Case Study - Is there a burglar in the house?

At 2am the (ever alert) medico-legal adviser received a phone call from a JMO working in the Emergency Department (ED) of a small metropolitan hospital. The police had arrived in the ED and wanted to know the names of any injured patients who had attended the hospital earlier in the evening.

The police said there had been a break and enter at the local shopping mall. A large glass window had been smashed during the break-in and there was a lot of blood around the scene of the crime.

Earlier that evening, the JMO treated a young man, Mr John Smith, who had lacerations to both his forearms. When the JMO had asked the patient how he had injured himself, Mr Smith said he had fallen through a window. The JMO cleaned, sutured and dressed the wounds and discharged the patient for follow up with his GP.

The JMO was not sure whether he should inform the police about Mr Smith's attendance and injuries. He rang his MDO to seek advice about what to do.

The JMO was advised that he owed the patient a duty of confidentiality. Exceptions to this duty of confidentiality included:

1. mandatory disclosure required by law eg a search warrant
2. an overriding duty in the 'public interest' to disclose information - this generally only applied if there was a direct threat of harm to another person.

Neither of these situations applied in this case. The JMO was advised to politely decline the police request for information.

This case history is based on actual medical negligence claims; however certain facts have been omitted or changed by the author to ensure the anonymity of the parties involved.

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