• News
    • Industry Trends
    • Hot Markets
    • Weekly Top 10
    • Hospital Strikes
  • Career
    • Traveler Tips
    • First-Time Traveler
    • Ask The Expert
  • Reviews
    • Agency Reviews
      • Share Your Experience
    • Hospital Reviews
      • Share Your Experience
  • Network
    • Your Photos
    • Traveler Stories
    • Traveler Lifestyle
  • Resources
    • Find A Hospital
    • Compact Licensure Map
    • Licensing
    • Certifications
      • ANCC
      • AHA
    • Continuing Education
      • CEU Directory
      • Nurse.com
      • Relias Academy
      • Wild Iris Medical Education
      • WorldWideLearn
  • Find High-Paying Jobs
    • Search All Jobs
    • Connect With A Recruiter
    • Top Markets
    • Travel CST Salary By State
    • Travel Nursing Salary By State
  • About Us
HCT Today
SHARE YOUR STORY GET THE SCOOP

HCT Today Dedicated News Site For Healthcare Travelers

May 27, 2022
  • StaffDNA Career Profile Benefits
  • Career Profile Login
HCT Today
SHARE YOUR STORY

  • News
    • Industry Trends
    • Hot Markets
    • Weekly Top 10
    • Hospital Strikes
  • Career
    • Traveler Tips
    • First-Time Traveler
    • Ask The Expert
  • Reviews
    • Agency Reviews
      • Share Your Experience
    • Hospital Reviews
      • Share Your Experience
  • Network
    • Your Photos
    • Traveler Stories
    • Traveler Lifestyle
  • Resources
    • Find A Hospital
    • Compact Licensure Map
    • Licensing
    • Certifications
      • ANCC
      • AHA
    • Continuing Education
      • CEU Directory
      • Nurse.com
      • Relias Academy
      • Wild Iris Medical Education
      • WorldWideLearn
  • Find High-Paying Jobs
    • Search All Jobs
    • Connect With A Recruiter
    • Top Markets
    • Travel CST Salary By State
    • Travel Nursing Salary By State
  • About Us
Industry Trends News

‘John Doe’ Patients Sometimes Force Hospital Staff To Play Detective (KHN)

Ryan WagonerMay 13, 20190 Views0

By Susan Abram and Heidi de Marco, Kaiser Health News

The 50-something man with a shaved head and brown eyes was unresponsive when the paramedics wheeled him into the emergency room. His pockets were empty: no wallet, no cellphone, not a single scrap of paper that might reveal his identity to the nurses and doctors working to save his life. His body lacked any distinguishing scars or tattoos.

Almost two years after he was hit by a car on busy Santa Monica Boulevard in January 2017 and transported to Los Angeles County+USC Medical Center with a devastating brain injury, no one had come looking for him or reported him missing. The man died in the hospital, still a John Doe.

Hospital staffs sometimes must play detective when an unidentified patient arrives for care. Establishing identity helps avoid the treatment risks that come with not knowing a patient’s medical history. And they strive to find next of kin to help make medical decisions.

“We’re looking for a surrogate decision-maker, a person who can help us,” said Jan Crary, supervising clinical social worker at L.A. County+USC, whose team is frequently called on to identify unidentified patients.

The hospital also needs a name to collect payment from private insurance or government health programs such as Medicaid or Medicare.

But federal privacy laws can make uncovering a patient’s identity challenging for staff members at hospitals nationwide.

At L.A. County+USC, social workers pick through personal bags and clothing, scroll through cellphones that are not password-protected for names and numbers of family or friends, and scour receipts or crumpled pieces of paper for any trace of a patient’s identity. They quiz the paramedics who brought in the patient or the dispatchers who took the call.

They also make note of any tattoos and piercings, and even try to track down dental records. It’s more difficult to check fingerprints, because that’s done through law enforcement, which will get involved only if the case has a criminal aspect, Crary said.

Unidentified patients are often pedestrians or cyclists who left their IDs at home and were struck by vehicles, said Crary. They might also be people with severe cognitive impairment, such as Alzheimer’s, patients in a psychotic state or drug users who have overdosed. The hardest patients to identify are ones who are socially isolated, including homeless people — whose admissions to hospitals have grown sharply in recent years.

In the past three years, the number of patients who arrived unidentified at L.A. County+USC ticked up from 1,131 in 2016 to 1,176 in 2018, according to data provided by the hospital.

If a patient remains unidentified for too long, the staff at the hospital will make up an ID, usually beginning with the letter “M” or “F” for gender, followed by a number and a random name, Crary said.

Jan Crary, supervising clinical social worker at Los Angeles County+USC Medical Center, leads a team who increasingly must play detective when patients cannot be identified.

Other hospitals resort to similar tactics to ease billing and treatment. In Nevada, hospitals have an electronic system that assigns unidentified patients a “trauma alias,” said Christopher Lake, executive director of community resilience at the Nevada Hospital Association.

The deadly mass shooting at a Las Vegas concert in October 2017 presented a challenge for local hospitals who sought to identify the victims. Most concertgoers were wearing wristbands with scannable chips that contained their names and credit card numbers so they could buy beer and souvenirs. On the night of the shooting, the final day of a three-day event, many patrons were so comfortable with the wristbands that they carried no wallets or purses.

More than 800 people were injured that night and rushed to numerous hospitals, none of which were equipped with the devices to scan the wristbands. Staff at the hospitals worked to identify patients by their tattoos, scars or other distinguishing features, as well as photographs on social media, said Lake. But it was a struggle, especially for smaller hospitals, he said.

The Health Insurance Portability and Accountability Act (HIPAA), a federal law intended to ensure the privacy of personal medical data, can sometimes make an identification more arduous because a hospital may not want to release information on unidentified patients to people inquiring about missing persons.

In 2016, a man with Alzheimer’s disease was admitted to a New York hospital through the emergency department as an unidentified patient and assigned the name “Trauma XXX.”

Police and family members inquired about him at the hospital several times but were told he was not there. After a week — during which hundreds of friends, family members and law enforcement officials searched for the man — a doctor who worked at the hospital saw a news story about him on television and realized he was the unidentified patient.

Hospital officials later told the man’s son that because he had not explicitly asked for “Trauma XXX,” they could not give him information that might have helped him identify his father.

Prompted by that mix-up, the New York State Missing Persons Clearinghouse drafted a set of guidelines for hospital administrators who receive information requests about missing persons from police or family members. The guidelines include about two dozen steps for hospitals to follow, including notifying the front desk, entering detailed physical descriptions into a database, taking DNA samples and monitoring emails and faxes about missing persons.

California guidelines stipulate that if a patient is unidentified and cognitively incapacitated, “the hospital may disclose only the minimum necessary information that is directly relevant to locating a patient’s next-of-kin, if doing so is in the best interest of the patient.”

At L.A. County+USC, most John Does are quickly identified: They either regain consciousness or, as in a majority of cases, friends or relatives call asking about them, Crary said.

Still, the hospital does not always succeed. From 2016 to 2018, 10 John and Jane Does remained unidentified during their stays at L.A. County+USC. Some died at the hospital; others went to nursing homes with made-up names.

But Crary said she and her team pursue every avenue in search of an identity.

Once, an unidentified and distinguished-looking older man with a neatly trimmed beard was rushed into the emergency room, delirious with what was later diagnosed as encephalitis and unable to speak.

Acting on a gut instinct that the well-groomed man must have a loved one who had reported him missing, Crary checked with police stations in the area. She learned instead that this John Doe was wanted in several states for sexual assault.

“He was done in by a mosquito,” Crary mused.

“It is a case that I will never forget,” she added. “The truth is that I am more elated when we are able to identify a patient and locate family for a beautiful reunification rather than finding a felon.”

>> Up next: Short-Staffed Nursing Homes See Drop In Medicare Ratings


This story originally appeared on Kaiser Health News.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

Healthcare Newsindustry trendsKaiser Health News
  • Share
  • Tweet
  • Share
  • Share
  • Email
  • Comment
  • SHARE‘John Doe’ Patients Sometimes Force Hospital Staff To Play Detective (KHN)
    • Pin
    • Share
    • Share
Previous ArticleTravel Nursing Stories: The Best Parts Of Working In Seattle
Next ArticleTop 10 Highest-Paying Travel Healthcare Jobs May 14-18
Ryan Wagoner
Ryan Wagoner is a reporter for Healthcare Traveler Today.

You may also like

Listen: A Sudden Freeze On ACA Payouts And What It Means For You

Alabama Compact Nursing License Bill Passes

U.S. News Releases 2018-19 Best Hospitals List

Leave a Reply

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

Browse Topics

  • Agency Reviews
  • Ask The Expert
  • Career
  • Compliance
  • Continuing Education
  • EMR Conversions
  • eNLC
  • Featured
  • First-Time Traveler
  • For A Laugh
  • Healthcare Roundup
  • Hot Markets
  • Housing
  • Industry Trends
  • Inspiration
  • Licensing
  • Market Data
  • News
  • Nurse Contributor
  • Strikes
  • Take A Break
  • Taxes
  • Top 10
  • Traveler Tips
  • Uncategorized
  • VMS/MSP
  • Weekly Polls
  • Your Photos
  • Your Stories

More Stories

×

Listen: A Sudden Freeze On ACA Payouts And What It Means For You

Over the weekend, Seema Verma, administrator for the federal Centers for Medicare & Medicaid Services, said she...

Travelers

Navigating Travel Nurse Contract Extensions

July 16, 2019
Holiday Inn Omaha Downtown-Airport-healthcare travelers take omaha

New ‘Healthcare Travelers Take Omaha’ Conference Set For Early April

January 30, 2019
pros and cons-travel pt-travel allied-pt compact

Traveler Tips: Is The PT Compact License Worth It For Travel PT?

January 22, 2019

Industry News

Make Your Mental Health A Priority

May 20, 2022

Traveler Photos

RN, Amanda M., making a quick stop at the New Mexico border.
RN, Karyn E., enjoying a snowy day outside.
RN, Amanda M., taking in the sights at the Grand Canyon.
RN, Naomi B., shares photos of her adventures from Arizona and other parts of the U.S.
RN, Naomi B., shares photos of her adventures from Arizona and other parts of the U.S.
RN, Amanda M., getting ready to zip line in Durango, Co.
RN, Amanda M., traveling with a group in Antelope Canyon near Page, Ariz.
RN, Mary G., driving along the edge of a large storm front near Shiprock, Arizona.
RN, Amanda M., taking in the sights at the Grand Canyon.
Copyright © 2021 StaffDNA. All Rights Reserved.

Helpful news, travel tips, expert advice and online resources—delivered straight to your inbox once a week.

“Get The Scoop” on the travel healthcare industry with HCT Today.

Learn More

Agency Review

    HCT Today wants to know what healthcare professionals think about their travel agencies. Below are 15 questions covering Recruiting and Accounting & Customer Service. This survey will take two minutes. You will either be asked a yes/no question or a scale with 0 being poor and 5 being excellent. All submissions will remain anonymous.







    Recruiting

    0 = Poor & 5 = Excellent



    YesNo


    YesNo


    YesNoN/A



    Accounting & Customer Service

    0 = Poor & 5 = Excellent




    Overall Agency Score





    Photo of The Month Contest



      By clicking submit you are agreeing to the Photo Contest Terms and Conditions.

      We Want To Hear From You

        We want to hear your stories, feedback, suggestions or tips! Have an insider tip on upcoming strikes or EMR conversions at your hospital? Let us know! Interested in contributing a story or sharing your experience to help other traveling professionals? We want to hear it!




        You may optionally provide contact information below. Including this information helps our team reach out should we need more information regarding your submission. This information will not be shared with third parties.


        NoYes






        Unless you have chosen to remain anonymous, by submitting this form you give Healthcare Traveler Today permission to contact you for details regarding your submission. You also give permission for HCT Today to share your information on HCTToday.com. We will never publish your contact information. For questions, email hcttoday@staffdna.com or call 469-429-6608

        Hospital Review


          Healthcare Traveler Today is collecting hospital reviews from nurses nationwide to get a better idea of what it's like working in specific facilities. We want to hear from you! Share your experience by completing the form below. All reviews remain anonymous.










          YesNo


          YesNo


          YesNo


          YesNo



          YesNo



          RNNOLPNCNAOther




          By submitting this form you give Healthcare Traveler Today permission to contact you for details regarding your submission. You also give Healthcare Traveler Today permission to share this information on the HCTToday.com site. For questions, email hcttoday@staffdna.com or call 469-429-6608.