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Special Crash Investigations

2003; Elsevier BV; Volume: 42; Issue: 4 Linguagem: Inglês

10.1067/s0196-0644(03)00608-5

1097-6760

Mary Pat McKay,

Autopsy Techniques and Outcomes

In the April 2003 issue of Annals, I published an article entitled “Commentary: Emergency Physicians and Emerging Technologies: Special Crash Investigations”1McKay MP Commentary: emergency physicians and emerging technologies: special crash investigations.Ann Emerg Med. 2003; 41: 578-579Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar (NHTSA Notes; article #132). In that article, I described the need for emergency physicians to become involved in the process of ensuring the safety of motor vehicle occupants by being on the alert for unusual or novel injury patterns related to new technologies in vehicles on US roads. There are now 2 additional and important points to make on this issue.The first point is in regard to compliance with the recent implementation of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) medical privacy requirements, effective April 14, 2003. As of March 27, 2003, the National Highway Traffic Safety Administration (NHTSA) has been declared a “public health authority”2Federal Register. 68 Fed Reg 15039 (March 27, 2003).Google Scholar and therefore is entitled to receive “protected health information” (ie, individually identifiable health information) without written consent or authorization.3HIPAA Privacy Rule, 45 CFR §164.512 (b)(1)(i) 2000.Google Scholar Therefore, reports to Special Crash Investigations are allowed under HIPAA.However, individuals have the right to an accounting of the disclosures of their protected health information. Although accounting is actually performed only at the request of the individual, the health care institution must have a mechanism for keeping track of disclosures. Many facilities are still developing quick and accurate methods of accounting for disclosures, and each facility may develop a unique system. Emergency physicians who make a report to NHTSA's Special Crash Investigations division should follow the requirements of their own institution. However, a written, signed, and dated note including the method of reporting (telephone, fax, or e-mail), to whom the data was reported (ie, NHTSA, Special Crash Investigations), and the data transmitted, entered into the patient's medical record, is considered sufficient.4HIPAA Privacy Rule, 45 CFR §164.528(b)(3) 2000.Google Scholar If the case warrants investigation, the Special Crash Investigator will obtain specific consent from the crash victims for the investigation. Of note, throughout the history of the program, with more than 500 investigations, no victim has refused consent (personal communication, A. Chidester, Director, Special Crash Investigations Section, NHTSA, May 2, 2003).The second relevant issue is the introduction of novel air bag technology into certain 2003 model year vehicles. These “smart” air bag systems deploy the air bag in a staged fashion after assessing the severity of the impact and whether or not the occupants are wearing a seat belt. It remains unclear whether this new technology will be more protective than existing air bag technology and whether novel injury patterns will result. Therefore, Special Crash Investigations is making a special request to emergency physicians to report any cases of injured front row occupants in the following vehicles (2003 model year only):•Acura MDX•Cadillac Escalade and Escalade ESV•Chevrolet Silverado Pickup, Avalanche, Suburban, and Tahoe•GMC Sierra Pickup, Yukon, and Yukon Denali•Honda OdysseyReports can be made by phone to (877) 201-3172, or by e-mail to [email protected] . Reports should include the date, approximate time, and location of the crash, as well as contact information for the person making the report and any relevant reasons for interest. In the April 2003 issue of Annals, I published an article entitled “Commentary: Emergency Physicians and Emerging Technologies: Special Crash Investigations”1McKay MP Commentary: emergency physicians and emerging technologies: special crash investigations.Ann Emerg Med. 2003; 41: 578-579Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar (NHTSA Notes; article #132). In that article, I described the need for emergency physicians to become involved in the process of ensuring the safety of motor vehicle occupants by being on the alert for unusual or novel injury patterns related to new technologies in vehicles on US roads. There are now 2 additional and important points to make on this issue. The first point is in regard to compliance with the recent implementation of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) medical privacy requirements, effective April 14, 2003. As of March 27, 2003, the National Highway Traffic Safety Administration (NHTSA) has been declared a “public health authority”2Federal Register. 68 Fed Reg 15039 (March 27, 2003).Google Scholar and therefore is entitled to receive “protected health information” (ie, individually identifiable health information) without written consent or authorization.3HIPAA Privacy Rule, 45 CFR §164.512 (b)(1)(i) 2000.Google Scholar Therefore, reports to Special Crash Investigations are allowed under HIPAA. However, individuals have the right to an accounting of the disclosures of their protected health information. Although accounting is actually performed only at the request of the individual, the health care institution must have a mechanism for keeping track of disclosures. Many facilities are still developing quick and accurate methods of accounting for disclosures, and each facility may develop a unique system. Emergency physicians who make a report to NHTSA's Special Crash Investigations division should follow the requirements of their own institution. However, a written, signed, and dated note including the method of reporting (telephone, fax, or e-mail), to whom the data was reported (ie, NHTSA, Special Crash Investigations), and the data transmitted, entered into the patient's medical record, is considered sufficient.4HIPAA Privacy Rule, 45 CFR §164.528(b)(3) 2000.Google Scholar If the case warrants investigation, the Special Crash Investigator will obtain specific consent from the crash victims for the investigation. Of note, throughout the history of the program, with more than 500 investigations, no victim has refused consent (personal communication, A. Chidester, Director, Special Crash Investigations Section, NHTSA, May 2, 2003). The second relevant issue is the introduction of novel air bag technology into certain 2003 model year vehicles. These “smart” air bag systems deploy the air bag in a staged fashion after assessing the severity of the impact and whether or not the occupants are wearing a seat belt. It remains unclear whether this new technology will be more protective than existing air bag technology and whether novel injury patterns will result. Therefore, Special Crash Investigations is making a special request to emergency physicians to report any cases of injured front row occupants in the following vehicles (2003 model year only):•Acura MDX•Cadillac Escalade and Escalade ESV•Chevrolet Silverado Pickup, Avalanche, Suburban, and Tahoe•GMC Sierra Pickup, Yukon, and Yukon Denali•Honda Odyssey Reports can be made by phone to (877) 201-3172, or by e-mail to [email protected] . Reports should include the date, approximate time, and location of the crash, as well as contact information for the person making the report and any relevant reasons for interest.