He’s never going to let her go by herself, because then she’s out of his control. He will take her, and it will be apparent right from the ER waiting area that there’s something odd about these two people. It will be a boy and a girl, and there will be obvious signs of control over the girl from the boy. She’s not going up to the desk by herself. He’s standing with her, and she clearly is giving a story that doesn’t seem all that credible. “You fell down the stairs is why you’re here?” Perhaps she is afraid she is pregnant and has vaginal bleeding. “Is this your husband? Is this your boyfriend?” He’ll still be standing there and not looking very caring or loving. He’ll often look quite menacing. He just wants to get her in and get her out. He won’t have health insurance, and she won’t either. Chances are, he will want to pay cash.
Explore This IssueACEP Now: Vol 37 – No 04 – April 2018
I’ve spoken with other ER personnel before, and the best thing you can do is get her alone. He will want to go everywhere with her. He will say, “I’m her husband, I’m the father of the baby,” whatever it takes, and she will say, “I want him right here with me.” Get a female to talk to her, if possible, and keep her there as long as you can.
Now, I know you and I are both sensitive and very aware of HIPAA violations and HIPAA protection, and when that question comes up, I always tell medical personnel I respect HIPAA the same way you do. I don’t want to get in trouble with HIPAA, but there are things you can do to bring attention to this girl who is in your care and in your control, because as physicians you can help her in a variety of ways without violating HIPAA.
She needs law enforcement. Whomever can break away, call the local police department and say, “I’m not going to violate HIPAA, and I’m not going to talk about who I have in the ER, but there is a gentleman who is standing in the emergency department wearing jeans and a red baseball hat and you might want to talk to him.” He’s not your patient. You’re not violating HIPAA by calling the police department. Chances are, if you develop a relationship with law enforcement and it’s a familiar name who makes the call to a certain officer, the person on the other end of the phone will understand what you are conveying.