General Question

elbanditoroso's avatar

Remember the Metro-North commuter train wreck north of NYC in December? Today' NYT has an article saying that the conductor (who caused the wreck) had previously undiagnosed sleep apnea. Given HIPAA and various privacy laws, how can this disclosure be legal?

Asked by elbanditoroso (22757points) April 8th, 2014

I thought that medical information was supposed to be private.

How is it, then, that the Times can report on medical diagnoses?

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16 Answers

BosM's avatar

If the Conductor in question agrees to the disclose there is no problem with the NYT writing about it in the article.

Lightlyseared's avatar

The Times got its info from the NTSB report on the accident so it can report on anything in the report. The disclosure from the doctors who diagnosed the sleep apnoea would have been at the request of the NTSB. The conductor probably was asked permission to make the disclosure but even if he said no the courts could probably have got the info anyway as the is public interest in what caused the crash (not just from the fact it’s in the news but so to try to avoid future crashes – that is after all why we investigate this stuff).

JLeslie's avatar

Why does sleep apnea matter? Are you saying he was not as alert because he doesn’t sleep well? I’m not sure we can be sure of anyone’s quality of sleep. Sleep apnea is pretty common. What if he had three children and the infant woke him up twice during the night? Unless his apnea is very severe I don’t think it probably matters.

If it is undiagnosed it isn’t on a medical record. I’m not sure how they came across the information? Did the conductor disclose it?

hominid's avatar

I’m just going to duck in here and point out that feeling sleepy is to sleep apnea as feeling sad is to depression. In other words, unless you have experienced depression or extreme sleep deprivation as a result of sleep apnea, you might think feeling really sad or really tired is the same thing. It’s not. I only mention this because I can already tell that the question (in General, by the way) is likely to get derailed. Note that the OP is asking about HIPAA and privacy.

janbb's avatar

It is posited that the engineer fell briefly asleep at the wheel so his sleep problems are definitely germane. As the the OP’s question, I don’t know whether the medical privacy laws are applicable in reports on accident investigations.

bolwerk's avatar

Medical information is supposed to be private with your doctor, pharmacist, or insurer. The press has no presumption of having to respect someone’s privacy in that regard (though they may not be able to snoop on records either).

Plus, his condition directly affected his job performance as a civil servant. He was probably obligated to disclose the condition as a condition of employment. Somewhere in the fine print, maybe of the contract, he probably agreed to certain medical disclosures and tests such as drug tests. There could well be privacy laws regulating that stuff, but that doesn’t mean they can’t be used against him in an investigation.

filmfann's avatar

Since there will be lawsuits, the disclosure of this information can only help the driver.

janbb's avatar

@hominid “derailed” – he, he

LuckyGuy's avatar

I’m guessing he, the driver, is setting himself up for a “It’s not my fault” claim.
~“I’m sick.I was only well enough to collect and sign a paycheck. Now I can only sign a disability check.”

jca's avatar

Since the information did not come directly from the medical personnel, but came from an accident investigation, HIPAA does not apply.

JLeslie's avatar

“Previously undiagnosed sleep apnea.” To me that means the conductor did not know he had sleep apnea, nor did his doctors. He did not lie on his paperwork if it was asked for his employment in that case. Am I missing something?

If it is now being reported he has sleep apnea, I guess he was diagnosed after the fact. If the legal proceedings are considered public record, and this was brought out during legal proceedings, it would be part of the public record I think? I am not a lawyer, so my knowledge of how that all works isn’t great. I have worked for a hospital and had to adhere to HIPAA. I can’t imagine a doctor said anything unless he was released to do so by the patient, or ordered by a judge, or some other legal situation that allowed him to speak about the patient’s health.

jaytkay's avatar

@LuckyGuy _I’m guessing he, the driver, is setting himself up for a “It’s not my fault” claim. _

That may be the answer. People will disclose their own medical info when they believe it will help them in a legal proceeding.

Or, if they make a medical claim in a lawsuit (“I was injured”) then they must make their medical records available to support the claim,

kevbo's avatar

HIPAA allows for disclosure of health information for a variety of extraordinary circumstances (such as outbreaks or other emergencies) and many of these circumstances are driven by government requests. As stated earlier, the information was disclosed to the NTSB due to the investigation. This, I’m sure is an allowable disclosure.

What’s odd though (and I don’t know the facts beyond what’s said here) is that it’s “undiagnosed.” If it’s undiagnosed, then how would it be in any medical record?

hearkat's avatar

@kevbo – The sleep apnea was ”previously undiagnosed”, meaning that it was not known that the conductor had this sleep disorder prior to the accident.

I am confident that the medical testing of the conductor has been done as part of the NTSB’s investigation, which means it is not the conductor’s personal medical file, but public record as part of the accident investigation. I would also bet that the conductor has legal counsel helping guide him through the process, who would fight if any disclosure was potentially harmful to his client.

The DOT has regulations regarding truck drivers and sleep apnea and CPAP compliance, also, because the risk of accidents is much higher with sleep deprivation.

jca's avatar

The driver of the train previously worked a different shift, and immediately prior to this accident his shift was changed so that he now worked the early morning shift (5 am or something similar). The sleep apnea combined with the new early hours are what the issue is.

Yes, he has a lawyer.

JLeslie's avatar

@jca I remember that now that you say it. The change in shift is a really big deal in my opinion. That is the main problem. If I had a drastic shift change I wouldn’t be as alert and I would have trouble staying awake. When nurses shift change they make mistakes too. People don’t take sleep seriously enough. The airlines have more rigorous rules about it, I wonder if the trains do.

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