“Jane Doe” and Patient Transfers: Revisiting Policy and Protocols

Aug 21st, 1970

Continued from Frontline Fall 2010 issue... ...of reporting which historically have been very low compared to other crimes. While the “Jane Doe” or anonymous reporting option has been implemented around the state, many questions and concerns still arise as the policy is still relatively new and procedures related to forensic medical evidence collection, such as law enforcement investigation processes, crime lab storage, etc, have needed to be modified in some jurisdictions. Furthermore, hospitals without SAFE programs or non-SAFE staff at hospitals may not yet be aware of the new policy, and may unknowingly provide inaccurate information to patient-survivors. Elsewhere in the country, legal scrutiny has begun to be applied to hospitals and their adherence to the VAWA forensic requirements. Currently in Austin, TX, the Texas Civil Rights Project and a sexual assault survivor are suing a hospital that refused that survivor a forensic medical exam because that hospital followed paperwork from the year 2005, before Texas enacted their own forensic compliance policy. MCASA and the Sexual Assault Legal Institute provide training and technical assistance for professionals regarding implementation of “Jane Doe” procedures, and welcomes inquiries related to this. Contact us at info [at] mcasa.org or 410-974-4507 for more information.
The 2004 National Protocol for Sexual Assault Medical Forensic Examinations from the Department of Justice, Office on Violence Against Women is in the process of being updated, but is still considered the most comprehensive, relevant, and current federal guidance available to the field of practitioners caring for sexual assault patients. The Protocol addresses an obligation to serve sexual assault patients and the need for established protocols for patient transfers, clearly urging the avoidance of patient transfers if at all possible. It is important to remember both that patients have the right to decline a transfer even if it may affect the quality of their care, and that law enforcement jurisdiction does not govern at which what hospital a sexual assault patient may present or receive an exam. In addition to best practice indicated by the National Protocol, violations of the Emergency Medical Treatment and Active Labor Act (EMTALA) may occur when appropriate procedures are not followed for patients reporting sexual assault. One example of a confirmed EMTALA violation in 1999 resulted in a 90-day termination process and $25,000 settlement for an emergency room that “failed to screen, follow procedure, keep log, and provide appropriate transfer” for a possible sexual assault victim. (US Government Accountability Office, 2001) Forensic nurses, law enforcement, victim advocates, and attorneys are all encouraged to visit the International Association of Forensic Nurses’ SAFEta website for more information on the National Protocol and for related technical assistance, or call MCASA with questions specific to practices in Maryland. Written by Amanda Cardone MCASA SAFE/SART Manager

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