HIPAA Rules Leave Massachusetts Mother in the Dark When does privacy go too far? Dianne Williamson TELEGRAM & GAZETTE (Massachusetts) Shirley Passarelli raced to the hospital Feb. 8 when she learned that her son had been found unconscious the night before and admitted to the intensive care unit. Thus began a three-week odyssey of frustration and heartache for the 53-year-old Southbridge woman, whose efforts to learn what happened to her son were thwarted by privacy laws and his status as an inmate at the Worcester County House of Correction. Christopher Earnest, 34, who is wrapping up a two-and-a-half-year sentence for passing bad checks, was taken by ambulance Feb.7 to St. Vincent Hospital after suffering what jail officials would describe only as a "medical emergency." He's on a ventilator and unable to communicate, so he can't convey his wishes about who may have access to his medical information. "Emotionally, this has wiped me out," said Ms. Passarelli, who initially was restricted in visits to her son but now sees him every day. "Standing there and looking at your son in this condition - not knowing how it happened, what's wrong or what's being done for him - has been hell. I don't know if he's going to live, or if he's been brain damaged. I try to understand the position of the hospital and the jail, but it's very, very hard." A federal law known as HIPAA sets strict standards for protecting confidential patient information. The Health Insurance Portability and Accountability Act restricts health care providers and others from offering information about patients without authorization, and sometimes even loved ones are denied access. In the case of Mr. Earnest, the situation was further complicated because he's an inmate at the House of Correction, according to Deputy Superintendent Jeffrey R. Turco. "We had to tell this woman that our hands are tied," Deputy Turco said. "From a personal standpoint, you want to give information to the parent. But we have a legal obligation to obey the law. This person, in essence, is a ward of us. Our understanding is that restrictions under HIPAA don't allow us to discuss someone's medical condition without prior authorization." The deputy added, "It breaks your heart. Of course this mother wants to know what's going on. In the zeal of Congress to protect people's medical information, certain scenarios like this might have been overlooked." Ms. Passarelli said she was informed by the jail Feb. 8 that her son had been found unconscious the night before and taken to St. Vincent. That day, she said she was initially told by a guard that her son might have overdosed, but that a hospital neurologist told her he did not. After that, she said, no one would tell her anything. Not only was she denied information, but her visits were restricted to once every three days and she had to first go to the House of Correction and fill out forms every time she went to the hospital. That restriction has since been lifted and her son is no longer under armed guard, jail officials said. This past weekend, she said, she was able to learn that her son has bilateral pneumonia and a staph infection. She said she was told that the incident is under investigation. Deputy Turco said the matter was initially under routine investigation, but isn't being probed any longer. He said no evidence exists that the inmate tried to harm himself or was a victim of foul play. Mr. Earnest is a roofer who became addicted to painkillers after he fell from a roof four years ago and was taken by Life Flight to the UMass Memorial Medical Center, his mother said. She said he wrote bad checks from her account to finance his addiction. "He's made mistakes, but he's my son and I love him," she said. She said she also wants to alert people to HIPAA laws and urge them to fill out HIPAA authorization forms and health care proxies. Alison Duffy, a spokeswoman at UMass, said it's also helpful if hospitals have "In Case of Emergency" numbers on patients' cell phones, in case they are unconscious or unable to speak. She said it's unusual for hospitals to withhold medical information from families because of the incapacity of a patient, but that HIPAA requires hospitals to "err on the side of caution if we're not sure" of family dynamics. Ms. Passarelli, meanwhile, continues to visit her son every day. She is unsure of his prognosis and said she feels helpless, but doesn't want anyone else to endure the anguish she's experienced. "I can't sleep, and I can't stop crying," she said. "But just talking about it makes me feel like I've taken at least one step to fight a battle I feel lost in."