The Indiana Medical Licensing Board ruled that Barnard violated the Patient Privacy Act

The Indiana Medical Licensing Commission said Thursday that Indianapolis obstetrician-gynecologist Caitlin Barnard, M.D., publicly discussed a 10-year-old rape victim who had sought an abortion in Indiana, following state and federal patient privacy laws. was found to have violated.

However, the Licensing Board determined that Mr. Bernard had not improperly reported child abuse and was qualified as a health care practitioner.

Ultimately, she was reprimanded and fined $3,000 with a maximum of $1,000 per incident.

“It was somebody’s job, nobody did it, but I don’t blame Dr. Barnard,” said director Dr. John Strobel, who said the child was allowed to return to the perpetrator. I talked about how it happened.

bernard Appeared In front of a board member at least 14 hours in advance they decided The doctor violated several professional standards. The point of contention was Complaint Indiana Attorney General Todd Lokita filed a lawsuit against the doctor, who tweeted throughout the day to coincide with the hearing but did not attend.

The incident has drawn national attention and has sparked concerns from health care workers and advocates that it could have a chilling effect on abortion care workers.

The state sought to suspend Bernard’s medical license. But the board refused to take any action that would affect Bernard’s ability to practice. She had not received any disciplinary action from the board until Thursday.

The origin of this problem is ongoing legal story Surrounded the doctor who oversaw a girl’s medical abortion last year. The case made national news and contributed to granting rape and incest exemptions in Indiana’s anti-abortion law.

Mr. Lokita filed a complaint against Mr. Bernard with the board in November. He alleged that Barnard “failed to immediately report child abuse and rape to Indiana authorities” after the girl’s abortion.

Rokita’s office also alleged that Bernard “failed to meet his legal and Hippocratic responsibilities” by “using the traumatic medical story of a child in the media for his own benefit.”

“As we have said over the last year, this lawsuit concerned patient privacy and a broken trust relationship between doctors and patients,” Rokita’s office said in a statement. “What do you do when it’s your child, your parent, or your brother facing a delicate medical crisis, and the doctor you thought was on your side ran to the press for political reasons? ? That’s wrong.”

Neither Bernard nor her lawyers responded to reporters’ questions late Thursday after the 14-hour board meeting.

Allegations against Bernard

Barnard’s attorneys argued that she properly reported child abuse to her social worker at IU Health, which was consistent with hospital policy and Indiana state law.

They argued that if abuse occurred in other states, it should be reported there. Bernard and IU health social workers testified on Thursday that doctors made the report last summer after abuse had already been reported in Ohio.

He also said the Indiana Department of Children’s Services (DCS) had never challenged the hospital’s policy to violate Indiana state law.

“I have not personally discussed anything with Indiana law enforcement regarding this matter,” Barnard confirmed. But on July 2, two days after she visited her 10-year-old, she filed a Termination Report (TPR) with DCS in Indiana. State law requires her to submit her TPR to government agencies within three days of having an abortion under the age of 16.

However, Deputy Attorney General Cory Voight said Barnard’s failure to notify the Indiana DCS and police “resulted in child abuse victims being sent back to Ohio to live with their abusers.” rice field.

Dr. Caitlin Barnard responds at the Medical Licensing Board hearing. (Whitney Downard/Indiana Capital Chronicle)

Voight called her actions a “serious breach” of patient confidentiality. provided details of the incident to a reporter for the Indianapolis Star.

“This board decision will literally affect the foundation of trust between physicians and patients,” Voight said. “No doctor has pursued his cause so brazenly.”

Bernard’s attorney, Alice Morical, countered: What Barnard shared with reporters was not protected health information.even if sothe law does not allow sharing such information HIPAA Violation Unless Bernard “knowingly” shared it.

“Dr. Ms. Bernard is particularly well suited to speak on reproductive rights issues. I’ve been interviewed by the media for years,” said Morikal, noting that the doctor is one of two people in charge of complex family planning. state expert.

Bernard later said her training focused on contraception, miscarriage and abortion care.

Doctors and lawyers also stressed that identifying information such as the patient’s age, race, and the date and place of the abortion has already been made public on the TPR.

The IU’s internal health risk assessment further concluded that Bernard did not disclose patient personal information to the media.

Instar reporter Shari Rudavsky said in a deposition that she followed up with Bernard’s story over a week later by phone to see if a doctor could provide additional information about the 10-year-old patient. I asked you please. The call came amid backlash from some who said the story was a hoax as The Star and other news outlets continued to cover the girl’s case.

But doctors refused to do so, Rudavsky said.

Paige Joyner, a HIPAA expert employed by Bernard’s legal team, testified that Bernard did not violate federal or state patient privacy laws.

Joyner said Bernard did not share any of its content. 18 identifiers protected by HIPAApoints out that abortion disclosure is not protected health information.

Dr. Peter Schwartz, a Pennsylvania obstetrician and gynecologist who chairs the American Medical Association’s Council on Ethics and Judicial Affairs, added that Bernard has a duty to speak up about the health care experience. At the same time, she has an obligation to respect patient rights and privacy. She testified that the doctor had met both expectations “very well.”

Still, privacy compliance and HIPAA law expert Andrew Mahler disagreed. He said Barnard violated patients’ privacy by sharing potentially identifiable information.

He pointed to a sentence in an Instar article that said a 10-year-old girl was on her way to Indiana, claiming this was a treatment date revelation.

Mahler also said Bernard didn’t have to say the patient was from Ohio or that he was 10 years old. Instead, the doctor could have told her the girl was a preteen from another state.

“I don’t know if it would be prudent to speak to journalists,” Mahler said.

Board members ramp up denunciations during deliberations

During Mr. Bernard’s testimony, one board member explained how a 10-year-old girl was sent back to her home in Ohio, where it was later discovered that her assailant also lived. I asked if it was.

Barnard said many victims live with their abusers long after their abuse. It is her DCS responsibility to decide whether to remove the child from the home or direct it elsewhere until the abuser is identified.

Testimony Thursday revealed that Ohio child protection officials had cleared the girl to be returned to her mother’s custody.

Another board member asked Bernard if, in hindsight, he would have handled the interview with the Instar reporter differently. Bernard was silent for a while.

The room where Dr. Caitlin Barnard’s medical licensing hearing was held on May 25, 2023. (Whitney Downard/Indiana Capital Chronicle)

“I’ve thought about it a lot,” she replied. “don’t know.”

Barnard added that it is important for people to know the “impact” of laws restricting abortion, including how children are “harmed.” The doctor said he did not expect the newspaper article to be specifically about the patient and said he had “very mixed feelings” about the end result.

He also said that if Hoosier passed a ban on abortion without exception, patients like the Ohio girl would be forced to leave Indiana. Barnard said that forced him to speak out against such policies last summer before Congress called a special session.

“I think it is very important that people understand the overall impact of the laws in this country on abortion and other things. I think it’s important,” Bernard said. Presenting a hypothesis rather than a real patient example, she continued, “doesn’t help people understand what’s going on.”

However, board member Dr Kirk Masten said this reflected Bernard’s own political intentions.

After more than 14 hours of testimony and legal statements, the Medical Licensing Commission, made up of six doctors and one attorney appointed by Republican Gov. deliberating on the conduct of

Dr. Bharat Balai was adamant that Mr. Bernard did not violate any law. He said IU Health was the responsible organization that investigated the matter and found no violations.

Masten held the opposite view, claiming that Bernard violated HIPAA by uniquely describing an Ohio girl to the news media. Permission to release information was not obtained from the patient’s parents.

“How many 10-year-old pregnant children are there in the United States?” he asked.

Dr. Rebecca Muller says she finds herself somewhere in between, calling Bernard’s remarks a “passion event” fueled by strong emotions following the Supreme Court’s ruling overturning Roe v. Wade. rice field.

Strobel stressed that the risk of a doctor harming a patient “is even greater when talking to the media.” While presenting real-life scenarios can be helpful, the “solution” is getting patients to agree to talk, he said.

When the board moved the discussion to Ms. Bernard’s duty to report child abuse, there was consensus that the doctors followed the policy.

Board members ultimately voted that Bernard violated state and federal patient privacy laws and failed to obtain consent from the 10-year-old patient’s guardian before speaking to the media about the matter. The Board acquitted her of two other charges of reporting child abuse and fitness to practice.

Mr. Strobel argued that a fine of $1,000 and a disciplinary letter were appropriate for each of the three offenses. “I didn’t expect this to go viral,” said Bernard, who said he was a good doctor and was fine with returning to practice.

The board has 90 days to finalize the order. Thereafter, Mr. Bernard and the Attorney General’s Office have 30 days to appeal the decision in Marion County Superior Court.

Almost a year of controversy

Last summer, Mr. Bernard said that Rokita’s office had a specific patient related to the care of a 10-year-old who sought an abortion in Indiana because the pregnancy progressed beyond the six-week deadline in Ohio. filed a lawsuit to stop the acquisition of records.

Bernard’s Legal Team voluntarily dismissed the lawsuit After moving to an Administrative Licensing Lawsuit against the Medical Licensing Board. The court formally dismissed the lawsuit on November 12.

Lokita applied for resumption January 9th Responding to Marion County Superior Court Judge’s Ruling He allegedly violated state secrecy laws. A court ruling in the lawsuit alleges that Rokita broke the law when she called a health care provider an “abortion activist posing as a doctor” during a television appearance. In a court filing, Lokita said the judge’s order was ” “A false discovery.”

Mr. Lokita withdrew his request to reopen the case in April, say you don’t need it anymore.

In a filing with the board, Bernard argued that public comments on the 10-year-old boy’s case fell within medical privacy rules. She also argued that it was “impossible” that she had knowingly violated Indiana’s Child Abuse Reporting Act because her reporting to authorities was consistent with policies in place at IU Health.

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