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Why we don't know more about shooting victims

Why we don't know more about shooting victims

Information is being withheld unnecessarily by area hospitals, legal experts say.

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About 1 a.m. Aug. 13, Esrail Britton was shot multiple times by a St. Louis County police officer after allegedly pointing a handgun at the officer.

Britton, 19, has since been charged with multiple felonies and, according to the most recent information, remains hospitalized.

The shooting happened at West Florissant Avenue and Chambers Road, in unincorporated St. Louis County, not far from the site of demonstrations that have convulsed the Ferguson area for more than a week.

But the public won’t hear about Britton’s condition from hospital officials. And the public may not be hearing about other gunshot victims or the full scope of injured individuals because of the hospitals’ concerns about privacy issues.

St. Louis-area hospital officials say once someone has been identified as a “victim of violence,” they cannot share any information about that individual.

Gunshot victims are routinely identified as “victims of violence,” hospital spokesmen say.

According to HIPAA guidelines released by the American Hospital Association, only patient information contained in the hospital directory can be released to the media. If a patient is a victim of violence they are typically not listed, for their safety.

Most local hospitals share information about minor injuries, but some don’t.

Officials with Barnes-Jewish Hospital, the area’s largest hospital and a Level I trauma center, said it has no way to track patients who come in with injuries from the Ferguson area protests.

As for Britton, St. Louis hospital officials won’t even confirm whether Britton is being treated at their facility. They said Britton would be considered a “victim of violence,” and disclosure about his condition would violate the Health Insurance Portability and Accountability Act, or HIPAA. That’s the federal law that protects patient information.

Unless Britton’s family shares news of his condition, the public will have to rely on St. Louis County police to provide status updates.

Last Wednesday, county police reported Britton was in critical condition. Two days later, county police officials told the Post-Dispatch he was improving. The Post-Dispatch has been unable to confirm his condition since last Friday.

Legal experts say the decision to withhold status updates on Britton reflects the hospitals’ interpretation of HIPAA.

“The bottom line is that the hospital is not prevented by HIPAA or Missouri law from providing you with a condition status and verification if you are asking about the patient name,” said Kelly Dineen, assistant professor of health law and ethics at St. Louis University’s School of Law.

Dineen said there is no special provision for “victims of violence” or “gunshot victims” under HIPAA.

Clinton Mikel, chairman of the American Bar Association’s eHealth, Privacy & Security Interest Group, said hospitals could share Britton’s status but are not required.

“Folks can be more protective of patient information than HIPAA specifically requires,” Mikel said.

Hospital administrators may have put the policy in place, Mikel said, because they might fear whoever dealt the gunshot wound may come back.

Yet, as demonstrations have continued throughout the week, it’s unclear how many gunshot victims are currently being treated by area hospitals.

Helen Sandkuhl, administrative director for emergency services at St. Louis University Hospital, said, ideally, gunshot victims are taken to Level I trauma centers. The area’s Level I trauma centers include St. Louis University Hospital, Barnes-Jewish Hospital and Mercy, Sandkuhl said. Depending on the location of the incident, it’s common for victims to be treated and stabilized, then transferred to a Level I trauma center.

SSM hospital officials will share only how many gunshot victims they treated after the patient is released. BJC HealthCare will not share any information about gunshot victims even after they have been released.

“We don’t have any discussion or conversation regarding gunshot victims,” said Bret Berigan, spokesman for BJC’s Christian Hospital.

Mikel said, under HIPAA, the hospitals are allowed to share general information that cannot be used to identify someone.

But once hospitals start releasing identifying characteristics such as age, gender and injury type, Mikel said, “then you’re trending pretty close to having information be identifiable.”

On Sunday night, DePaul Health Center reported it had treated and released two gunshot victims.

During Monday night protests, Capt. Ronald S. Johnson confirmed two protesters had been shot. It’s unclear how those individuals are faring.

The Post-Dispatch is part of a consortium of news organizations working with Kaiser Health News to cover the Affordable Care Act. KHN is an editorially independent program of the Henry J. Kaiser Family Foundation.

Samantha Liss is a business reporter at the Post-Dispatch. Follow her on Twitter @samanthann and the business section @postdispatchbiz

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