My son stepped on a nail in the neighbors yard, I cleaned it and looked at it a little better and cleaned it again with peroxide and bandaged it. This happened Sunday 15th 2009. No school on Monday so I continued cleaning it and Tuesday I sent him to school after cleaning it again and not seeing any redness or swelling. The principal sees him limping down the school hall so she sent him to the nurses office, so around 9:30 am the nurse calls me telling me his wound was infected and swelled and had redness, suggested he be seen by his primary physician. So I went to the school to pick him up thinking he was in pain and it was serious enough. Upon my arrival at the school the nurse repeated herself to me 6 times that he needed to see his primary physician but I didn't need to take him home until his appointment, which in return upset me because if it that serious and he is in pain he needed to stay off his foot, so I lashed out at the nurse telling her he will be seeing his primary physician and I was taking him home if it's as serious as she was implying.
So I was able to make him an appointment for Wednesday 18th, 2009 at 4pm.I called the school and asked if my son could go to school until his appointment, they told me he couldn't come back to school until he was seen. Later the nurse called me and I informed her of why my son wasn't there and she said that he could have went to school that the school officials don't communicate to one another. I watch twins that are only 13 months old, no car seats for them, no consent to take them anywhere except if they needed emergency attention, so I tried to find someone including parent's of twins to come and watch them till I was done at my sons doctors office with no luck. So I rescheduled his appointment for Thursday 19th at 4pm, I called the school and informed them of his appointment.
The principal called me later in the day Wednesday and asked for the doctors number, me thinking the only information can be given over the phone is that a patient did in fact have an appointment. But that wasn't the case here, the school nurse asked the receptionist questions concerning my conversation with the receptionist and the receptionist responded with what I said to her, and asked if my son was an existing patient or a new patient, asked what he was being seen for and what time his appointment was, and yes the receptionist gave her all this information and then some unknown to me at this time. Shortly after giving the principal the number the nurse calls me back and says she has all the information she needed and that was the end of the phone call. I was confused so I called my doctors office and identified myself and I asked the receptionist what kind of information was given out and she told me, which in return I called the principal and made arrangements to have a meeting with her and the nurse to discuss the situation.
My meeting was Friday 20th,2009, I was seated in a room and the nurse and principal followed shortly after. The nurse started with handing me a history form that I filled out at the beginning of the year and pointed to a paragraph I signed that states " In case of illness or injury of my student, I understand the school will attempt to contact parents or guardians first. then they will contact other persons i have listed- if none of these are available, the school is authorized to make whatever arrangements are deemed necessary to maintain my students health, including but not limited to, emergency medical treatment".
The nurse and principal had spoke to me through out the day of Tuesday and Wednesday. They never called the other 2 contacts I had on the history form. But they are saying that paragraph is what gave them legal right to call both myself and my sons primary physician. The nurse also as she held a book up and stated my last resort was to hot line you. And I asked for what? And neither the principal nor the nurse gave an answer.
Now I am getting a written statement from the receptionist of the conversation between her and the nurse. I have talked to the head nurse at the doctors office and she clearly stated that there was in fact a HIPAA violation had happened in this situation. I feel that the school was also in the wrong because there was no emergency reason for the information to be asked. I have the doctors note that states clearly there was no signs/symptoms of infection and that she gave him a tetnus shot and sent him home. And the school officials stated that they could have gotten a doctor to give them the same thing just that there was an infection.
Now first of all the school did not go through the proper channels, they also knew of the HIPAA laws that was in place for any medical information given to anyone without just cause of emergency medical treatment over the phone without the proper identification in person or in writing. Then when I brought this to their attention they threatened their last resort which was Hot lining me.
So to me I took their statements as a threat from retaliation. They clearly abused their authority to the fullest, so I need to find out what my legal rights/remedies I have and what steps I need to take to get a resolution to this matter without my son or myself in the line of retaliation from the school officials.

This is all very confusing and hard to follow. I don't see any HIPAA violation if the doctor's office provided info to the school nurse.

Frankly, if my child was impaled by a nail lying on the ground, I would have immediately gone for a tetanus shot.

The bottom line, however, is that HIPPA was intended to protect patients, and to do so in four main ways: to ensure health insurance portability (hence the name, the “Health Insurance Portability and Accountability Act”), to address fraud and abuse in healthcare, to ensure privacy and security of individuals’ health and medical information, and to standardize the handling of that information and to enforce those standards.

Medical consumers should know their basic rights under HIPAA. They include that one’s medical information cannot, without permission, be shared with one’s employer or be used for advertising or marketing. Also, private notes about one’s mental health counseling sessions cannot be shared with out permission.

On the other hand, HIPAA expressly allows that one’s medical information can be used and shared for the following:

To facilitate and coordinate treatment and care.
To pay doctors and hospitals for your health care.
To provide information to your family, relatives, or friends who are involved with either your health care, or your health care bills (unless you object).
To make sure that doctors give good care.
To make sure that nursing home are clean and safe.
To protect the public health; and
To make required reports to the police, such as reporting a wound from a weapon.

While this may seem like a long list of people to whom, and circumstances under which, your private medical information may be disclosed, remember that it is the exception and not the rule. Nearly all other scenarios require your health care professionals to keep your medical information private, and if they don’t, they may have violated the HIPAA law.

That looks like you copied and pasted from some site. But the key is the above portion. This justifies sharing info with the school nurse. So again, I don't see a violation.

Protected Health Information – All forms of patient-related information, including
Name, address, birth date and site, social security number, race, type of medical
Condition, status of medical condition, blood type, and other data that could be
Used to identify the patient, and which may be transmitted or maintained in any
Form, including verbal statements. All PHI that could identify an individual is
Confidential.

When using or disclosing protected health
Information or when requesting protected
Health information from another covered
Entity, a covered entity must make
Reasonable efforts to limit protected health
Information to the minimum necessary to
Accomplish the intended purpose of the
Use, disclosure, or request.

Disclosure means the release, transfer,
Provision of access to, or divulging in any
Other manner of information outside the
Entity holding the information.”

Okay without an emergency reason which I clearly stated in my first post given by my sons primary doctor that there was no emergency to give anyone the right to information about my son over the phone without knowing who this person was. And in fact the doctors office has already stated that there was in deed a HIPAA violation in there office in this situation.

Why didn't you spend this much energy taking him to an immediate care clinic, rather than waiting days for an appointment and keeping your child out of school.

They were apparently concerned and your lack of involvement in getting your child the medical attention that he needed only compounded your problem. She probably contacted the doctor's office as an alternative to contacting DCFS and filing a complaint of neglect, as your child was recommended to seek medical attention, emergency or not, and you were failing to do so.

Assuming there was, and I don't concede it, then the doctor's office needs to take action against the employee involved.

They might be subject to a fine if you pursue the issue.

And with your statement------Frankly, if my child was impaled by a nail lying on the ground, I would have immediately gone for a tetanus shot.------My son has had all his shots first of all and you can only do so much when the doctors are full at the times you can make available, and I was told by the school nurse he had to be seen by his primary physician I could have taken him to a walk in clinic here and got the tetnus shot and the school nurse refused.

Okay the ins I have if it isn't an emergency they will not cover the cost at the local ER. And for not being involved, well let's see if it was in fact infected, swelled, or red my judgment then would have been to take him in to be seen in the ER. I cleaned the wound and inspected it and found nothing as so did our primary physician

I do not think it is very likely that a school nurse would require you to see only the primary physician for such an injury.

That said, I understand that you are angry. If you want legal resolution, consult an attorney.

Originally Posted by sh3d3vilinme View Post
On the other hand, HIPAA expressly allows that one's medical information can be used and shared for the following:

To facilitate and coordinate treatment and care.
That looks like you copied and pasted from some site. But the key is the above portion. This justifies sharing info with the school nurse. So again, I don't see a violation.

First of all a school nurse can only access a student and suggest. Not make a MD evaluation and make medical decisions

That's why I am here. Is to find out what my legal options are and for a attorney what would this be considered under, criminal, civil. I have spoke to several different organizations like the US Department of Education, and US Department of Civil Rights as well as an individual from HIPAA, and each have said yes there is a violation but because it does include a medical practice and school both in violation it's unsure what category this falls under who's jurisdiction.

Another thing that most people don't understand about HIPAA is that its penalties are not about compensation for the individual. They are punitive in the way of fines or sanctions.

The only compensation I want... is for this to never happen again to me or anyone else. If they feel they can step on parents and students rights for privacy and my rights as a mother making medical decisions for my son without concern of retaliation/threats from a overly exaggerated school nurse.

Then you suggest to the office mgr of the doctor's office and the school priincipal that retraining of personnel is in order.

And, unless his tetanus shots were very recent (within the last 6 months) then you could not know, just by observation, if there was infection or not. The purpose of tetanus shots is to PREVENT infection, not treat it.

I work in the legal field - anyone who takes on a cause for the good of mankind (unless they have unlimited funds and any number of people standing behind them) usually loses. You write a letter to the authorities about your experience and let it go. An expensive lawsuit isn't going to teach anyone anything about how to handle people in the future.

The purpose of a lawsuit is to make a person "whole," not to teach people lessons. You will spend a lot of money and gain nothing.

I don't even see a judgment in your favor as I see no monetary damages.

It's harsh reality but that's how the legal system works.