This story showed up on the New York Times website. It tells of the difficulties police have during investigations at hospitals under the health information privacy laws.
It's online at http://www.nytimes.com/2004/06/28/nyregion/28hospital.html?pagewanted=all&position=
In Sex-Abuse Inquiry, Privacy Trumps Evidence Gathering
By THOMAS CRAMPTON
Published: June 28, 2004
Susan Stava for The New York Times
The parents of a 15-year-old girl, who was sexually assaulted at St. Vincent's Westchester Hospital, had been assured of their daughter's safety.
HARRISON, N.Y. - The crime scene seemed to be as secure as an investigator could hope for: a locked psychiatric ward in which the presence of every patient and staff member is monitored. A 15-year-old mentally handicapped girl had been sexually assaulted for hours, and left with a mutilated vagina, bruises across her body and a damaged bladder.
But the investigation, here at St. Vincent's Westchester Hospital, was not so simple.
The police officer who arrived at the hospital cited a lack of cooperation by a doctor and a hospital official, and the officer did not conduct basic forensic work.
The difficulties are not unusual at St. Vincent's, said Capt. Anthony Marraccini of the Harrison police; officials there usually cite patient privacy laws.
"It often takes us days to get to a crime scene in the hospital, and they often will not even tell us if suspects are in the facility," Captain Marraccini said.
In any case of sexual assault, he said, the scene of the crime can yield invaluable evidence for prosecution. "It makes all the difference to quickly access a crime scene."
The first arrest in the case - one of two patients in the locked room with the girl - came nine months after the assault. The girl's parents are suing the hospital.
The police and hospital officials say the incident, which took place on Aug. 14 of last year, highlights the difficulties faced in balancing criminal investigations with the protections provided by privacy laws related to health care.
Captain Marraccini said the restrictions cited by hospital officials have led to antagonistic encounters in many of the 17 cases of alleged sexual assaults that officers have been called to investigate there since 2000.
"In a way, St. Vincent's is like a separate country with separate laws that they govern it by," he said. "There are times I have been tempted to arrest hospital officials for obstructing a criminal investigation."
Relations with the police on an institutional level remain cordial, but officers investigating crimes have encountered difficulties with individual staff members at the hospital, said the Harrison chief of police, David R. Hall.
"In my view, St. Vincent's as an institution has been highly cooperative with the police," Chief Hall said. "Have there been doctors up there who have done things they should not have done? Yes."
The hospital emphasized the high quality of care delivered and its desire to cooperate with the police.
"This is not a snake pit, this is not 'One Flew Over the Cuckoo's Nest,' " said Spencer Eth, the medical director and senior vice president of the hospital. "People are not in danger when they seek treatment here."
Dr. Eth said incidents do occur at the hospital, but investigations are always conducted.
"We are in the business of giving care, not making money from lawsuits," Dr. Eth said. "This is not a case of patient abuse, it is a case of hospital abuse."
The girl's stay at St. Vincent's was the first time in her life that she had spent a night away from family members. Her parents and sisters, who spoke on the condition of anonymity, said that the girl suffers from multiple mental and physical disabilities and that they went to extraordinary lengths to reassure her about being away from the family.
By last August, her self-confidence had grown to where she could stay alone in a room for nearly an hour, and her parents said doctors were impressed that they had helped her to the developmental level of a 5- year-old through nurturing at home.
But when a doctor was faced with the delicate task of rebalancing her many medicines, he persuaded the parents to place the girl in the temporary care of St. Vincent's.
Her parents said they were assured that she would be under constant supervision at the four-story brick hospital, which has a 125-year history of caring for patients with psychiatric problems. The hospital's floors, one of which was recently emptied so that a reporter could tour it, run in a V shape away from a glass-encased nurses' station. The rooms, designed to minimize the danger of patients injuring themselves, have bolted windows, no ceiling fixtures, no heavy chairs and no curtain rods. Bathrooms are communal and the many paintings that line the halls - soothing country scenes and images of jazz musicians - are bolted to the wall.
Despite these precautions, in the 36 hours that she was out of her parents' care, the girl suffered what an examining doctor from another hospital told her parents was a "vicious sexual assault."
The girl described to her parents, the examining doctor and later in videotaped testimony, how her two roommates "danced like on MTV" with each other before sexually assaulting her more than half a dozen times over a two-hour period. Locked in the room with her assailants, she said, the girls threatened to take her away from her family forever if she described what happened.
An orderly opened the door at one point because of the noise, shouting at the girls to be quiet, the mother said.
Shortly after the attack, which took place during the quiet time after lunch, the girl's parents arrived for visiting hours and found their daughter "half naked and acting like a zombie," they said. Not suspecting that she had been attacked and fearing that their presence was upsetting their daughter, the parents left the hospital.
Soon after midnight, however, a call came from a doctor saying that their daughter had been sexually assaulted and that they should come and collect her in the morning.
In an account told by the mother and corroborated by the police report about the incident, the doctor who made the call, Maurizio Zambenedetti, declined to speak with the officer brought to the hospital by the parents and refused to give information about possible suspects.
The Harrison police officer wrote in the report that both Dr. Zambenedetti and another hospital official "would not cooperate with this officer."
Contacted by telephone, Dr. Zambenedetti declined to comment on the incident.
A hospital spokesman, Michael Fagan, said that since the family arrived at 3 a.m., and the staff members on the shift when the attack occurred were gone, the police were invited to return the next day.
"They offered to have the police return when the relevant people who were there would speak to the police," Mr. Fagan said. "To the best of my knowledge, the police did not return."
For investigating any sexual assault, Captain Marraccini of the Harrison police said, the crime scene presents a strong base from which to construct an effective prosecution. "The case can be very strong when you take hair samples, check for pubic hairs, signs of a struggle or skin samples under the fingernails of a suspect," Captain Marraccini said. "In this case all we have now are the injuries suffered by the girl and a physical assessment by a doctor at another facility."
If patient privacy laws prevent the police from seeing who is staying at the hospital, Captain Marraccini said, the police could wait a few hours while the relevant floors were evacuated.
"They could lock down the floor, seal off the crime scene and give access to police once the patients are off," Captain Marraccini said. "The way they acted, we were blocked at the very first step, with even the doctor reporting the crime refusing to talk with police."
St. Vincent's Westchester, a private hospital, is accredited by the Joint Commission on Accreditation of Healthcare Organizations and licensed by the New York State Office of Mental Health and the New York State Office of Alcoholism and Substance Abuse Services.
For state-run facilities, the standard procedures are clear, according to Roger Klingman, a spokesman for the Office of Mental Health.
"When there is an allegation of a crime at a state-run facility, we report it to the police, allow access to the crime scene and the police investigation takes precedence over our own internal investigation," Mr. Klingman said. "Nothing in the mental hygiene law prevents police from investigating a crime." The police cannot get instant access to medical records, Mr. Klingman added, but such information can be obtained by the district attorney, even in cases of patient-on-patient abuse.
"Our policy is to never be adversarial with police," Mr. Klingman said. The New York State Office of Mental Health, which runs more than two-dozen state psychiatric centers while licensing and regulating more than 100 inpatient psychiatric programs, is running a joint investigation with the Department of Health into allegations of patient abuse at the hospital, Mr. Klingman said.
As for the August attack in the St. Vincent's psychiatric ward, the Westchester district attorney, Jeanine F. Pirro, has charged Wanda Green, 18, on 42 counts, including 12 counts of sexual abuse in the first degree.
The indictment alleges that Ms. Green and a 15-year-old fellow roommate subjected the girl to forcible sexual contact. The other roommate, whose identity cannot be revealed because of her age, pleaded guilty, while Ms. Green still awaits trial.