hospital, burn center, sanitarium or other medical facility. Any person who knowingly files a false report shall be fined not more than 500 dollars or imprisoned not more than 6 months, or both. La. R.S. 14:403.4.
Information Regarding Suspects. A hospital shall notify the appropriate arresting or investigating law enforcement agency that a doctor has ordered the discharge of a patient from a hospital as soon as reasonably possible after the order has been written, if all the following conditions exist:
- the law enforcement agency has certified in writing that the patient has been issued a summons or arrest warrant for an offense, but as a result of the need for emergency medical care, the warrant has not been executed prior to admission to the hospital.
- the law enforcement agency has provided the hospital with a written request to be informed upon the discharge of a patient from the hospital.
- the law enforcement agency has provided contact information for use by the hospital in making the notification.
No hospital shall be held civilly liable to any person for failure to comply or timely comply with these requirements unless the failure is intentional or due to gross negligence. La. 40:1300.271.
Child Abuse. For purposes of child abuse, a “child” means any person under eighteen years of age who, prior to juvenile proceedings, has not been judicially emancipated or emancipated by marriage. Ch. C. Art. 603.
- Mandatory Reporters, such as health practitioners and mental health/social workers, who has cause to believe that a child’s physical or mental health or welfare is endangered as a result of abuse or neglect or that abuse or neglect was a contributing factor in a child’s death shall report. Ch C. Art. 609. Violation of the duties imposed upon a mandatory reporter subjects the offender to criminal prosecution.
- Permitted reporters or any other person having cause to believe that a child’s physical or mental health or welfare is endangered as a result of abuse or neglect, including a judge of any court of this state, may report. Ch. C. Art. 609.
The filing of a report, known to be false, may subject the offender to criminal prosecution.
Newborn In Utero. If a physician has cause to believe that a newborn was exposed in utero to an unlawfully used controlled dangerous substance, the physician shall order a toxicology test upon the newborn, without the consent of the newborn’s parents or guardian, to determine whether there is evidence or prenatal neglect. If the test results are negative, all identifying information shall be obliterated if the record is retained, unless the parent approves the inclusion of identifying information. Positive test results shall not be admissible in a criminal prosecution.
Child Death Investigation. In each unexpected death of a child fourteen years of age and below, a death investigation shall be performed in accordance with the child death investigation protocol established by the Louisiana Child Death Review Panel that may include, at the discretion of the coroner but not be limited to, a complete autopsy performed by the coroner of the parish where the death occurred pursuant to the death investigation procedure established by R.S. 33:1563. The death investigation findings shall be reported to the appropriate authorities including the police, healthcare providers, and the child protective services if appropriate, within three days of the conclusion of the death investigation. La. R.S. 40:2019.
Elderly. Any person, including but not limited to a health, mental health, and social service practitioner, having cause to believe that an adult’s physical or mental health or welfare has been or may be further adversely affected by abuse, neglect, or exploitation shall report as provided in the statute. For purposes of this provision, an “adult” is any person over sixty years of age or older, any disable person eighteen years of age or older, or an emancipated minor. La. R.S. 15:1504.
Internal Incidents of Neglect or Abuse. Under La. R.S. 40:2009.20, hospitals have a duty to make complaints to the state regarding internal incidents of neglect or abuse, as do the individual healthcare providers who work in hospitals. The Louisiana Department of Health and Hospitals interprets this statute as applicable to patient abuse by not only a hospital employee, but also by others who come into the hospital, including hospital visitors or non-employee healthcare providers. The report must be made within 24 hours of the incident. For detailed information on this particular reporting requirement, see Emily’s article entitled “Hospitals Don’t Have to Report Internal Incidents of Neglect or Abuse -- OR DO THEY?” in the March 28, 2008 issue of the LHA’s Impact Lawbrief.
In light of the above, hospitals should consider whether their existing policies are written to trigger a report when a reportable event arises.